Integration Vs Inclusion

Autism is an invisible disability and as such, in my experience, many schools seem to oversee or fail to see the autistic difficulties which autistic pupils experience, therefore, failing to meet their educational and social needs and not making reasonable adjustments, as required by the law (SEN code of practice 2015).  For example, if a pupil uses a wheelchair, the school will make adjustments for that pupil to being able to access the buildings, such as ramps or lifts.  When it comes to autistic students, many schools fail to see their need.

What do we understand by integration and inclusion?  Let’s have a look at the definitions

Integration
Disabled people of all ages and/or those learners with 'Special Educational Needs' labels being placed in mainstream education settings with some adaptations and resources, but on condition that the disabled person and/or the learner with 'Special Educational Needs' labels can fit in with pre-existing structures, attitudes and an unaltered environment.
For example: The child is required to "fit in" to what already exists in the school.

Inclusion
Disabled people of all ages and/or those learners with 'Special Educational Needs' labels being educated in mainstream education settings alongside their nondisabled peers, where there is a commitment to removing all barriers to the full participation of everyone as equally valued and unique individuals. 
For example: Education for ALL

The fundamental principles of 'inclusion' are far deeper. Inclusion in education involves the process of:

• Increasing the participation of students with disabilities in, and reducing their exclusion from, curricula and communities of local schools;
• restructuring the cultures, policies and practices in schools so that they respond to the diversity of students' needs;
• accepting diversity as normal and as a rich source for all students;
• responding to the diverse needs of all students;
• accommodating both different styles and rates of learning;
• ensuring the quality of education to all students through appropriate curricula, support and teaching strategies;

SEN code of Practice: early education settings, schools and LEAs will need to be able to demonstrate, in their arrangements for children with special educational needs, that they are fulfilling their statutory duty.  Under the Disability Discrimination Act 1995 and October 2010, schools must make reasonable adjustments to make sure all pupils can be involved in every aspect of school life. 

Schools are required to make reasonable adjustments in order to avoid that pupils with learning difficulties are placed at a substantial disadvantage.  For this, schools must take reasonable and appropriate steps to overcome barriers which impede or complicate the academic and social attainment of pupils with learning difficulties.  For example, a teacher always addresses the class facing forward to ensure that a pupil with hearing difficulties is able to lip-read. Also the teacher makes sure that pupil sits within close range to be able to lip-read.

Inclusive Practice

Inclusive practice can be defined as attitudes, approaches and strategies that we take to ensure that no learners are excluded or isolated from the education on offer.

In other words, we all work to create a culture where all learners feel welcome, accepted, safe, valued and confident that they will get the right support to assist them to develop their talent and achieve their goals.

If the IEP focuses on strategies to help a child fit into a classroom, this is integration. If school personnel talk about extra adaptations or services to help the child fit into a classroom, it is integration.  When looking at the IEP, strategies will be used to adapt and improve the classroom so that all students achieve success. Inclusion is about helping everyone.

Integration models assume there is something wrong that must be fixed in order to fit into the present system.

 It is argued that integration implies that disabled people need to be integrated into “mainstream” society and that it is they rather than society which is required to change.

 In contrast, inclusion takes as its starting-point the fact that a just state of affairs is one in which disabled people are included in society and hence the required policy response is a broad one which includes comprehensive civil rights legislation, an analysis of the effects of present and future policy on disabled people and the participation of disabled people in the democratic decision-making process

On the assumption that the successful implementation of any inclusive policy is largely dependent on educators being positive about it, a great deal of research has sought to examine teachers' attitudes towards the integration and, more recently, the inclusion of children with special educational needs in the mainstream school

Acceptance of a total inclusion or ‘zero reject’ approach to special educational provision. Teachers' attitudes were found to be strongly influenced by the nature and severity of the disabling condition presented to them (child-related variables) and less by teacher-related variables. Further, educational environment-related variables, such as the availability of physical and human support, were consistently found to be associated with attitudes to inclusion

There has been some research evidence that children with autistic spectrum disorders benefit from contact with normally developing peers and that this contact also benefits their classmates (Strain and Hoyson, 2000). However, success is only documented in relation to well supported situations, where professionals are trained and mere placement (even with 1 to 1 support of an untrained teaching assistant) does not guarantee true inclusion or the meeting of needs (Jordan and Powell, 1994).

The guiding principle of ‘the least restrictive environment’ is a sound one, providing that meeting the individual’s needs (including the basic right to freedom from persecution, stress and distress) is a paramount consideration.

In reality, and this is the case for most secondary schools I know that autistic students get terribly bullied by his mainstream peers.

Autism

We can all be more or less sociable, but we humans are indubitably social animals. We all have the need to communicate with others at certain moments, either to accept or to reject, to gain or to avoid.  Similarly, we tend to repeat experiences that were positive to us and try to avoid situations which produce negative feelings.  But many people do not allow themselves to experience positive interactions.

We have all heard about the triad of impairments in autism.

This triad is the way autism gets diagnosed.  Most autistic individuals struggle on this areas, certainly in the area of social interactions. However, within the realm of autism we seem to be dealing more with a square than a triangle, as we need to account for the sensory issues a huge percentage of autistic people have.  Autism is a behavioural based condition rooted in difficulties in the emotional, social- communication, cognitive and sensory domains. 

                                                            Social Development 

                                                            and Interaction                         Social

                                                                                                            communication

                                                            Rigidity

                                                            Imagination          Sensory

                                                                                            issues

The above model is based on what individuals cannot do or struggle to do, therefore the term impairments, which is rather negative and it seems to convey the very clear message of one being faulty!

Intensive interaction is based on the premise that an individual is not faulty nor broken and although the individual may struggle in some areas, they can certainly excel in many others, as it is the case for most autistic individuals I know.

 Intensive Interaction recognises the whole person and not focuses on which areas they may struggle with.

The triad model is therefore, old fashion and very negative for the person.  If we are to support a person’s emotional well-being, the starting point should not be based on what they cannot do but rather what they can do.  The social and emotional well-being is prior to any learning taking place as we need to be in an optimal metal state in order to being able to receipt and process any new learning.  Therefore, in order to learn new skills we need to be in a good place both mentally and physically.  In other words, if we suffer from toothache or a migraine, it will be almost impossible for us to focus on learning a new skill as the pain will take over our processing.

Although most behaviours do, not every action we undertake has a communicative intent.  Think about the sensory internal activities/noises and actions some individuals do.  These seem to have neither communicative intent, nor communicative value. Rather, they serve a function for that particular individual.  And of course, a particular behaviour may serve different functions. For example, to play with saliva may have a powerful visual or tactile effect on an individual (it could be a multidimensional visual, olphative -sense of smell-, tactile experience), who also may use this behaviour to avoid social interaction (people avoiding this person as s/he is playing with saliva).  Similarly, this behaviour could be a means of controlling his/her environment (by avoiding interactions with others and/or being in control of the flow of the saliva).  This person may not know effective and appropriate ways of communicating with others but s/he is certainly proficient in the use of saliva as a means of controlling his/her immediate environment, as well as providing gratified sensory multi-layered stimulation in some cases.  In other words, one behaviour may serve multiple functions.

In order to know and try to help a person, we need to analyse the way that person behaves and the possible functions that behaviour may serve for that particular individual:

It seems to be all about :

To get or avoid:  

•                     social interaction

control over environment

•                     sensory input

Most of these interactions seem to be communicative acts (although not all, as discussed before, as some acts may be entirely self-referential). On some occasions a person can suffer from ''sensory overload'' and needs to retreat to a 'comfortable place' where he or she feels secure (these could be special places, items, activities, gestures, repetitive behaviours, etcetera).

The understanding of certain behaviour comes through a thorough and comprehensive assessment which covers:

•                     biological

•                     psychological

•                     social

•                     environmental aspects

Sometimes a specific behaviour is intrinsically or internally rewarding, so that it becomes self-reinforced. That is, the behaviours are so rewarding that what happens around the individual is not nearly as important as their internal experience.

For example: spitting, the functions of this behaviour could be to avoid social interaction (learned behaviour), or simply sensory (visual, tactile, auditory, smell); and the meanings of this behaviour could also be various: to gain or avoid social interaction, self-regulation. All these seem to be related to social interaction (in order to gain or avoid) and sensory needs.

We need to help an individual who lacks in social skills or even in the fundamentals of the communication process to learn that communicating can be a rewarding and enjoyable end in itself.

apporpiate interaction

The person feels in control

The 'communicative partners' follow, engage and imitate in order to give the person a sense of control as well as familiarity and ownership of the interaction.  These provide a positive experience which, in turn, will make the interactions with others desirable.

My thoughts on Autism

These are my thoughts about what I know, so far, about autism.  And I mean so far, as research will indeed lead us to know more about the genetics and morphology of what we call Autism, therefore changing practices and beliefs.

It seems that the term Autistic Spectrum Disorder is not an accurate one, when describing the neurological connexions that seem to characterise people with Autism.  Baron-Cohen refers to a condition to describe Autism rather than a disorder.  As he, so accurately explained, a disorder means that something is broken.  In the case of Autism, the neurological connexions and consequent behaviours may be impaired, differently connected and wired, but these are certainly not broken as many studies come to show.  People with Autism may be wired differently (in terms of neural interconnections) but these are not broken.  And so it seems fair to speak about a condition rather than a disorder.  Whichever the case, it should be people with Autism who chose the term to describe their condition.

When it comes to the triad of impairments (problems with social and emotional understanding, problems understanding and the use of communication and language, problems with flexibility of thought and imagination), used to diagnose Autism, the triad is illustrated by a triangle.  But it seems that the picture should be a square rather than a triad, as more people with Autism than not, present with an imbalance in their sensory domain or experience problems with their sensory perception and consequent responses.

In regards to curing Autism, it is not only a lie but an offence to people who have Autism.  Autism is part of the person and you cannot get rid of. 

In terms of therapies to help alleviate the negative or most contra productive symptoms of Autism there is a huge variety of approaches.  I would suggest to be wary of those therapies which may offer a cure.  Also we cannot believe those backed up by research, as it can be biased and thus non-accurate.  There is an abundant body of therapeutic approaches available for parents and professionals.  Some of them offer to cure, some are backed up by huge bulk of research showing how beneficial they are, others seems to be too clever and complex and therefore artificial to us humans, who after all, are nothing but social animals and have been for thousands of years, since man is man.  Other approaches seem to be fit for and work well in the training of animals.  As humans we need a naturalistic human approach if we are to help someone.

There is some great work out there too which I believe should be recognised and acknowledged.  The work of people who try to put together a coherent and comprehensive approach to help with socialisation and communication as well as meeting other needs (medical or sensory wise) seems to be the way forward.  A natural approach which meets a person’s needs, for who s/he is regardless of the condition a person may present with, seems to make sense.

The support needed for people with Autism variates as much as we all differ from each other and therefore it cannot be a unique model to fit all.  What it seems to work is an approach which meets the person needs and engages in an emotional level in order to reach and being able to help that person.  This is a vital premise, a must, if we really want to make a difference in a person’s life.  The support must be throughout all aspects of a person’s life, from the physical to the emotional through the social and communicative. The support must be therefore emotional, transitional and social-communicative.

We must remember that it is an internal need that makes us function, that makes us be who we are and do what we do, and that any support offered must be internalised, meeting that internal need, if it is to succeed.

We are social animals and as such we need touch and care, and to be able to communicate efficiently in order to make our immediate environment as comfortable, or bearable for one as possible.  That is the true sign of intelligence, to make the most of what we have to meet our needs, rather than an IQ test, which measures a person’s capacity for logic-academic reasoning.

Thus, we need to support those areas which seem impaired or that function differently and are not beneficial to a person.  In the case of Autism, the social-communicative areas may not lead to a successful management of the environment for a person and therefore any approach which helps, must have a strong social-communicative component, alongside emotional, transitional and physical support.

If we need help communicating we need to work on communication no end. But communication is linked to the emotional as well as the physical side of a person, for obvious reasons, and these areas should all be supported together to be able to make a difference in a person’s life.

Sometimes we all get it completely wrong when interacting and miss-read the body language of the people who with we are interacting. In spite of my extensive experience, I got it so wrong in this video:

I approached too fast and got to close to her so she has hidden her security/comfort blanket as a sign of disapproval.

I did not recognise her body signalling (you are too close and I am not comfortable).

I did copy her loud vocalisation and completely missed the point that she was using it as a complain signal.

When she gently bangs her head against the wall, I copied the motion. Behaviours that are dangerous to a person we should not copy as it may reinforce the behaviour.

I hit the side of the bed for no apparent reason???

When she pulls my hair I acted as a game and kept the interaction going when, perhaps, should move away, communicating her that this hurts and when she hurts people, these move away. Or , at least, should show her what I was truly feeling (pain) rather than smile at her, as this coveys a very confusing message.

Good points:

I am trying to model appropriate behaviour as when she bangs her head against the wall, I tried to massage the area she hit.

Hair pulling, I tried to model for her to use gentle hands.

Pinching my arms: I am trying to teach appropriate and non-harmful ways to interact with others such as clapping or using gentle hands when touching others.

Intensive Interaction sessions/workshop; Tangley Park Family Centre - Hampton, Richmond

Kidzactive: Intensive Interaction sessions for children with Autism.

The charity runs Intensive Interaction sessions for children with autism aged 7-11 very Saturday morning (during term time) in Tangley Park Family Centre in Hampton, Richmond.

Our trainer Fernando Teixido-Infante has previously worked with Kidzactive and will employ the Intensive Interaction Technique to enable staff to teach a small group of children how communication can be both meaningful and enjoyable. Parents will also be trained I this technique to continue the work at home.

Intensive Interaction sessions are most beneficial to non-verbal children, those who are in their early stages of communication or those who are not receptive to communication and may remain isolated as a result.