Continuing the Integration of Preschool
Children with a Mild and Moderate
Intellectual Disability Into Community
Preschools: Support and Resource
Requirements
Deirdre Burns, R.N.M.H, Early Intervention Clinical Nurse Specialist, COPE
Foundation
Abstract
This study1 examines what 'supports' and 'resources' are required to continue the
successful integration of children with a mild and moderate intellectual disability into
preschools. The study involved 28 participants, 14 parents and 14 preschool teacher
representatives. The children involved attended a special preschool service in
conjunction with inclusive community preschools. A 28-item questionnaire was
administered via a semi-structured interview. Data was of a qualitative and
quantitative nature describing preschool characteristics, teacher experiences and
attitudes to integration and staffing issues such as support and resource needs.
Results revealed a positive attitude from preschool teachers, mainstream peers and
their parents towards intellectually disabled children being present in the community
preschools. Respondents also reported that there could be a number of benefits for
all involved in this 'integrated' preschool education. The study concludes that there is
a definite need to work collaboratively with the community preschool teachers, giving
support, training, advice and information on how best they can enhance their own
preschool programme delivery to the intellectually disabled children, whilst
maximising the benefits of early intervention for all involved in this integrated
preschool enrolment.
Literature Review
A report by NAMHI (1997) on Early Intervention Services in Ireland, recommended
support for the child in a local (community) preschool and specialist preschools The
White Paper on Early Education, Ireland (1999) highlighted that since the 1930’s,
there has been research evidence that the provision of stimulation and education at
an early, preschool age tends to accelerate the physical, social and cognitive
development of children with disabilities. The report highlights that significant
research, particularly in the last decade, has shown the “effectiveness of early
intervention programmes for children with disabilities”, and that the “evidence
emerging from these studies is unequivocal in highlighting the significance of the
In this study, the term ‘special needs’ is used throughout to refer to children with Intellectual
disabilities. Though the latter term is the recognised terminology for COPE Foundation it was
felt that ‘special needs’ was the most widely used among parents and preschool teachers.
1
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early years in the development of children with disabilities and in stressing the value
of targeted systematic, intensive and high-quality intervention (Dept of Education,
1999: 82). In addition, the need to extend the focus of attention beyond the
immediate context of the actual intervention programme, to include the child’s family
and home/community environment, providing a comprehensive ‘web of support’ is
outlined. It states clearly “even though each element has its own clearly defined role,
each can contribute to the effectiveness of the other, necessary components of the
intervention programme”. (Dept of Education, 1999: 82). The paper also addresses
the ‘shortcomings’ that currently exist and the need for these to be addressed for
present provision of ‘early education’. “The absence of liaison between these teams
and preschool settings and schools which children identified with disabilities will
attend” is addressed. (Dept of Education, 1999:85). Karnes and Lee (1978) have
noted, “Only through early identification and appropriate planning can children
develop their potential”. Literature in the area of preschool integration reveals that six
core areas have been the focus of research studies.
1. Integration, special preschool or mainstream? (E.g., Buysse & Bailey, 1993;
Forness, 1977; Guralnick, 1981; O’Connell, 1984).
2. Imitation, modelling and peer interaction (e.g., Stevenson, 1972; Wasson,
1980; Guralnick, 1976; 1981; Quilitich and Risley, 1973)
3. Language (e.g., Guralnick, 1981; Shatz and Gelman, 1973; Abelson, 1976;
Guralnick and Brown, 1989)
4. Children’s interactions with their learning disabled peers (e.g., Van
Bourgondien, 1978; Ruble, 1983)
5. Teacher’s attitudes to Integration (e.g., Abelson, 1976)
6. Resources and supports (e.g., McDonnell & Hardman, 1988; Pieterse, Bochner
and Bettison, 1988; Guralnick and Groom, 1987,1988; Kohl and Beckham, 1984;
Bacon and Schultz, 1991)
These six core areas examined specific aspects of preschool integration rather than
service delivery issues. This study sought to incorporate all six areas of community
preschool service delivery and evaluate them.
Methodology
Participants: 14 participants were selected from a group of children aged between
three-six years, who attended both a special preschool and a community preschool.
The children had previously been assessed as having mild to moderate Intellectual
disability.
Interview Procedure: Semi-structured interviews took place with one preschool
teacher and one parent representing each of the 14 children, giving a total of 28
participants. The questionnaire comprised of 28 questions and was designed to gain
both qualitative and quantitative information from the interviewees. Each interview
lasted approximately one hour. The questionnaire was divided into 3 parts:
1. Examined the preschool characteristics
2. Examined attitudes and experiences of staff and parents towards integration
3. Examined staffing issues related to successful preschool integration.
Results:
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The data analysis is of both a qualitative and quantitative nature. Teachers
responded to all three parts whereas the parents’ responses were limited to their
personal experiences of their child’s preschool.
Preschool Characteristics
A) Preschool type
Over 78 percent of special needs children attended Montessori preschools, whilst the
others attended either a community preschool or a preschool attached to a National
school. All preschools were in urban locations with no parents reporting having to go
outside their locality; this they responded was very important to them.
B) Preschool teachers experience and training
The number of years’ teaching experience ranged from two years to 23 years. Almost
72 percent of teachers had over 10 years experience, and reported that the more
experience they had the more competent they became with special needs children.
One teacher who only had two years experience felt competent about having special
needs children in her preschool because of her previous experience with a special
needs child in her neighbourhood. Almost 50 percent of the teachers had Montessori
training, the remainder having completed courses ranging from 10 weeks to one-year
part-time courses.
Five of the teachers trained in Montessori, reported that their training didn't always
equip them to deal with the special needs children's behaviours. The Montessori
teacher who had previous experience with a special needs child in her
neighbourhood reported feeling far more competent when dealing with special needs
children. The three teachers who had completed the NCVA course felt that even
though they had completed a module in special needs, it wasn’t sufficient particularly
in relation to misbehaviours. They reported that they needed advice with individual
children.
C) Staff/pupil ratio
Class sizes in this study ranged from eight to 22 children. The most common teacher:
child ratio was 1:7; the lowest was 1:5. Some teachers reported that ratios could vary
from day to day and that they would encourage the special needs child to attend on
days with the lowest ratios to be able to give them extra help. Parents reported being
aware of group sizes of 1:2 in special preschool. All teachers showed flexibility with
days and times for parents. Parents reported that they felt the teachers were very
flexible when allocating sessions in conjunction with special preschool service
(which had less flexibility).
D) Types of disabilities
As can be seen from Table 1 over 85 percent of teachers reported that they dealt
with children with speech impairments and just over 71 percent reported having had
a child with Down’s syndrome in their preschools at some stage. None of the
teachers reported having enrolled children with epilepsy or cerebral palsy in the past
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and cited no reasons for not doing so. All teachers reported that they enrol special
needs children annually, ranging from one to three children per session. All teachers
showed flexibility by allowing special needs children leave at six years old even
though their peers would leave preschool at five years. Parents reported that it was
better to leave children an extra year to help them cope better in their next school
placement; the children were hopefully "more mature".
Table 1. Profile of disabilities dealt with in preschool past and present
Profile of disabilities dealt with in preschool past and present
Types of disabilities
Frequency
% of teachers
Developmental delay
Speech impairments
Visual impairments
Hearing impairments
Physical impairments
Epilepsy
Downs syndrome
Cerebral Palsy
Learning disability
Other
7
12
1
7
1
0
10
0
4
1
50.0
85.7
7.1
50.0
7.1
0.0
71.4
0.0
28.6
7.1
E) Supports to preschool
As can be seen from Table 2, there has been little support offered to preschools at
present. Over 21 percent of preschools had managed to obtain an assistant for the
special needs child through a FAS scheme. Over 64 percent of teachers reported
receiving some support from special preschool teachers. This support was given by
visits to special preschool by the teachers (6 respondents) or by the special needs
preschool teacher visiting the community preschools (3 respondents). Other than this
very little support currently exists.
Table 2. Supports available to help integrate children into preschools
Supports available to help integrate children into preschools
Supports
Frequency
% of schools
Speech therapist
Physiotherapist
Teacher’s assistant
Occupational therapist
Social worker
Psychologist
Preschool support
Nurse
Community nurse
Other supports
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0
3
0
0
0
9
1
0
0
00.0
00.0
21.4
00.0
00.0
00.0
64.3
7.1
00.0
00.0
4
1. Attitudes and Experiences Towards Integration
All teachers reported having difficulties with some of the mainstream children
attending preschool. Over 50 percent of children attending preschools were reported
to have 'behaviour difficulties'. When teachers were asked about ‘toileting’ they
reported no difficulties in this area, did not consider the special needs children not
being toilet trained as a difficulty and went as far as to make alternative
arrangements, such as 'pull-ups'. However, some preschool teachers expressed their
anger that the health boards were inflexible in requiring that 'all' children attending
preschool had to be toilet trained.
A) Interactions at preschool
Teachers and parents both responded positively to their experiences with the
community preschools placements. The study showed that 92 percent of parents
interacted with the special needs children. Overall parents of special needs children
felt that the other children's parents went out of their way to interact with their
children. Teachers themselves felt that there was 100 percent positive interaction
with the special needs child being in the preschools. One parent of a special needs
child said that "every-one talks to my little boy", another spoke of her child being
"invited to parties as the other children do". One parent of a child with Down’s
Syndrome said, "I often wondered how other parents feel about my child attending
the preschool", even though she herself had a "good feeling". Teachers reported that
over 92 percent of children interacted at some level, with 50 percent interacting ‘all
the time’. These interactions took the form of children sharing, taking turns, involving
special needs children in what they are doing; helping a special needs child out if
they had a problem. Some teachers reported that at times the other children helped
the special needs child "too much". One parent expressed her delight ‘that the
children at her son's preschool were the children that he played with in his
neighbourhood and that this was really good when he was playing out on the street
at home’. Free play and break time encouraged the most positive interactions. Story
time was when least interaction occurred. Almost all of the teachers responded that
children were ‘sensitive’ with over 70 percent showing ‘support, sensitivity and
protection’ towards special needs children. All teachers reported mainstream peers
as being protective in one way or another.
B) Imitation and copying
Imitating and copying was a common occurrence in the preschool, over 92 percent of
teachers reporting seeing the special needs children copying or imitating. Some
teachers however reported that sometimes the special needs children copied
negative behaviours and that they felt uncertain about how to deal with these
situations. Imitation was reported to occur ‘always’ during free-play (100%) and at
break-time (86%) less frequently. Imitation was reported to have occurred ‘least’
during structured play (57%). Some teachers spoke about using copying and
imitating as a method to teach special needs children new tasks and skills. Parents
also reported observing their children learning through imitation and copying when
with their siblings. Teachers reported that the special needs children ‘always’
participated in the daily programme, doing jobs just as the other children. This
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included giving out lunches, school bags and putting away toys. Teachers were
positive about the benefits to the other mainstream children (63%) of having the
special needs children in their preschools (65%). Benefits reported were that it
"encouraged the children to be more patient", and increased "helping behaviours".
2. Staffing issues
When asked, 12 of the teachers felt they did not require extra staff specifically for the
special needs children and reported that they coped well. However, two teachers had
responded that they required extra staff to assist with behaviour difficulties they were
experiencing with the special needs children, "particularly when they were disrupting
the classroom" and "disturbing the others from doing their work".
A) Preschool programme
Only 43 percent of teachers reported having received a special preschool
programme even though all should have had received these programmes via the
special needs children's parents. One Parent reported "…that … not feel able to give
programme to preschool teacher" and another parent reporting that the teacher might
ask "…questions I might not be able to answer". All parents suggested that the
programme would be best administered via special preschool teacher to community
preschool teacher directly. Of the 43 percent of teachers who had received a special
preschool programme, they reported that it was beneficial either in 'certain areas' or
'generally', but felt that it would be beneficial if the special preschool teacher and
themselves had more interaction and discussion about reaching teaching goals.
B) Supports and resources
Teachers reported that they needed more information with over 85 percent looking
for support and advice on special preschool programme. Over 71 percent of teachers
felt that they needed information about specific syndromes, and over 64 percent
required advice in relation to behaviour. One teacher reported that, "I wanted to ask
the parent of the special needs child to take him out because his behaviour was
disruptive to the other children, but didn't because the end of the school year was
near". Another parent had been asked to take her child out of preschool because the
teacher "could not handle her child's behaviour". Fifty percent of teachers had had
contact with special preschool, which took the form of phone calls or special
preschool teachers visiting community preschool or community preschool teachers
visiting the special preschool themselves. All preschool teachers felt that contact was
needed, some requested at least 'once a year' whilst others would like 'once a term'.
The teachers expressed strongly that they should all be working together using the
expertise of the special preschool service and suggested an open day in the special
preschool. All parents also felt that the special preschool teacher should visit 'once a
term' and that an open day would be important.
Discussion
The purpose of this study was to examine what supports and resources are required
within the community preschools, to help support and maximise the benefits of 'Early
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Intervention' to the special needs children and their families, whilst expanding the
'web of support' from the special preschool to the integrated community preschool.
The literature review highlights the significance of the early years in the development
of children with special needs and points out the value and effectiveness of early
intervention in this area. It refers to the need to extend intervention programmes to
include the community, and how each area can contribute to each other's
effectiveness. Current Irish research points to 'shortcomings' that exist in the absence
of liaison between teams and community preschool settings. There are benefits to be
gained for all involved in supporting this integrated preschool service as this study
has shown.
Integration: Special Preschool or Mainstream?
The results of this study suggest that the teachers involved all had a positive attitude,
which began when they enrolled or accepted the children with special needs into
their preschools. Bochner and Pierierse (1984) point out that a positive attitude must
exist between preschool teachers and intellectually disabled children if
mainstreaming for these children is to be successful. They point out that the
acceptance or rejection of such children is a reflection of the attitude of the preschool
teachers towards inclusion. In fact studies have found that the attitude of preschool
teachers is as important as their skills and competencies in the successful integration
of these children (Chow and Winzer, 1992; Westwood, 1982; Stewart, 1990). The
positive attitude of the teachers in this study was demonstrated by their flexibility in
dealing with problems in their preschool. This was done by decreasing the time the
child with special needs spent in the community preschool, offering parents a choice
of sessions, a lower child to staff ratio and ensuring preschool sessions didn't overlap
with special preschool sessions. Further evidence of positive teacher attitude is that
93 percent of preschool teachers reported not being in receipt of any government or
other agency subsidy. In New South Wales a subsidy was given to encourage
integration of children with special needs (Bochner and Pierierse, 1984). Nearly 93
percent of the teachers in the present study enrolled special needs children through
their own choice. One teacher reported having received a small grant because of the
geographical location of the preschool but not specifically for the special needs child.
The results also revealed that there was no set recommended ratio for special needs
children. The most commonly cited ratio of 7:1 was reported by almost 43 percent of
the respondents. However, in two cases teachers reported that they employed extra
staff for the special needs child to assist with 'behaviour difficulties'. Only 14 percent
of preschool teachers reported that extra staff was required for special needs child.
These extra staff was hired to deal with the special needs child’s behaviour
difficulties in the classroom. Almost 93 percent of teachers observed interaction
between all parents and special needs children irrespective of kinship. Of the
interaction between mainstream and special needs children, teachers indicated that
92 percent of reported interactions were positive. Can this alone be an indication that
integration works? Guralnick (1981) points out that we don't know if integration into
preschool really works, while O'Connell (1984) argues that, based on available
literature, these children can benefit from integrated settings. So what are these
benefits?
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Imitation/Copying
When teachers were asked, "Do you see the special needs children imitating or
copying other children", 93 percent of teachers responded that they saw imitation and
copying occurring in their preschools. Stevenson (1972) has shown the powerful
influence of imitation and modelling on the learning of all children and Wasson (1980)
looked at the rationale which says that delayed preschoolers will benefit from
imitating non-delayed peers. This study revealed, however, that negative behaviours
would be copied also. Free play encouraged the maximum time for imitation (100%)
and positive interaction (92.9%), whereas interactions occurred least frequently
during structured play (35.7%) and story time (21%).
Researchers agree that some play materials are more conducive to certain play
behaviours (Updegraff and Herbst, 1933; Poling, 1976; Wall, 1977), while Peck,
Apollini and Raver (1978) suggest that the varying levels of imitation may be due to
the nature of the task or the difficulty of the task being modelled. When asked if the
'"special needs child was active in the daily programme" teachers reported that all
special needs children were involved in the daily programme, e.g. giving out the
bags, the lunches and drinks to their mainstream peers. Synder et al (1976)
suggested, that using commonly found rewards in the preschool such as juice and
cookies, could lead to reinforcing peer interaction between mainstream children and
special needs children.
Children's Interactions
Over 70 percent of mainstream children in the preschools showed some ‘support,
sensitivity and protection’ towards the special needs child with many teachers
reporting that this was not very different to other peer-peer relationships. They did not
think that the special needs children were seen as 'different'. This explanation and
observation is supported by Ruble (1983) who says that due to the constant changes
in the preschoolers’ world, they are less likely to be interested in enduring
comparisons with others. When teachers were asked, 'In what ways do the other
children communicate with the special needs children', some teachers reported that
they saw the other children ‘just talking away’, or that ‘if the special needs child
doesn't talk back to the other child they would just go away and play’. They reported
not hearing the mainstream children alter their voices, however, parents in contrast
reported that when they observed their own special needs children in a group they
heard the other children ‘altering their voices, by talking slower, using gestures, and
using less words’. This is in agreement with Gelman and Shatz (1977); Dunn and
Kendrick (1982) who agreed that children do adjust their own speech according to
the needs of the listener. Likewise, Guralnick and Brown (1989) have found that
children adjust their speech when talking to a child with a mild disability. Does this
mean that the language in the community preschool is not being aimed to meet the
special child's needs; if so what then of the parent replies of 'sending their children to
mainstream preschool to help with their language development'. This study showed
that speech therapy support is not available to the children with speech impairments,
what then has the special needs child to gain within this social area of development
without support and advice on other methods of communication, such as Lámh, for
the teachers offering this integrated service?
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Preschool Programme
The data revealed that only 42.9 percent of teachers had received a special
preschool programme for the special needs child even though the data should have
revealed 100 percent, which had been given to the parents to pass onto all teachers.
All teachers reported that they would like a special preschool programme to support
their own programme. Some parents responded that they had some difficulty with
giving the community preschool teacher the programme even though all felt that it
would be of help. Among these the most common difficulty expressed was that
parents felt they might be asked questions and that they would not be able to answer
them.
Conclusions and Recommendations
The findings reported and discussed in this study are encouraging given the current
trend in the delivery of 'Early Intervention programmes' and the integration of special
needs children into community preschools. This study has shown that there are
benefits and gains for all involved with these developments. However, the question
that must be asked is how long can this integrated service be sustained without
additional supports and resources being put in place? Surely by extending our 'web
of support' we can look forward to the benefits of working in a collaborative way with
our community preschools in order to maximise the 'Early Intervention' we bring to
the children and families of our communities. The following points should be taken
into consideration when offering supports and resources:
1. Establish a link with the community preschools the children with special needs are
attending.
2. Arrange a meeting with the community preschool teachers at the early stage.
3. Run an ‘Open Day', inviting the preschool teachers.
4. Run training in the following areas:
● Teaching Lámh augmentative communication
● Managing misbehaviour positively
● Teaching through the 'Task analysis method'.
● Supporting the learning of independent living skills.
● Supporting good social behaviours.
5. Act as a resource for information, such as specific syndromes or health issues.
6. Offer support whereby teachers’ queries and concerns may be answered.
7. Set up a communication process between parent, community preschool and
special preschool by means of a book system.
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