Including Children with Down Syndrome1

Running head: INCLUDING CHILDREN WITH DOWN SYNDROME

Including Children with Down Syndrome into the General Education Classroom:

Desire, Necessity, and Instructional Strategies

Angela R. Moore

The University of Akron

Including Children with Down Syndrome into the General Education Classroom:

Desire, Necessity and Instructional Strategies

Research shows the majority of parents of children with Down syndrome desire greater inclusion of their children into the general education setting. Children with Down syndrome tend to be highly social and highly functioning, therefore making inclusion a greater possibility (Freeman, Alkin, Kasari, 1999). As children with Down syndrome are incorporated into the general classroom setting, educators are faced with the challenge of successfully integrating these students into their programs. The following examines this topic in four areas. It serves the following:

  1. To give background information on Down syndrome necessary for understanding the points which follow.
  2. To give background information on inclusion.
  3. To explain the increase, desire and usefulness of Down syndrome inclusion.
  4. To examine four highly successful instructional strategies of including children with Down syndrome as identified by Wolpert (2001), and present current research in each area.

This report focuses on these three points. It seeks to explain each and present current research and information, which relates to each area.

Characteristics of Down syndrome

Down syndrome is a medical condition in which children are born with an extra 21st chromosome. Also known as trisomy-21, this condition occurs before birth. While the cause is unknown, the probability of children being born with Down syndrome increases in mothers over the age of 35 (Cunningham, 1982). 7,000 children with Down syndrome are born each year in the United States (Hanson, 1987). The severity of this condition varies in all people. Some may be highly functioning and go on to hold jobs and live independently. Others may require assistance throughout their lives (Cunningham, 1982). Down syndrome can be classified as trisomy-21, in which the extra chromosome is present in all cells, or it can be classified as mosaic, in which only select cells carry the third chromosome (Hanson, 1982).

As stated by Tingey (1988) the physical characteristics of children with Down syndrome are similar in most. These include smaller skulls, shorter necks, creases in the hands, slanting eyes with folds at the corners, protruding tongues, depressed nasal bridges and smaller ears. 40% of children with Down syndrome are born with cardiac defects, many of these requiring heart surgeries. Children with Down syndrome are also characterized by having low muscle tone, which slows their physical development (sitting up, walking, and so forth). Finally, children with Down syndrome are more likely to have deficient gastrointestinal tracts and immune systems (Tingey, 1988).

The intellectual characteristics of children with Down syndrome are also similar but have varying degrees of severity (Appl, 1998). Appl states that most children with Down syndrome score in the mild to moderate range of mental retardation. Some children, however, may be normal or near normal. Children with Down syndrome generally develop in the same sequence as those developing normally; they just develop at a slower rate. Appl also states that their attention spans are shorter and motivation is less than that of children developing normally. They can complete tasks within one step of their current level. Finally, the language development of children with Down syndrome is slower. They often have difficulty with spontaneous speech and intelligible language. Many require the aid of a speech therapist (Appl, 1998).

Characteristics of Inclusion

In order to discuss the usefulness, desire and strategies for including children with Down syndrome into the general education classroom it is necessary to first define inclusion. According to Dover (1994), inclusion is difficult to define. It occurs when a student with special needs is placed in a regular class. After this placement educators and parents adopt a program that meets the individual needs of the student in this new setting. The student then participates in neighborhood schools and general classrooms while being provided with special needs support services (Dover, 1999).

Dover (1994) also states that there is more than one model for inclusion. Full inclusion occurs when a student is placed in a general classroom for 100% of his education. Collaborative inclusion happens when a student participates equally in a general education classroom and a special education classroom. When a special education staff member assists the student in the general classroom it is referred to as support instruction. Social mainstreaming occurs when the student participates in the general classroom for social purposes only. He is not expected to complete assignments and tests. During home class inclusion, the secondary student only participates in homeroom. Pullout or resource inclusion occurs when the student leaves class at set times to work with special education staff. Finally, nonacademic inclusion happens when the student only participates in music, art and physical education.

Finally, Dover (1994) explains that the model of inclusion chosen for an individual student depends on his personal capabilities. This model should be unique and personalized to each individual special needs student. It is the responsibility of the educators and parents to determine personalized inclusion programs that will best suit the individual student. Inclusion works to provide special needs students with the highest quality of education.

Increase, Desire and Benefits of Down syndrome Inclusion

The inclusion of children with Down syndrome and special needs has been increasing since 1975 (Damer, 2001). In this year Public Law 94-142, Education of the Handicapped Act, was issued. It stated that every child must be entitled to “free and appropriate public education” (FAPE) in the “least restrictive environment” (LRE). It also required that all children be placed in an environment appropriate to their abilities, and all school districts pay for the education of special needs children. This Act began what we now refer to as mainstreaming and inclusion (Damer, 2001).

Not only has inclusion for children with Down syndrome been required and increased, it has also been desired. A study by Freeman et al. (1999) examined the perceptions of parents in regards to the schooling of their children with Down syndrome. It found that 80% of the parents tested wanted their children to be included in general education classrooms. It also discovered greater levels of satisfaction among parents of children in these general education classrooms. Another study done by Gilbert, Campbell, and Cuskelly (2003) found that a high percentage of general education teachers who had taught children with Down syndrome believed it to be beneficial to the child. On the other hand, a low percentage of teachers who had not taught children with Down syndrome believed it to be beneficial.

While current research shows the desire for inclusion of children with Down syndrome, it also shows the benefits of Down syndrome inclusion. Freeman et al. (1999) states that inclusion of children with Down syndrome into the general classroom is mainly successful. This experience is enhanced and successful for children with Down syndrome due to their high level of sociability. A study conducted by Wolpert (2001) found that included children with Down syndrome have higher academic gains that those who are segregated.

Successful Instructional Strategies

A study by Wolpert (2001) identified four successful instructional strategies used in the inclusion of children with Down syndrome into the general education classroom. These strategies, listed in order of highest success, are individual instruction, small group instruction, peer tutor instruction and computer assisted instruction. This section examines these four strategies. For each strategy it identifies proof of success, reasons for success, and examples of strategies.

The study by Wolpert (2001) identified individual instruction as the most successful strategy in teaching children with Down syndrome in an inclusive setting. This study questioned 250 parents of children with Down syndrome in inclusive classrooms, and found that parents rated this strategy as “highly successful.” On a scale from 1-5, with 5 being “highly successful,” this strategy had a mean value of 4.46. Along with this finding, Wolpert (2001) also discovered that 94% of the parents stated that the student’s desk was the most effective place for instruction. Not only is this strategy effective, parents encourage it. This point is expressed by an unnamed parent in the study by Freeman et al. (1999) who states, “I would like my daughter to be in the same class she is in now but that she have more attention from her teachers or the teacher’s aide so she can develop more of her talents and mental capacities” (p. 148).

Hendrickson and Frank (1993) give insight into the reason for the success of individual instruction. Through individual instruction teachers are able to assess the individual needs of the student with Down syndrome. He or she is able to personally see the progress and challenges of the student and deal with these on a one-to-one basis. This setting gives the student a greater chance to respond. It is here that the student is free from peer pressure and fear of speaking in front of others. Individual instruction assists in the development of social skills in the child with Down syndrome. The student is able to communicate on a personal level and interact socially with the teacher. Finally, Appl (1998) regards this strategy as effective because it allows the teacher to assume a more active role when giving instructions. Rather than using a form of questioning, the teacher can use directives aimed specifically at the student. Instructions in the form of questions often confuse children with Down syndrome because they give them a choice. During individual instruction the teacher can express his or her exact requests.

The study by Wolpert (2001) identified small group instruction as the second most effective strategy in including children with Down syndrome. On the same 5-point scale, with 5 being “highly effective,” small group instruction had a mean value of 3.86. The success of this strategy occurs for many of the same reasons that individual instruction is successful. Teachers are still able to see the individual needs of the student, and the student still has a higher ability to respond. With small group instruction, however, the child with Down syndrome is able to develop social skills through teacher interaction and peer interaction (Hendrickson & Frank, 1993).

Many specific examples exist when including a child with Down syndrome through individual and small group instruction. Wolpert (2001) suggests modifying activities to also suit the needs of the child with Down syndrome. For instance, a teacher in the Wolpert (2001) study modified her use of Uniflex cubes in the classroom to include a child with Down syndrome. Uniflex cubes are colored and used by students for counting and adding. While the other students used the cubes for these purposes, the child with Down syndrome sorted them by color. This enforced concepts for the child with Down syndrome while also allowing him to be part of the class activities. McCoy (1995) suggests combining basic skills with content matter. For instance, if a teacher were assigning vocabulary words in a social studies unit, he or she could choose specific terms and ask the child with Down syndrome to use them as spelling words or practice writing. It would all be dependent upon the student’s individual abilities. This allows the teacher to keep the child with Down syndrome involved in class activities while assigning him work appropriate to his own level.

The third most successful strategy for including children with Down syndrome, as identified by Wolpert (2001), is peer tutoring. It received a mean average of 3.39 on the 1-5 point scale, and fell closely behind small group instruction. Peer tutoring involves using peers of the same age to reinforce and teach basic concepts to the student on a one-to-one basis. It allows the teacher to serve as manager and facilitator of the information (Wolpert, 2001). A report by Hendrickson and Frank (1993) relate peer tutoring to high levels of achievement among students with disabilities.

The same report by Hendrickson and Frank (1993) also gives insight into the reasons for success of peer tutoring. Peer tutoring positively affects the child with Down syndrome’s self-esteem. He is able to relate to someone of his own age and receive encouragement and support from that person. Peer tutoring, like individual and small group instruction, also assists in social skill development and increases the student’s opportunity to respond. Unlike any other inclusion strategy, however, peer tutoring benefits the tutor by reinforcing learned concepts. Finally, peer tutoring is successful because it allows the teacher to choose specific concepts. These concepts allow for self-pacing and mastery before moving on to new concepts.

Hendrickson and Frank (1993) give a specific example in using peer tutoring. They describe the use of flashcards to reinforce concepts. The tutor holds up these cards, and the tutee gives answers. The tutor awards points for correct answers on the first few tries. At the end of each session the points are calculated and recorded. After receiving a set number of points, the team is given a reward of some sort. These rewards include material things, free time, and so forth. This example can be used as a tool in peer tutoring.

The final successful inclusion strategy stated by Wolpert (2001) is computer-assisted instruction. Computer tutorials can be used to reinforce learned concepts. This strategy had a mean value of 2.98 on the 1-5 point scale (Wolpert, 2001). A study by Trifiletti, Frith, and Armstrong (1984) found that using SPARK-80, a tutorial plus drill and practice program, 40 minutes each day was twice as effective as using only teacher instruction. Hasselbring and Goin (1988) discuss a study that shows the effectiveness of a math program called Fast Facts. The study tested two groups of handicapped students. The first group received only class instruction. The second received class instruction and practice using Fast Facts. The results showed that the group receiving only classroom instruction showed no change, while the group receiving instruction and computer practice increased the number of math facts committed to memory by 73%.

Wolpert (2001) attributes the success of computer-assisted instruction to several factors. First, they are interactive and one-on-one. The student can receive individualized and specific instruction from the computer. Next, the programs are non-threatening to the child with Down syndrome. They provide a consistent quality of rewards and corrections. Finally, these programs use small steps with repetition. This allows the student to move at his own pace, and learn new concepts only after mastery of the beginning concepts. It is important to note, however, that computer-assisted instruction cannot replace teacher instruction (Hasselbring & Goin, 1988). This strategy must be used alongside either tutorials or teacher instruction. It is only effective when concepts are already taught to individuals and stored in their long-term memory (Hasselbring & Goin, 1988).

Many examples of computer-assisted instruction exist. There are a large variety of programs to consider. McCord (2001) explains several things to keep in mind when selecting programs to use for children with disabilities. It is important to look for programs that automatically save students file. This helps the student stay on task and practice the correct concepts. It is also important to make sure the navigation controls are easy to use. A program that is difficult to navigate can confuse and frustrate a student more than assist him. Also make sure the program has a limited number of response options and gives rewards for correct answers. This will keep frustration to a minimum and motivate him to continue with his computer session. A few examples of appropriate computer programs to use for children with disabilities are Children’s Songbook, Music Ace and Music Ace 2, Musicshop, Performer, and Rock Rap’n Roll (McCord, 2001).

The desire of parents and characteristics of children with Down syndrome make it possible to successfully include them into the general education setting (Freeman et. al, 1999). Educators can do this through several models of inclusion (Dover, 1994), and several models of successful instructional strategies (Wolpert, 2001). While individual and small group instruction are shown to be successful, strategies for including a child with Down syndrome can be approached from different angles. These include peer tutoring and computer-assisted instruction (Wolpert, 2001). As more children with Down syndrome are included in the general classroom, educators are able to apply a wide amount of knowledge, resources and instructional strategies to allow for successful inclusion.