Snaefridur Thora Egilson

Assistance to pupils with physical disabilities in regular schools: promoting inclusion or creating dependency?

Drawing on the perspectives of pupils with physical disabilities, their parents and teachers, this study explored the adult support provided to pupils with physical disabilities in regular schools. Data were collected through observations at schools and qualitative interviews. In all, 49 individuals participated in this study: 14 pupils with physical disabilities, 17 parents, and 18 teachers. Six themes emerged that characterised the provision of assistance: (1) roles and responsibilities; (2) quantity and content of support (3) proximity to the pupil, (4) school priorities, (5) independence and autonomy of the child; and (6) the relationship between the teacher and the assistant. An over‐reliance on adult support was found for some pupils and contexts, while this support appeared to be under‐utilised or ineffectively delivered in other situations. Lack of modifications of the traditional curriculum, teacher instructions, and educational activities increased the pupils’ need for adult support in school. While it is acknowledged that teacher assistants can make valuable contributions in promoting participation and learning among pupils with disabilities, it is argued that the constant presence of an assistant can result in limited use of the children’s strengths and may possibly create unnecessary or unhealthy dependencies. The findings signify that the education system must align with important stakeholders – the pupils, their parents, and external support services – to identify alternative ways to promote participation and learning of pupils with disabilities in regular schools.

Theoretical perspectives and childhood participation

Abstract The concept of participation is at the centre of the concerns of those occupied with issues of disability. Although commonly used, it is seldom well defined and is conceptualized in different ways by different authors. This paper explores participation by juxtaposing conceptual frameworks of disability and the results of a recent study of school participation of disabled children. We start by outlining important conceptual frameworks in understanding disability, such as the International Classification of Functioning, Disability and Health (ICF) and social perspectives. We then present the study results which reveal participation as a complex interaction between the child and his or her environment where individual aspects interact with contextual requirements of different school settings. Viewed from the findings of this study none of the theoretical perspectives considered entails the level of complexity that is necessary to understand all the aspects of participation of the disabled children i...

School Participation of Pupils with Physical and Psychosocial Limitations: A Comparison:

Several features in the school environment affect pupils with disabilities, serving as either supports or barriers to their school participation. The purpose of this study was to investigate and look for differences in the pupil-environment fit of students with physical and psychosocial limitations, using the School Setting Interview (SSI). The SSI is a client-centred instrument, which focuses on school activities where adjustments need to be made to accommodate pupils with disabilities and to enable their participation. Descriptive statistics and Mann-Whitney U tests were employed to compare the fit of the two groups and their school environment. The results reveal that, in order to participate actively, both groups of pupils required adjustments to many school settings. Pupils with physical limitations frequently need adjustments, but their needs were met by the schools to a more satisfactory extent than were the needs of pupils with psychosocial limitations. The findings support the usability of the SSI for pupils with various types of limitations. They also stress the importance of eliciting the perspectives of the pupils themselves in order to facilitate the planning and implementation of client-centred occupational therapy interventions in school.

Evaluation of therapy services with the Measure of Processes of Care (MPOC-20): The perspectives of Icelandic parents of children with physical disability

The aim of this population-based study was to examine how parents of Icelandic children with physical disability view the services of physical, occupational, and speech therapists and how family centered those services are. A secondary aim was to compare the differences of parental perceptions of therapy services based on age, residence, and disabilities. Parents of 88 (46%) children aged 2–18 answered the Measure of Processes of Care–20 (MPOC-20), and six parents participated in a focus group interview. Descriptive data were used to explore central tendency and variability, and comparisons were made using analysis of variance. Overall, the parents found the therapy services respectful, supportive, and coordinated; they felt enabled in their parent role and worked mostly in partnership with the professionals. Nevertheless, parents perceived they received insufficient information from therapists. Parents reported a wish for more cooperation, teamwork, and a key worker. Findings indicate that the MPOC is reliable and easy to use within the Icelandic context.

School function assessment: performance of icelandic students with special needs

The purpose of this study was to determine the performance of a sample of Icelandic students, aged 6 to 12 years, with various impairments, on the School Function Assessment (SFA). The SFA was administered to 75 Icelandic students with identified special needs, 35 with physical impairments and 40 with cognitive/behavioral impairments. Both diagnostic groups demonstrated most participation in mealtime/snack time but had low scores on the school playground. Differences were found between the two study groups on all three parts of the instrument, with higher performance and participation scores for the students with cognitive/behavioral impairments. The findings raise the awareness of some of the challenges encountered by Icelandic students with special needs and indicate the importance of adapting Icelandic school settings to promote social participation of all students.

Performance of Extremely Low Birthweight Children at 5 Years of Age on the Miller Assessment for Preschoolers

The purpose of this geographically defined national study was to evaluate the performance of extremely low birthweight children (ELBW < 1000g) born in Iceland in 1991-1995 and compare them to a cohort of matched control children born full term. The Miller Assessment for Preschoolers (MAP) was used to provide an overall profile of 32 ELBW children and 55 control children at 5 years of age. The results indicated that score patterns on the MAP between ELBW and normal birthweight children differ. The differences were significant on the Total Score, and the Foundations, Coordination, and Complex-Tasks Indices. This study found that the ELBW group had specific problems in basic motor tasks, coordination, and fine motor skills. The results validate the need for early assessment, regular follow-up, and consultation to promote optimal task performance and social participation of children born prematurely.

Family-centred services for young children with intellectual disabilities and their families: Theory, policy and practice:

This paper outlines the reported discrepancies between the aims of the welfare services in Iceland and the experiences of parents raising young children with intellectual disabilities. Prevailing views on disability and service delivery were also considered. A multi case study design was employed to reflect the situation in different parts of the country. Families of eight children with intellectual disabilities and professionals in three different municipalities formed the cases. The findings reveal a high convergence between the three cases with variations based on individual experiences rather than geographical location. Overall, parents praised the preschools but experienced support services often as fragmented and uncompromising. Particular components of the services were consistently regarded as hard to reach and not in accordance with the needs of the family. Cultural-historical activity theory is introduced as a beneficial framework for further study and system improvement.