Disabilities and impediments

An important component of the inclusion programme has been the introduction of pre-school education in order to allow children with disabilities and impediments to their learning to develop the skills that will allow them to maximise their chances of future success in the classroom. The benefit of EI on children with DS however, remains inclusive (Wishart, 1996). This in turn highlights the issue of whether it is possible or desirable to integrate children with DS into mainstream education. Within this scenario the research will be assessed to decide whether EI is effective for children with DS and what is the best course of action to follow in the case of the child in question.

DS is a chromosomal disorder characterised by the presence of an extra #21 chromosome. Instead of having 46 chromosomes in each of his/her cells, a person with DS has 47. DS is the most prevalent chromosomal disorder, and also the most frequently recognised cause of physical and intellectual impairment (Selikowitz, 1990). What this means is that children with DS develop intellectually at a much slower pace than other children who do not have a learning disability (Selikowitz, 1990).

However as with all children their rate of development varies considerably, with some developing more slowly and others at a faster rate. According to Wishart (1993), the ‘range of ability levels in DS children at all ages is in fact unusually wide for a learning disability of known aetiology’ (Wishart, 1993:391). Such variation can be attributed to both biological and environmental factors, which will have an impact on the level of ability acquired by children with DS (Laws et al., 2000).

In the past people with DS were perceived as being sub-human and labelled ‘uneducable’. By the 1960’s attitudes, treatment and expectations of people with DS had begun to change. Research into the condition of DS illustrated various degrees of intellectual impairment among individuals with DS, dispelling the myth that DS is a homogenous condition (Carr, 1988). The implication of this is therefore that theories such as EI may be able to impact on some DS. EI to enhance early development is a relatively new phenomenon as it was still widely accepted that intellectual functioning was largely innate (Goddard, 1916) and thus training would not affect a child’s intellectual ability (Lerner, Lowental and Egan, 1998).

However numerous empirical studies have disputed this notion by demonstrating that a person’s intellectual development can be changed by environmental experiences (Hunt, 1961; Bandura 1976). The emphasis is on the early years in human development because development is at its most receptive to learning during this period of human life. In fact child development research has established that the rate of human learning and development is most rapid in the pre-school years. For example Bloom’s research into cognitive growth found ‘…that 80% of the child’s development is completed by age four’ (Lerner, Lowenthal, and Egan, 1998:27) – hence the sooner EI commences the better.

EI can be defined as ‘systematic strategies aimed at the optimal development of infants and toddlers with special needs…’ (Mitchell and Brown, 1991:xii).The importance of EI particularly applies to children of school age or younger who may be at risk of having developmental problems. The rationale being that if early development proceeds at a faster rate, more closely approximating a typical developmental course, higher final levels of cognitive, linguistic, adaptive, academic, and other skills can be attained (Spiker and Hopman, 1996). Many studies have demonstrated the positive effects of participation in EI. This evidence is particularly strong with respect to school readiness for children from families of limited education and low income who are deemed to be at risk as ‘school failures’.

These children often enter the school system with smaller vocabularies and fewer critical skills than do their more advantaged peers. The Perry Pre-school Project conducted from 1962- 1967 is an example of the success of such early intervention programmes. Taking an active learning approach based on the work of Piaget they were able to raise attainment of students with low IQ scores from families of a low socioeconomic status that were identified as at high risk of school failure (Schweinhart and Weikart, 1997). The longitudes research follow ups showed lasting effects of EI for participants identified as environmentally at risk. Other longitude research using similar samples (see Reynolds et al, 2001) have corroborated such findings therefore establishing that not only is EI effective in proving cognitive skills but also has long term benefits.

The field however is very much divided about the benefits of early development on children with DS. For example, Gibson and Harris (1988), in their review of 21 early intervention demonstration studies for infants with Down syndrome, concluded that evidence has yet to be obtained that children with Down syndrome are better off in EI programming than if they were taken care of by ‘ordinarily prudent parents’.

These findings are also supported by Spiker (1990) who using the same technique has Gibson et al (1988) reported that effectiveness of EI for children with DS remains a premature statement to conclude. However such studies have used comparisons with retrospective data from early studies where expectation was less positive and often failed to consider variables such as medical problems and parental education. Evidence also indicates that there is a wide range of ability amongst individuals with DS and therefore such drawn conclusions are far too rigid and pessimistic.

One way of measuring the benefits of EI programmes on children with DS is to compare it against other children with DS who have not experienced EI. For example Cunningham (1983) compared data gained from their research with cognitive developmental data of several other longitudinal studies. The findings indicated that ‘compared to no intervention, intervention groups attain higher developmental scores’ (Cunningham, 1986:102). More recent longitudinal comparative studies such as those carried out by Connolly et al (1993) and Hines et al (1996) are generally consistent with such findings, thus indicating that EI programmes can have immediate benefits for children with DS including IQ achievement.

In fact skills previously assumed to be beyond the ability of persons with DS are now being taught successfully and that formal skills such as reading are being attained by much younger ages than previously as a result of earlier teaching methods (Bryne et al, 2002). Studies carried out by Pueschel and Hopmann (1993), Farrell and Elkins (1995) and Bryne et al (2002) generally indicate that children with DS can acquire basic reading skills. In addition Buckley et al (1996) having studied individual case histories of older children with DS who had been identified as having better reading levels found that all the children had been taught to read at a young age.

It was therefore concluded ‘…that it might be valuable to start teaching children to read from as early as 2 or 3 years of age’ (p.271).Gains in other areas such as language and memory are less pronounced indicating that children with DS fare better in learning to read compared to all other cognitive skills. However as already noted there are various degrees of intellectual impairment, thus these finding should not blind us to the fact that despite intense early educational activities some children’s developmental capabilities will be more limited than others.

The long term success of EI for children with DS is far more difficult to substantiate. In contrast to findings for children environmentally at risk research on the long term effectiveness of EI for children with DS is often limited and contradictory. This may be attributed to the progressive decline in the rate of development for children with DS. It has been shown that, until adolescence, measured intelligence in children with DS decreases with increasing age (Carr, 2002).

Numerous studies show evidence of loss of previous gains at follow up testing – evidence of regression. However there is enough evidence to suggest that participation in EI will slow that decline down. For example Connolly et al (1993), compared a group of 10 adolescents who had participated in early intervention in Tennessee with 10 age-matched adolescents who had not. They reported that the early intervention subjects had significantly higher scores on measures of cognitive abilities and adaptive behaviour than did the comparison subjects.

Although evidence exists of more advanced development in DS infants, this may not be entirely attributed to EI. According to Cunningham (1986) changes in expectation and child-rearing practices have been equally important. Previously parents of DS children ‘…were given low expectations and little incentive to teach their child…Thus many Down’s syndrome children probably received less stimulation then their normal peers…’ (Cunningham, 1986:102). Family support is pivotal as rearing children with disabilities presents challenges beyond those of rearing a child without disabilities. Theories such as EI have encouraged parents to provide more positive stimulation with DS children and it may be this that initiates development rather than the EI theory itself.

In addition Rao (1997) found that children with DS who attended both centre based educational intervention and integrated pre-school fared better then those who only attended EI programmes. It therefore seems likely that additional stimulation from attending integrated pre-school provisions enhances the effect of EI programmes. Furthermore, ‘…children with Down syndrome not involved in early intervention programs, but attending regular preschools, tend to show higher cognitive functioning than those who are only in home care or receive only home based services’ (Rao, 1997:184). In fact it is now widely advocated that pre-school children with ‘special educational needs’ including those with DS can benefit academically and socially in integrated settings.

The ideological commitments to integration or inclusion, combined with financial constraints of school districts, are now making segregated settings for children with Down syndrome less common. Since the introduction of the Warnock report (1978) government policy has aimed to increase the number of children with ‘special educational needs’ including those with DS to be educated with typical developing peers within mainstream schools. Mainstreaming is often considered to be synonymous with integration.

The fundamental ideal underlying the concept of integration is the belief that people with disabilities have a right to participate in inclusive environments. It’s premise derives from the principle of normalisation which ‘… emphasizes the desirability for people with learning disability to live a lifestyle as close as possible to the norms of the surrounding society’ (Thomas and Pierson, 1995:249) Undoubtedly integration of children with disabilities into mainstream education is an ideal to be desired. But we need to assess whether this process is effective for children with DS in terms of their academic and social development.

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