Welcome to Room 128!
Inclusion Practices for Students with Cerebral Palsy
by
Linda A. Dixon
University of West Georgia
Carrollton, Georgia
When Melissa McCreary, a third grade teacher, received her class list last year, she found
that a student with a disability would be joining her classroom in the fall semester. "As a teacher,
I could easily understand that a child is different, but I didn't know how to help a child with a
disability feel not out of place in my classroom (Mickel & Griffin, 2007).” Michael Anwar is a
fifth grade general education student at Evergreen Elementary in the Mead School District in
Mead, Washington who was born with cerebral palsy. He has a type of cerebral palsy called
ataxic cerebral palsy, which affects his gross motor skills (balance, posture, functional mobility),
fine motor skills (hand skills), and communication skills (articulation and breathing) (Anwar,
2007).
This fall I will teach, as part of my fourth grade classroom, a student that is qualified as
Other Health Impaired which refers to his cerebral palsy and orthopedic impairments. He also
has a significant attention deficit and is primarily a visual learner. I will work alongside
paraprofessionals and special education staff to implement a plan of learning that meets his
specific needs. Two other students receive special education services under the emotionally /
behaviorally disordered (EBD) label. Mood plays a great deal in how they approach their day
and learning. Anxiety and the feeling of being overwhelmed play a huge role, as well as building
the trust and bond between student and teacher (P. Herres, personal communication, June 9,
2010).
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Rationale for this Research Paper
The needs of my special education students have motivated me to research the history
and practice of inclusion and especially how to include a student with cerebral palsy in the
regular education activities of my classroom. According to the President’s Committee on
Employment of People with Disabilities (1994), nearly 49 million people residing in the United
States (19% or one out of every five) have limitations or disabilities. “It is a fact that many of us
are only temporarily able-bodied. As with all change, the concept of inclusion has met resistance,
but the value and benefits of inclusion surpass those of exclusion and segregation (Shilling &
Cole, 1997).” This means to me that this research and study will be essential not only in the
coming fall but also throughout my tenure as a teacher in the years to come.
Key Words and Their Definitions
Some understanding about the history of inclusion and the definition of relevant terms is
helpful in comprehending the ramifications of these statistics and real-life situations. The goal of
inclusive education is “authentic membership, full participation, reciprocal social relationships,
and learning to high standards…in age-appropriate general education classrooms with supports”
to all students whether they be “disabled” or not (Jorgensen, 2009). The history of inclusion
sheds light upon the current practice and will be addressed in greater length especially in relation
to how students with cerebral palsy can benefit in such a system.
Cerebral palsy is defined as “an abnormality of motor function (the ability to move and
control movements) It is acquired at an early age, usually less than a year of age, and is due to a
brain lesion that is non-progressive. A palsy is literally a “paralysis, generally partial, whereby a
local body area is incapable of voluntary movement (motor function) (MedicineNet, Inc., 19962010).” It is not a disease to be cured; it is a lifetime condition. The word cerebral indicates that
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there is a brain abnormality which will not continue to get worse. It is not always possible to
determine the cause of cerebral palsy. New technologies, such as MRI, help physicians identify
and understand the root causes. When a certain threshold of low oxygen and decreased blood
flow to the brain is reached, a series of events occur at biochemical and cellular levels that result
in "death of neurons" (nerve cells) (Myers & Shapiro, 1999).
Cerebral palsy is characterized by a problem with motor control, because the brain is
unable to regulate muscle tone, strength, and fluidity of movement needed to perform a motor
task as one would expect. For a motor disability to be called "cerebral palsy," the brain, not the
muscle or spinal cord, must be its source (Taft, 1999). “Tone” is defined as the muscle
contraction when at rest. If it is too high, it is called spastic. If it is too low, it is referred to as
hypotonia. Both extremes interfere with movement (Delgado & Combes, 1999). When a person
is diagnosed with cerebral palsy a doctor determines the kind and the topographical classification
or location of the palsy. This enables his team to develop a precise plan of management.
Cerebral palsy is divided into specific kinds: spastic (in which one or more extremities
are held in a rigid posture, choreoathetoid (associated with writhing movements of the arms or
legs), and hypotonic (flaccid or floppy, rag doll appearance) (MedicineNet, Inc., 1996-2010).
The topographical classification is used to further describe types of spastic cerebral palsy. They
identify the areas of the body affected by cerebral palsy. Monoplegia affects one limb of the
child's body; diplegia, both of the child's legs; triplegia, one arm and both legs. Hemiplegia
affects one side of a child's body; quadriplegia, the child's entire body. Double hemiplegia affects
the child's entire body, but the arms are involved more than the legs (Myers & Shapiro, 1999).
Treatment may include casting and braces to prevent further loss of limb function, speech
therapy, physical therapy, occupational therapy, or the use of augmentative communication
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devices, (MedicineNet, Inc., 1996-2010). “Orthoses” refers to any device used to stabilize or
immobilize a body part, prevent deformity, protect from injury, or assist with function (casts,
braces, etc.) (Delgado & Combes, 1999). “Orthotics” is a word that is used often in the
description of care of children and adults with cerebral palsy and this word refers to the science
of orthoses. Students with cerebral palsy experience their environment differently from the time
they are born; therefore they come to the table with a different perspective and experiential
background (P. Herres, personal communication, June 9, 2010). At this point in the history of
education in the United States they enter a school setting that is open to them and where they can
have educational experiences side by side with more “typical” students. However, this has not
always been the case.
The History of Inclusion in American Schools
People with disabilities have had a long history of exclusion, abandonment, or out-right
violence (Smith & Erevelles, 2004 as cited in Leaftstedt, Itkonen, Arner-Costello, Hardy,
Korenstein, Medina, Medina, & Regester 2007). “In the past, people with cerebral palsy did not
have many options (Anwar, 2007).” This was the case in 1950 when the special needs child
could expect to be excluded from both the schoolroom and mainstream society. This child could
also expect to be institutionalized, unnamed, negatively labeled with words such as “moron” and
“retarded”, restricted in daily schedule with little socialization of any kind, considered
uneducable, and buried as a county obligation without record of birth or death (Schilling & Coles
1997). Prior to 1930, few children deemed "handicapped," attended public schools (Osgood,
2005). They were perceived as a burden to society (James T. Byers, Secretary of the National
Committee on the Provision for the Feeble-Minded as cited in Osgood). Between 1930 and 1950,
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the number of children identified with disabilities increased, but the prevailing attitude toward
them did not change (Nietsch, Siegel, Keefe, & Horn, n.d.).
The United Cerebral Palsy of New York City (UCP/NYC) was founded during this time
(1946) when almost no community or school-based services existed. This non-profit organization
enabled parents of children with cerebral palsy to secure services and advocacy (10 myths and
misunderstandings about cerebral palsy, 1999). Even so by 1965 the special needs child was
given at best segregated care and education opportunities. This child could expect to be named,
to be kept at an institution near the parents, to receive better care with improved technology and
research, to have a staff of better trained individuals providing care, and to have opportunities to
socialize with special needs children. If he attended school, it would be a segregated one (away
from “typical” students) and it would not begin until he reached age twelve. Negative labeling
continued to restrict the individual by applying terms to limit his abilities and contributions.
One such former student with mild cerebral palsy recently wrote about his experiences
growing up in this kind of setting. He relates that he participated in an “Individualized Program”
at the segregated school from first to fifth grade, had lunch at separate tables and rode a separate
bus. He was aware that he was in the wrong place and was unhappy with being separated from
the “regular” kids. His regular education exposure was attendance in regular Math and Art only
(Stussman, 1997).
Legislative Reforms and Mandates
In the 1960's, relying on prevailing research at that time, critics exposed these segregated
programs and their underlying philosophy causing a radical review of special education and a
call for reform (Osgood, 2005 as cited in Nietsch et al., n.d.). In 1963, a group of concerned
parents formed the Association of Children with Learning Disabilities (Nietsch, et al., n.d.). This
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began a chain of legislative reforms and mandates to ensure the rights and services of all children
regardless of ability level. Early legislation included Public Law 90480 (Architectural Barriers
Act) in 1968 that stipulated that if an agency received federal funding they must provide access
to facilities for persons with physical impairments.
In the 1970s, the Rehabilitation Acts (Public Law 93-122, Sections 502 and 504)
mandated equal access to programs and transportation, employment, facilities and programs. The
U.S. Government established a task force to review "characteristics of learning disabled children,
extent of current services, methods of treatment, and estimates of prevalence" (Wong, 1998, p.
15 as cited in Nietsch, et al.,, n.d). The findings of the task force led to the first legislative action
to grant children with special needs the right to an equal education. In 1975, the most farreaching legislation was realized in PL 94-142-Education for All Handicapped Children Act
(EAHCA) which mandated the right to free and appropriate education regardless of condition
(Schilling & Coles 1997). This act would ultimately be revised in 1997 as the Individuals with
Disability Education Act (IDEA) and reauthorized in 2004 as the Reauthorized Individuals with
Disability Education Act (Public Law 108-446 - 108th Congress as cited in University of the
State of New York 2009). This act provides that schools must have the goal of “free and
appropriate” education; they must contain annual performance objectives for each child,
objectives must be reviewed each year, and teachers and administrators must determine how best
to place students in the “least restrictive environment” unless their handicaps require special
treatment or equipment or are so severe that they cannot be taught effectively in the regular
classroom (Oliva, 2009). The Individuals with Disabilities Education Improvement Act of 2004
states “Congress finds the following:
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“Disability is a natural part of the human experience and in no way diminishes the right
of individuals to participate in or contribute to society. Improving educational results for
children with disabilities is an essential element of our national policy of ensuring
equality of opportunity, full participation, independent living, and economic selfsufficiency for individuals with disabilities. Almost 30 years of research and experience
has demonstrated that the education of children with disabilities can be made more
effective by having high expectations for such children and ensuring their access to the
general education curriculum in the regular classroom, to the maximum extent possible
(Jorgensen, 2009, p.1) .”
Mainstreaming vs. Inclusion
The journey during the last thirty years has witnessed landmark legislative mandates and
changes in the structure of the school setting for children with disabilities. However, this journey
has had its bumps in the road along the way. A public school education in the "least restrictive
environment" has now become a mandate, but all services are not provided equally throughout
the country (10 myths and misunderstandings about cerebral palsy, 1999). Even after milestone
legislation, the special needs child continued to be labeled “mentally retarded”, was educated at
segregated schools or summer camps, and was allowed to view “normal” children at play, but
was not to join them. He was able to live at home with family members and was treated by a
therapeutic recreation specialist who implemented a designed program. However, concerns arose
as the child came to be dependant emotionally and physically on family for support and
unaddressed as far as future long term health support was concerned (Schilling & Coles 1997).
Some distinction should be noted between “mainstreaming”, a term largely used in the
1970s and 1980s, and full inclusion practices that have been utilized since then. Ann T.
Halvorsen and Thomas Neary distinguish inclusion from mainstreaming in this way.
Mainstreaming is a model in which the student has dual citizenship; sometimes he is in the
regular class and sometimes he is pulled from it for segregated activities. Inclusion has as its
model an IEP (Individualized Education Program) plan within core curriculum context and
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general class activities. Suzanne E. Wade and Judy Zone advocate that “all groups must be
educated with peers in the regular classroom. Carol A. Kochhar, Lynda L. West, Juliana M.
Taymans further support the inclusive practice of “children learning side by side although they
have different educational goals.” In an inclusive setting students work on different materials,
and at different rates with a resource specialist and are pulled from the regular education setting
only if the student is unmanageable or needs special treatment that can’t be provided in the
regular class (Oliva, 2009).
Students with disabilities found themselves with very changed education settings after the
federal legislation mandates in the 1970s. One such student (mentioned earlier in this paper as
unhappy with the “Individualized Program” of his segregated school) was suddenly
mainstreamed in the neighborhood school with an IEP (Individualized Education Program)
which supported him with reading assistance. The change to inclusion in the regular program
with supports took his reading abilities from first grade level to a sixth grade level proficiency in
the first year alone. His school life was interrupted at this point with his parents’ relocation to
Israel where he had no IEP but where it was noted that his cerebral palsy was affecting his
writing and speaking speeds. To compensate, he used a portable typewriter and later a computer
which allowed him to advanced significantly ultimately enrolling in college at Humboldt State
University—Northern CA. Modifications were made for him in college so that he could have
more time on tests. He joined a bowling league in order to socialize, met his wife, has had
children of his own, and is now a technology coordinator in Washington, D. C. (Stussman,
1997).
Such a success story helps to identify the strengths of the inclusion model as giving
students with disabilities the equal playing field necessary for achieving high expectations and
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the dreams they dare to dream. There are still disconnects between the ideal inclusive setting and
the reality across the spectrum of American schools. It has been observed that students may
participate in inclusive education but find that work and leisure are still largely segregated
(Schilling & Coles 1997). In the 1990s equal access to all school and community opportunities
was still an evolving process for high school students with disabilities. Their schedule of
activities included removing them from the high school campus so that they could participate in
functional education during the day. This limited the number of regular education classes that
students with disabilities could take which in turn limited social interactions with fellow
students. Graduation with the rest of the high school class was delayed due to missing requisite
classes that were missing. This “separate and different” status called upon educators to redefine
“best practices” philosophies used when designing instructional opportunities and physical set
ups (Tashie & Schuh 1993).
Research Findings and Validation of Inclusive Practices in Education
Today, educators must comply with federal laws including civil rights law, IDEA, and
Response to Intervention (RTI) guidelines. In addition to special education requirements, school
systems are expected to meet No Child Left Behind mandates that impact state and local practice
(Nietsch, et al., n.d.). The federal law and the Courts have spoken often and clearly about school
inclusion. The Individuals with Disabilities Education Act (I.D.E.A.) states that schools must
establish procedures: 'to assure that, to the maximum extent appropriate, handicapped children,
including children in public and private institutions or other care facilities, are educated with
children who are not handicapped, and that special classes, separate schooling, or other removal
of handicapped children from the regular educational environment occurs only when the nature
or severity of the handicap is such that education in regular classes with the use of supplementary
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aids and services cannot be achieved satisfactorily.' (20 U.S.C. S 1412 (5) (B)) (The Inclusion
Institute at Syracuse University, 2010). President Bush signed this act on December 3, 2004
stating, “The Individuals with Disabilities Education Improvement Act of 2004 will help
children learn better by promoting accountability for results, enhancing parent involvement,
using proven practices and materials, providing more flexibility, and reducing paperwork
burdens for teachers, states and local school districts (University of the State of New York,
2009)”.
With time and changed practices some important findings about the benefits of inclusion
have been documented. Students with intellectual and other developmental disabilities educated
in general education classrooms demonstrate better performance in reading and math (Cole,
Waldron, & Majd, 2004) and significantly higher gains in adaptive behavior when compared
with students with intellectual and other developmental disabilities educated in separate settings.
The largest, longitudinal study of education outcomes of 11,000 students with disabilities, the
National Longitudinal Transition Study, showed that more time spent in a general education
classroom was positively correlated with higher scores on standardized tests of reading and math,
fewer absences from school, fewer referrals for disruptive behavior, and better outcomes after
high school in the areas of employment and independent living (Wagner, Newman, Cameto,
Levine, & Garza, 2006 as cited in Jorgensen, 2009). This positive correlation was found for all
students with disabilities, regardless of their disability label, the severity of their disability, their
gender, or their family’s socio-economic status (Jorgensen, 2009).
A meta-analysis of research in inclusive education conducted by McGregor and
Vogelsberg (1998 as cited in Jorgensen, 2009) found among many other benefits:
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Students with intellectual and other developmental disabilities in inclusive had a higher
likelihood to be identified as a member of a social network by peers without disabilities.
Students with disabilities demonstrate high levels of social interaction in settings with
typical peers.
Social competence and communication skills improve when students with disabilities are
educated in inclusive settings.
The performance of students without disabilities is not compromised by the presence of
students with disabilities in their classrooms.
Typical students derive benefits from their involvement and relationships with students
with disabilities.
The presence of students with disabilities provides a catalyst for learning opportunities
and experiences that might not otherwise be part of the curriculum, especially relating to
social justice, prejudice, equity, and so forth.
Although many teachers are initially reluctant about inclusion, they become confident in
their abilities with support and experience.
The IEPs of students with disabilities who are included in general education classes are of
higher quality; that is, they include goals and objectives that are more closely related to
desired adult outcomes and roles than the IEPs of students with disabilities who are in
segregated classes.
There is evidence to suggest that while start-up costs may initially increase the cost of
inclusive services, the costs over time decrease, and are likely to be less than segregated
forms of service delivery (Jorgensen, p. 3, 2009).
A separate study gathered teachers’ perceptions of children with disabilities and found
that teachers are overall more comfortable with students that have mild and/or physical
disabilities. When labels accompanied the students, teachers were slightly less comfortable than
when no labels were used in the description of the individual, special needs child. Even though
school personnel are including children with disabilities in the regular education classroom, their
attitudes and comfort level can contradict the actual practice (Huang & Diamond, 2009). This
study found specifically that:
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Inclusion allows the opportunity for all children to interact with and learn from each other
and benefits students with and without disabilities.
Attitudes of adults are critically related to policy decisions at the local and national
levels.
The higher the teacher’s education level and years of experience, the more comfortable
he or she tends to be with including a child with disabilities.
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Labeling the student is necessary to provide him or her services, but it discourages the
teacher from emphasizing the student’s individual characteristics and stereotypes can
occur
An effect of labeling special needs students was that they were less likely to be selected
for gifted programs, that they were perceived as “different”, and that expectations were
lowered for them.
Teachers appear more willing to include children who do not inhibit learning in their
peers.
Concerns and fears arise due to the perception that there will be insufficient resources and
training for teachers in inclusive programs.
Teachers perceive the term “disability” unfavorably
Many teachers report they are not confident in their ability to teach special needs
students.
Teachers cited several specific supports and resources needed when including special
needs students in the classroom: additional planning time, training, personnel, material
resources, consistent parent involvement, adequate class size, pull-out options, and
monetary compensation.
Teachers may be reluctant to include special needs students when they foresee that this
will lead to more responsibilities (Huang & Diamond, 2009, p. 3).
Current Education Realities and Practices
Having an understanding of key terms, the historical background of inclusion and the
research to support this practice leads finally to appreciating today’s education realities and how
inclusive education will need to improve in the coming years. A child born with disabilities
today enters a world where attitudes are light years ahead of society twenty years ago. Those
who have disabilities are visible in every possible public venue alongside a public that has
acquired greater insight about their capabilities. While we do not live in a perfect world, we do
live in a society which is far more accepting and in tune to the needs of those with physical and
cognitive challenges (10 myths and misunderstandings about cerebral palsy, 1999).
Throughout their lives, children with disabilities will have constant, natural opportunities
to interact with youngsters who are non-disabled. The school setting is now integrated and
children who have disabilities learn side-by-side with their typically- developing peers (10 myths
and misunderstandings about cerebral palsy, 1999). They are now termed with “person first”
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language and live within the community semi-independently. Public Law 101-336 Americans
with Disabilities Act (ADA) ensures the private sector rights and services that extend to all parks
and recreational facilities. Full inclusion alongside peers is the mandate at educational,
vocational and recreational sites (Schilling & Coles 1997). An article, written with a Catholic
audience in mind, demonstrates how religious organizations are also finding ways in which
“people with disabilities [can] participate in the life and mission of the church (Masters, 2009).”
Parents of children with disabilities are called upon to help direct the process and their
involvement is vital as it brings disability awareness to those who want to include and
understand all who desire to be a part of this social group.
Transformational Changes through Assistive Technology
Tremendous improvements for students with special needs have been made possible
through assistive technologies. There are also simple modifications that can be made to a
person's school to facilitate independence and productivity. Through the federal "Tech Act,"
Technology Related Assistance for Individuals with Disabilities (TRAID) Centers have been
established in every state, offering free information and referral for assistive technology devices
and systems (10 myths and misunderstandings about cerebral palsy, 1999). Michael Anwar, the
fifth grade student with cerebral palsy, has an Individual Education Plan (IEP) and a team that
includes his parents, a para-educator, teacher, education specialist, school psychologist, as well
as occupational, physical, and speech therapists. He has become very independent at school with
his therapist’s help. His teacher and para-educator support him in using assistive technology. He
uses a laptop with technology so he can type instead of write. He is able to be independent in
P.E., Music, and Library because teachers adapt or modify assignments as necessary (Anwar,
2007).
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Federal laws now mandate that assistive technologies be considered when special
education programs are being tailored for students with challenging learning and behavior needs.
Media specialists need to make sure that these technologies are readily available to students and
teachers. Web sites such as CAST (Center for Applied Special Technologies) and Closing the
Gap give information about appropriate resources and technology for use with students with
disabilities. Some of the specific technologies that they recommend are:
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Microsoft Windows XP and awareness of its accessibility features
JAWS for Windows is a screen reader from Freedom Scientific that allows the user to
have the screen text read aloud via the computer's sound card
ZoomText is a CD-ROM package is both a screen magnifier and a screen reader which
reads at an adjustable reading rate
Kurzwell 3,000 Version 9 is a program that offers text-to-speech, word attack tools,
study skill tools such as outlining and note taking and online access to books and
encyclopedias
Texthelp Read and Write 7.1E Gold is software that allows the user to easily obtain
assistance including text-to-speech, a pronunciation tutor, a spelling checker, and a builtin scanner
Inspiration is a CD-ROM to develop ideas and organize their thoughts graphically. The
audio feature supports students' multiple learning styles
Activation switches can be used by students with limited mobility with subtle body
movements to operate resources and equipment
Intellikeys is a powerful, easy-to-use alternative keyboard that plugs directly into the
standard USB port
Reading Pen II is a portable, pen-shaped scanner and audible dictionary designed for
persons with dyslexia who can scan across a line of print, which is then converted into
audible words
PocketTalker Pro is an amplification device that allows students with hearing
impairments to hear sounds from a variety of sources
Keyguards are overlays placed on top of computer keys that prevent students with limited
finger mobility from pressing the wrong keys
Adjustable workstations are expensive, but can be tailored to specific needs
Listening Stations are headphone boxes that allow students to listen to media without
disturbing others
SMART Board is an interactive device that allows one to control the computer display by
simply touching the projection on the white board screen (Neal & Ehlert, 2006, p.4).
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For the student with cerebral palsy improving and allowing for compensation of motor
skills encourages as much independence as possible. A student’s physical needs impacts social,
emotional and educational needs and goals and as specialists maximize the student’s physical
potential changes in all areas improve as well (Delgado & Combes, 1999). In particular,
therapeutic and surgical techniques are helping to minimize the effects of cerebral palsy and new
treatment methods are helping to control problems such as spasticity and seizures. Special
equipment, such as computers to assist speech and orthotics, and mobility devices gives greater
freedom of movement to children with limited motor skills (Frei, 1999).
Collaboration, Empathy and Unity as a Team
So how can educators and administrators provide students with disabilities with “the least
restrictive” environment and include them in authentic learning alongside their peers? The task
although mandated can seem daunting, especially to those who have not had training in the field
of special education or have never met a child who has cerebral palsy. Empathy, collaboration,
and informed teaching practices and strategies are three ways for teachers to make a positive
impact on the lives of students with disabilities.
When addressing needs and implementing strategies to improve the educational
experience of students with disabilities, the desired goal is to interact as a team in a collaborative
setting to discuss all issues impacting the student. The goal is to involve parents. Rhonda
Armistead challenged school psychologists to examine and improve practices with parents with
the reminder that "every child has a family context-a family story." This interaction between
parents and educators often becomes difficult and laced with powerful emotions and
defensiveness on both parties’ parts. Positive and equal communication can be achieved through
enlightened and deliberate practices (Nietsch, et al., n.d.).
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Failing to value each other's knowledge about a child's problem and the concerns that
parents have can undermine effective parent-educator interactions. Of concern to parents are
issues such as whether the child will learn to read, finish high school, or attend college, but
educators generally operate within the context of a single school year. Sometimes, cultural and
socioeconomic differences can block the process of alliance building between parents and
teachers (Nietsch, et al., n.d.).
Parents need to have input to help guide teachers as they set goals and content objectives
and there needs to be parent-professional partnerships in which communication is kept positive
and clear (Frei, 1999). Parents are in the position of having precise knowledge about their child’s
physical and emotional needs and the management plan that is being implemented by medical
professionals. There must be good communication among the team members (Delgado &
Combes, 1999). When 78 families of disabled students who had received or were still receiving
services were interviewed, the results were illuminating (Pruitt, Wandry, & Hollums, 1998 as
cited in Nietsch, et al., n.d.). When asked how educators could be more sensitive to family needs,
70% responded that educators should recognize that the parents know and understand their
children, and that their contributions are important ones that should be heard, valued, and
respected.
Educators also have knowledge about the student with special needs that comes from
observing the student in the school setting, understanding standards and expectations explicit in
the curriculum, and through goal setting on a school level. There needs to be respect for every
individual who plays a key role in the life of the child. Parents will always be the "constant" in a
child's life acting as an advocate for their child. However, parents need to learn to cooperate with
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treating professionals; and those professionals need to learn to work in the same way with
parents. This is the way to secure the best advantages for the student’s future (Taft, 1999).
As a part of their research study, Nietsch, et al. (n.d.) identified seven barriers to effective
collaboration between educators and parents of children with disabilities. Understanding that
these barriers exist is the first step to removing them and communicating more effectively.
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Public school professionals viewed parent advocacy groups as imposing changes without
educator input
State and federal mandates were viewed as a loss of control over education by local
school systems
Educators and parents must be conversant with local, state, and federal law in addition to
their other roles
The perceived expense of special education may leave educators reluctant to provide a
wide range of services and parents maybe frustrated by a lack of support
In the absence of training, educators may feel unprepared, inexperienced, or disinclined
to work with parents, especially if they have had bad experiences dealing with the small
percentage of parents who are angry or argumentative
Parents and educators view the problem from different perspectives, resulting from
different sets of knowledge, assumptions, timelines, and cultures
Parents may not be viewed as equal members of the problem-solving team
(Nietsch, et al., n.d., pp. 1-4)
Effective Teaching Interventions
Amber’s parents had never been involved in her education and did not attend IEP
meetings. She had trouble in school and was told that with her given abilities, she would be
limited to working at a grocery store bagging groceries for the rest of her life. Her one desire was
to be a teacher, but that didn’t seem very likely. However, when she mentioned this dream to her
special education teachers, they made it their task to move her from self-contained classes to
general education and advanced placement classes. They encouraged and tutored her along the
way. April's story provides a look at how teachers can have a lifelong impact on students.
Individuals have dreams, aspirations, and unique skills. Having teachers who listen to them
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enables students to build strong social support networks and reach those dreams (Leaftstedt,
Itkonen, Arner-Costello, Hardy, Korenstein, Medina, Medina, & Regester, 2007).
Why should teachers sharpen their teaching techniques and be concerned about the needs
of students with disabilities? Educators need a positive view of their role in reaching the
potential of the special needs student despite the often times overwhelming task of keeping up
with tedious regulations and paperwork. Special education has grown from a legal mandate to a
complicated set of procedural rules and regulations with long IEPs, the demand to be highly
qualified and the never ending task of keeping students accountable for a host of curricular
standards. Even so teachers must focus on students first and foremost as individuals and treat
them with respect as they grow to be contributing adults. Teachers must keep their expectations
high for all students (Leaftstedt, et al., 2007).
Once teachers understand the individual behind the disability, they are able to fine-tune
instruction to the particular need or stage of development of the student. This is not a new
concept by any means, but being especially knowledgeable about the special education needs of
a cerebral palsy student includes understanding their motor problems. If students have severe
motor problems, social actions are also difficult to perform. In an article directed toward teachers
of such students, Greenspan (2002) explains the process of moving through six core experiences
or milestones. As the present stage is identified, the teacher can draw on many of the child's
different capacities and harness even limited motor ability using all of the child's operating
senses and abilities. Teachers and parents “should capitalize on every opportunity to allow the
child a sense of accomplishment (Greenspan, 2002)”. The specific milestones and capacities are
as follows.
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Milestones for Healthy Development
(1) The child learns to focus and pay attention
(2) The child learns to engage another person and respond facially
(3) The child becomes purposeful and intentional--physical challenges may make it
harder to master two-way communication and to learn logic ("If I drop this, she
will pick it up") and mastery ("I can make things happen")
(4) The child combines many skills in order to solve a problem
(5) The child uses ideas creatively through pretend play
(6) The child builds bridges between ideas through pretend play and games
(Greenspan, 2002)
Suggestions for Utilizing the Child's Different Capacities




Pair the special needs student up with another carefully chosen child and find
activities in which the boy with motor problems can be an assertive play partner
Use a tape recorder for the child to "write" stories
Another child can help him with motor skills while playing board games
Create social games in which the child develops interaction and in which the
physically challenged child practices the skills he does have, including thinking and
motor skills
(Greenspan, 2002)
An alternative treatment program is called Conductive Education (CE) which is largely
meant for parents who are seeking to improve the motor skills of their children with cerebral
palsy. The approach centers on physical challenges paced in small steps to develop positive
experiences and overall increase in improved motor ability. The way in which tasks are designed
allows for tiny opportunities for success for each person so they build their esteem, confidence,
and internal desire to accomplish more and more. This increases their self-motivation to achieve
(Waiss & Borcsok, 2007).
This technique originated in the 1940s in Budapest, Hungary and is not widely used in
the United States, but it is mentioned in this paper because of interesting theories that it
postulates about how children are motivated. The idea is that children with motor disorders are
unconsciously taught that they are not expected to accomplish tasks for themselves, so they
gradually see failure in their efforts, become frustrated, then complacent. CE targets the
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disability from the person outward-not from the outside symptoms of the disability backwards. It
is holistic in approach and does not see any distinction in development between the mind and the
body; it believes both must be addressed in tandem. CE believes you can teach the person to
overcome the disability by stimulating new neural connections in the brain that compensate for
the damaged portions. This they refer to as “orthofunction”. A natural byproduct of improved
physical function is improved cognitive function (Waiss & Borcsok, 2007).
Another interesting dimension to this technique is the group dynamic which serves to
motivate each individual to do more and to achieve more because they work together in friendly
social competition with each other. This leads to improvement in interpersonal relationships,
reduction of fear, increased sense of community and connectedness, development of self esteem
and self control, and allows the individual to be motivated by the accomplishments of others in
the group (Waiss & Borcsok, 2007). This approach, with its belief in the persistence of the
special needs child, is similar to the advice given by an adult with cerebral palsy:
“Do not limit children. If children do not perceive barriers, they will amaze you with
what they are capable of doing. It is more natural to include a child with a disability in a
“regular class” and, if necessary, pull him out for one or two subjects rather than the other
way around. The public school system should be a microcosm of the “real world.
Education is learning how to interact with others (Stussman, Barak, 1997).”
Because general education teachers have expressed the need for greater training in
reaching the needs of students with disabilities, a program in Chattanooga, Tennessee has been
developed to assist them called “Kids Like You, Kids Like Me”. Siskin Children's Institute and
Creative Discovery Museum partnered to address inclusion by promoting teacher and student
understanding and acceptance. During the course of the program teachers talk one-on-one with
people who have disabilities, hear stories about real-life successes and gather best practices
approaches to support inclusive education (Mickel & Griffin, 2007). The goal of the program is
20
to help teachers to find the similarities in all children. The core message is that all children and
adults need and want to have friends and enjoy fun experiences. The workshop incorporates
activities that illuminate learning styles and heighten disability awareness. Collaboration with
other general and special education teachers is also informative. Participants leave with fact
sheets and classroom activities that serve as a reference. They also leave with a broader
understanding of special needs children (Mickel & Griffin, 2007).
The Future of Inclusion for Students with Cerebral Palsy
So much has changed in the world of the special needs student and in particular for the
child with cerebral palsy. It is easy to come to the conclusion that there is nothing left to do.
However, there are future goals for inclusion to be truly effective. In the future every special
needs child will need to be mainstreamed recreationally, evaluated fairly to ensure that
segregated programs are truly needed, benefit from community partnerships, and participate in
all levels of programs (Schilling & Coles, 1997). Some attention to the current and future needs
of students with disabilities has been creatively and poignantly drawn by documenting the life of
a boy named Samuel who has cerebral palsy. His father, Dan Habib, a veteran photojournalist
and newspaper editor, has created a fifty-eight minute documentary film using still photography
and video taken since Samuel was a baby. The documentary examines the cultural and systemic
barriers to inclusion by openly discussing them without judgment or agenda. Through such
discussion the benefits of inclusion for all special education students is explored (Beem, 2008).
The author is not an educator, but best practices of education are evaluated and the
success with which schools include special needs students in the regular classroom is also
analyzed. The article suggests that inclusion “is still happening inconsistendy [sic] throughout
the country. It varies state to state, town to town and classroom to classroom.” A link to a web
21
site is provided that gives more information about the film and the case study that includes
Samuel, his family, his teachers, administrators, typical students and their parents. There is also
list of resources and scholarly articles that provide current research on the issue of inclusion and
the experiences of students, parents, and teachers (Beem, 2008).
Conclusions and Inferences
I have learned so much from investigating the practice of inclusion and about students
with cerebral palsy. In another course that I am taking at West Georgia, a fellow student who has
a child with a disability had this thought-provoking comment:
“If we truly look at ourselves and our own lives we will see that at some point in time we
are all a "special needs" person. These children will have to learn to live in society with
society's expectations so why should they be treated differently than other students at
school when it comes to using the media center as part of [their] education process?”(K.
Tino, personal communication, June 22, 2010).
This comment helped me to truly understand what inclusion is all about. The challenge for me as
a regular education teacher is being willing to change the way I do things from how I teach to
how I set up my room. Being flexible and collaborative with colleagues and parents will enable
me to support these students. I would also strive to use “labels” that are in no way demeaning of
these children. I infer from this study that students with disabilities will be included more
successfully in a regular education classroom that is taught by an experienced and highly
educated teacher who feels that supports and collaboration are available. The information I
gathered also allowed me to chronicle the reasons that inclusion is a part of our students’ school
experience. Functional skills can and must be addressed in a way that does not limit a student’s
access to mainstream education and the opportunities that accompany it (P.L. 94-142 (1990)
IDEA). Through effective faculty collaboration, clear establishment of goals and guidelines, and
22
student supports, flexible systems for all students will ensure that they have the same rights and
access to excellent educational services.
Concentrating on the individual strengths, needs, and abilities of the learner enables me
as a teacher to set appropriate expectations and to create an atmosphere which fosters learning
opportunities and social interactions with peers. This has been my goal since becoming an
educator in 1985, but I now find that I understand the needs and background of students with
cerebral palsy better from having read widely about this condition, its treatment and how to
specifically assist students with technology, teaching strategies, and interventions. Working as a
team this fall will allow me to put this research and reflection into practice in my own classroom.
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