Inclusion for Students with HighFunctioning Autism ...

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Psychology in the Schools, Vol. 49(10), 2012 View this article online at wileyonlinelibrary.com/journal/pits

2012 Wiley Periodicals, Inc. DOI: 10.1002/pits.21652

INCLUSION FOR STUDENTS WITH HIGH-FUNCTIONING AUTISM SPECTRUM DISORDERS: DEFINITIONS AND DECISION MAKING JENINE M. SANSOSTI

State Support Team–Region 8, Cuyahoga Falls, Ohio FRANK J. SANSOSTI

Kent State University

General education placements are believed to offer numerous benefits for students with highfunctioning autism spectrum disorders (HFASDs), yet decisions about including students with HFASDs remain controversial. This article presents data from a qualitative analysis of definitions and decision making considerations for a school district with a rapidly increasing HFASD student population. Focus groups and individual interviews were conducted with a diverse group of educators from four elementary schools that offered inclusion placement options as part of their continuum of services. Objectives for this study included documenting how educators from different schools and professional disciplines define and make decisions about inclusion for students C 2012 Wiley Periodicals, Inc. with HFASDs.

Currently, students with high-functioning autism spectrum disorders (HFASDs), namely highfunctioning autism/Asperger syndrome, are characterized as having significant difficulties in social interactions and unusual patterns of interests or behaviors (American Psychiatric Association, 2000). From a cursory view, these characteristics appear to be the same as those diagnosed with classic autism. However, students with HFASDs typically display cognitive functions within the average to above-average range, and, at times, may demonstrate superior intellectual functioning. Moreover, students with HFASDs typically display the ability to speak in grammatically and syntactically correct structures. As a result, many students with HFASDs demonstrate the capacity to attend general education (GE) classrooms. Despite their relative strengths, students with HFASDs should not be regarded as having a mild disorder that requires only minimal educational support. Due to the severity of their social skills limitations, students with HFASDs are at an increased risk of being socially isolated by peers (Locke, Ishijima, Kasari, & London, 2010) and demonstrating mood problems (i.e., anxiety, depression; Berney, 2004). In addition, many students can become easily stressed and emotionally uncontrollable when faced with change and/or environmental stressors, leading to an increased risk of tantrums, noncompliance, and, at times, aggressive behaviors (Myles, 2005). Additionally, contemporary research indicates that the adaptive behaviors/skills (i.e., daily living skills, social communication, motor skills) of students with HFASDs are often lower than their intellectual and/or communicative skills (Lee & Park, 2007; Myles, et al., 2007), suggesting these students will likely struggle to accomplish a variety of daily tasks (Sansosti, Powell-Smith, & Cowan, 2010). Given these challenges, most students with HFASDs will require supportive educational programming throughout their academic tenure, despite their higher functioning abilities. Recent reports from the Centers for Disease Control and Prevention (2012) estimate that an autism spectrum disorder (ASD; including HFASD) currently occurs in 1 in 88 births in the United States. State departments of education have reported similar increases in the numbers of students with HFASDs receiving special education. Recent U.S. Department of Education statistics (USDOE, 2010) indicate that there has been a 35-fold increase in the number of students receiving special Correspondence to: Jenine M. Sansosti, State Support Team–Region 8, 420 Washington Avenue, Cuyahoga Falls, OH 44221. E-mail: [email protected]

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education services under the Autism category. In addition, it is possible that the number of students served under the Autism category underestimates the actual frequency of students with HFASDs who need supportive education, as students with HFASDs may receive services under another special education category (e.g., Other Health Impaired, Specific Learning Disability, or Emotional Disturbance) if they qualify for special services at all (Sansosti et al., 2010). The increased number of students with HFASDs occurs in the context of a growing emphasis on an inclusive model of education. Data from the USDOE (2010) reveals that participation of students with ASDs (statistics specifically related to HFASDs currently are not available) in the GE curriculum for more than 80% of the day increased from 9% in 1992–1993 to 31% in 2005–2006, representing an increase of 244%. Inclusion of students with HFASDs is viewed by many professionals and families as the primary form of treatment or intervention, providing opportunities for acquisition of knowledge and skills and fostering independence and social responsibility (National Research Council, 2001; Starr, Foy, & Cramer, 2001). In general, the extant literature examining student outcomes associated with inclusion reveals positive results, particularly with regard to social engagement. Research has demonstrated that included students with HFASDs not only exhibit higher levels of engagement and social interaction (Dahle, 2003), but also have larger networks of friends or are selected by their peers to be included in activities with the same frequency as students without disabilities (Chamberlain, Kasari, & Rotheram-Fuller, 2007). However, several studies have offered contradictory findings, indicating that students with HFASDs in inclusive environments have fewer friendships, are less accepted by peers, and demonstrate no substantial differences in educational outcomes (Orsmond, Krauss, & Seltzer, 2004). Research on the academic achievement of included students is scarce and continues to be an area in need of further investigation (O’Keefe & Henderson, 2010, April). Although research generally has demonstrated that students with HFASDs can be educated within inclusive settings successfully, there is increasing acknowledgment that some students with HFASDs might benefit from time in segregated programs where they can develop skills that are difficult to train within GE classrooms (i.e., behavioral regulation, adaptive skills) and where they are less likely to be shunned by others. Unfortunately, few criteria and/or guidelines exist for making decisions regarding inclusion of students with HFASDs in GE settings. Although a small number of studies have suggested that elevated IQ, increased communication, and fewer autism-like characteristics lead to placement of students with a ASD in GE (White, Scahill, Klin, Koenig, & Volkmar, 2007), there is little in the literature that elucidates how judgments and decisions for including students with HFASDs are made. Furthermore, an analysis by Yell, Katsiyannis, Drasgow, and Herbst (2003) indicated that individualized education programs (IEPs) for students with ASDs tend to be the most often disputed by parents and often contain procedural errors, including lack of consideration for least restrictive environment. Clearly, decisions about including a student with an HFASD require consideration of multiple complex factors, including individual student needs and educational goals, available supports and best-practice approaches to instruction, and the potential impact of introducing a student with significant instructional and/or behavioral support needs into a GE environment. Additionally, these decisions are filtered through educators’ understandings of inclusive education and its goals, as well as their personal beliefs and attitudes about the appropriateness of including students with HFASDs. At present, little research has documented how these factors affect decisions regarding inclusion of students with HFASDs. The purpose of this study was to explore the attitudes, experiences, and decision-making processes associated with inclusive educational practices for students with HFASDs. Specifically, this study examined: (1) educators’ operational definitions of inclusion; (2) common beliefs regarding inclusion of students with HFASDs; (3) key considerations in making instructional placement decisions; and (4) educators’ evaluations of their schools’ inclusion efforts, including recommendations for improvement. Psychology in the Schools

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M ETHOD Design This study employed a phenomenological perspective (Bogdan & Biklen, 1998), which attempts to understand the meaning of lived experiences, events, and interactions for people in particular situations. Phenomenological research takes the position that the facts of a situation are but one way of understanding it; uncovering the beliefs, attitudes, and perspectives related to a phenomenon provide another mechanism for understanding its occurrence. Within the phenomenological approach, a case study method was used to develop the research design. Case studies can be particularly useful when questions of how and why are being asked about a set of events over which the researcher has little or no control (Yin, 2003). Setting and Participants Participants were selected using purposeful selection (Miles & Huberman, 1994). A mid-sized suburban fringe/rural school district in west central Florida that had demonstrated a disproportionate increase in the number of students on the autism spectrum was identified. At the time of data collection, the school district comprised 37 elementary schools, 20 secondary schools, four alternative/technical schools, and five charter schools, and had a total enrollment of approximately 62,200 students. The most notable characteristic of the district was its rapid projected growth. In 2004, the district approved local funds for building 28 additional school sites to be completed by the beginning of the 2009–2010 school year. Within this same period, the number of students receiving special education under the classification of Autism increased by 288%. This growth rate far exceeded all other special education categories within the district and corresponded with national trends. Such significant expansion led the participating district to expand its capacity to meet the needs of students with ASDs along a continuum of placement/service-delivery options, including both “selfcontained” classrooms for students with ASDs and development of pilot Autism Inclusion programs at four elementary schools (pre-kindergarten through fifth grade). Following identification of the school district, the first author and two district administrators targeted the four elementary schools with Autism Inclusion programs for recruitment of participants. From each of these schools, a list of potential participants was generated based on the following criteria: (a) GE teachers who were responsible for the delivery of inclusive education for students with ASDs; (b) special education personnel at the school (self-contained and resource teachers) who were involved with the instructional and placement decision making for students with ASDs; and (c) additional personnel who were actively involved in the instructional planning and decision making for students with ASDs, including one administrator and up to two specialists (e.g., behavior specialist, school psychologist, speech/language pathologist) from each of the targeted schools. Based on these criteria, over 70 educators were eligible for participation in this study. However, the two focus groups were capped at a maximum of 8 participants, thus limiting the potential number of participants to no more than 16. In all, 15 educators attended two focus group sessions (7 in Group 1, 8 in Group 2) and participated in subsequent individual interviews (see Table 1 for demographic characteristics of the participants). Because there are no firm guidelines for determining the appropriate sample size for qualitative research employing a phenomenological paradigm, researchers agreed that additional participants would be recruited if significant discrepancies were noted among the initial 15 participants such that valid, generalizable conclusions could not be drawn without further data collection (Englander, 2012). However, themes obtained from the 15 participants were highly consistent when triangulated across data sources and did not necessitate further participant recruitment. Psychology in the Schools

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Table 1 Participant Demographics Grade Level

Total Years in Education

Years in Current Position

Pre-K–5 Pre-K–5 Pre-K–5 Pre-K–5 2nd Kindergarten 2nd Primary (K –2nd )

28 38 7 30 4 18 1.5 5

8 8 1 15 4 15 1 1

M.A. (Curriculum & Instruction) M.A. (Guidance Counseling) M.A. (Special Education) M.A (Education) B.A. (Elementary Education) B.A. (Elementary Education) B.A. (Science) M.A. (Special Education)

Pre-K–5

12

6

B.A. (Special Education)

Pre-K

7

2

B.A. (Special Education)

Primary (K–2nd )

4

3

B.A. (Psychology)

Intermediate (3–5)

7

2

B.A. (Psychology)

Pre-K

13

4

B.A. (Education of Hearing Impaired)

Pre-K

6

6

M.A. (Special Education)

Primary (K –2nd )

4

1

B.A. (Psychology)

Position Assistant Principal Principal Behavior Specialist School Psychologist GE Teacher GE Teacher GE Teacher SE Teacher (Inclusion Resource) SE Teacher (Inclusion Resource) SE Teacher (SelfContained/Autism) SE Teacher (SelfContained/Autism) SE Teacher (SelfContained/Autism) SE Teacher (SelfContained/Autism) SE Teacher (SelfContained/Autism) SE Teacher (SelfContained/Autism)

Highest Degree Completed

Note. Participants had a mean of 12.2 total years in education and a mean of 5.1 years in current position. Overall, 9 participants completed their Bachelor of Arts (B.A.) degree and 6 completed their Master of Arts (M.A.) degree. Pre-K = prekindergarten; K = kindergarten; GE = general education; SE = special education.

Data Collection Focus Groups. The first author developed a structured moderator guide and questioning route (Krueger & Casey, 2000) to obtain a comprehensive understanding of the ways educators determine an appropriate instructional placement for students with HFASDs (available on request). This guide was designed to provide a standardized introduction of the project followed by questions intended to address key issues. Initial questions asked participants to describe their personal roles in educating students with HFASDs. Key questions focused on specific issues (e.g., support needs, diagnostic labels, student characteristics) and promoted discussion specific to instructional plans and/or resources, strategies, and supports needed to support the education of a student with an HFASD. Each focus group session was recorded using a digital audio recorder to document the exact comments and interactions during the sessions. Following each focus group, the audio file was downloaded onto a computer as an MP3 file. Field notes also were recorded on the moderating guide/questioning route, including exact comments from participants whenever possible. Individual Interview. Following the focus groups, an individual interview was conducted with each of the participants. The purpose of the individual interview was to explore participants’ experiences, beliefs, and attitudes regarding inclusion in an open-ended manner from multiple personal Psychology in the Schools

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and professional perspectives. To ensure consistency across participants during the interviews, the first author developed a semistructured interview protocol (available on request). The protocol consisted of a series of open-ended questions and a set of prompts to solicit additional information as necessary. Each protocol also contained a brief set of demographic questions to obtain more contextual information about participants’ background and experiences. As with the focus groups, each individual interview was recorded using a digital audio recorder and downloaded onto a computer as an MP3 file. Researcher notes were also recorded on the interview protocol to document each participant’s response to questions. Procedure Researcher Identity Memo. In the qualitative paradigm, the researcher is viewed as the primary instrument for data collection and analysis. As such, it is important for researchers to disclose potential sources of bias within their personal histories or philosophies. A researcher identity memo (Maxwell, 2005) was created by the first author, who led all data collection and analysis efforts. This document detailed personal recollections about her past experiences, current work, and beliefs about the importance of natural community and educational supports. Recruitment. The first author contacted potential school-based participants by telephone to describe the purpose of the study and participation requirements. Individuals were called in a counterbalanced manner that balanced school site and professional role to prevent oversampling individuals from one school or specialized role. Once individuals indicated an interest in participating, educators were assigned to one of the two focus group sessions. Assignments to the two focus groups sessions were counterbalanced with respect to both role (e.g., administrator, specialist, teacher) and school building. Focus Groups and Interviews. Two focus groups were conducted prior to the individual interviews. The rationale for conducting focus groups first was to: (a) assist in “priming” participants for later discussions during individual interviews, and (b) avoid the potential for biasing the larger group dialogue. Prior to starting each focus group, the first author reviewed the purpose of the study, expectations for participation, availability of professional development pay, and protections of identity. Once participants’ signed informed consent was obtained, the first author asked introductory and key questions as previously described. Both focus groups were conducted at the district’s main offices, after school hours, in a private conference room, and each lasted approximately 21/2 hours, with a 15-minute break. After the focus groups were completed, the first author met with each participant and administered the individual interview protocol. The individual interviews were conducted privately after school hours, either at the school site or in a private room located within the district’s main offices. The average interview lasted approximately 60 minutes (range, 45 minutes to 120 minutes). Transcription and Data Validation. The first author transcribed the two focus groups and the subsequent individual interviews. Prior to data analysis, participants reviewed their individual interview transcripts to confirm accuracy. Participants were asked to submit a request for minor modifications (i.e., fewer than five individual words or one phrase/sentence) via email or phone, along with a brief rationale for the change. Eighty percent of the interview transcripts were accepted with no changes; two participants requested minor revisions to their wording to better reflect their meaning, and one participant identified a typographic error. Psychology in the Schools

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Data Analysis While transcribing focus group/individual interview recordings, a theme list for each research question was generated. Consistent with suggestions by Creswell (2007), the first author developed a list of preliminary themes, or common ideas from participants, during the data collection period by reviewing field notes. Themes and codes were later expanded in detail as interview and focus group sessions were transcribed. After a complete set of themes/codes had been developed, an expert panel consisting of four university faculty members with experience in qualitative research and/or special education reviewed them for consistency with the research questions and made five changes, mostly minor. Following certification of the themes/codes, transcripts from both focus groups and one individual interview were electronically coded. A university colleague, who reviewed the coded transcripts to confirm the accuracy of application of themes/codes and to identify uncoded text segments that should have been coded, conducted an internal reliability check. Of the 510 coded text segments in three selected transcripts, eight disagreements were identified (98.4% agreement). Disagreements were resolved in one of three ways: (a) apply an alternative, more appropriate code (n = 2); (b) modify code definition to incorporate the content of disputed text segment (n = 4); or (c) add a new code to capture the content of the disputed text segment (n = 2). Each transcript was read in its entirety to identify responses that were salient to the research questions and representative of emergent themes. On the transcripts, coded text segments were marked such that they were enclosed with brackets (e.g., []) and highlighted. The theme’s code or codes (e.g., 1-A) were entered, along with any additional information about how the theme should be coded and notes about how that segment related to others. Notes also were taken separate from transcripts to describe themes emerging across research questions or within specific participant groups (e.g., educators from a common school, educator roles, parents vs. educators). Finally, a spreadsheet was created, with each code from each transcript listed by participant. Codes were sorted and counted to compile all text segments illustrating major themes. A variety of measures were employed to ensure the validity of this study’s conclusions (Creswell 2007). Triangulation was used to search for convergence across data collection methods (individual interviews and focus groups) and across informant types (general educators, special educators, specialists, and administrators). Researcher reflexivity was established through completion of a researcher identity memo, and prolonged engagement in the field is evident in the first author’s year-long employment in one of the participating district’s Autism Inclusion schools. An audit trail, detailing the specific procedures, instruments, and decision making for the study, was reviewed and approved by the expert panel prior to the onset of the study, and peer debriefing was completed with these same colleagues throughout the data collection and analysis phases. Finally, a summary of results was shared with a select group of participants (member checking); these individuals confirmed that the themes and conclusions of the study were indeed representative of their experiences and views. R ESULTS Educators’ Operational Definitions of Inclusion Across participants, definitions of inclusion varied but a representative overall definition offered by one participant and echoed by many was “to take the kids with special needs and include them in with the Basic Ed kids for as much time as you possibly can.” Beyond the general notion of educating students with disabilities alongside GE peers, participants’ comments indicated that they believed (a) inclusion for students with HFASDs is fundamentally different from inclusion for students with other disabilities, (b) inclusion as a general educational practice is inherently flexible and variable, and (c) inclusion means not being dependent on an adult aide. Psychology in the Schools

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Including Students With HFASDs Is Different From Other Kinds of Inclusion. When asked whether inclusion was different for students with HFASDs compared with students with other types of disabilities (e.g., Specific Learning Disability [SLD], Emotional Handicap), two thirds of educators (n = 10) answered in the affirmative. Several suggested that GE teachers might require more collegial assistance for developing the necessary supports for included students with HFASDs than for students with other types of disabilities. Participants claimed that students with HFASDs in the GE setting often require more support than students with other disabilities and may need supports mostly unique to students with HFASDs (e.g., sensory “diets,” visual schedules, behavioral contracts, social skills instruction). In addition, participants noted that a student with an HFASD may be more likely to stand out in the GE setting than classmates with other types of educational needs due to their social, communicative, and/or behavioral difficulties. One special educator remarked, “A kid with SLD may not appear on the outside as a special needs child . . . whereas little kids will ask, especially our little kindergarteners (imitating voice), ‘Why is [peer with an HFASD] screeching? Why does he do that?’” Inclusion Is Defined on a Case-by-Case Basis. Participants most frequently stated that inclusion was defined on a case by case basis, reporting that a student’s age, academic strengths/weaknesses, communication skills, behavioral support needs, personal preferences, and degree of independent functioning can play an important role in determining what his or her inclusive experience may look like. A first-year GE teacher summarized this view by stating that inclusion “is just another form of differentiated instruction.” This individualized definition of inclusion was seen by educators as both a strength of the approach, in that students’ supports matched their needs, and a challenge because there was no one clear definition to guide schools and teachers in developing inclusive education. When defining inclusive education as a case-by-case endeavor, participants often referred to the amount of time a given student with an HFASD spends in the GE setting as an important variable. Participants noted that students with HFASDs were more likely to be placed in a GE setting on a full-time basis; children with lower-functioning autism were more likely to be placed in a selfcontained special education classroom, but have “inclusion time” in which they visited GE settings on a limited basis (e.g., recess, circle time, math). However, several educators stated that only when GE students recognize the child with an HFASD as their classmate and peer do they consider the child to be “truly included.” Inclusion Means Not Being Dependent on an Adult Aide. A consistent theme was that if a student is dependent on a full-time adult aide to be in a GE setting, he or she is “not truly included.” Although 3 participants described the use of a one-on-one aide as a potentially useful support, far more participants (n = 9) contended that the use of a full-time aide could be a barrier to the student’s integration into the GE environment. To explain their resistance to relying on one-on-one aides for students with HFASDs, educators described many instances of students becoming dependent on the aide rather than accessing more naturalistic forms of support available in the GE setting (i.e., peers or teachers). For example, 1 participant indicated that when students with HFASDs are paired with an aide on a full-time basis, the child [is] basically just learning to interact with that adult, not really the mainstream. And then the child never has to wait their turn! Or share materials, or. . . . That one-on-one para provides all of the cues for them to socially interact, “now’s the time, now you do this,” they don’t have it on their own.

Participants also indicated that students receiving one-on-one adult support may miss out on some learning opportunities because the aide may anticipate and/or intervene in or prevent conflict Psychology in the Schools

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situations that might have been beneficial for students with HFASDs to experience. In general, most participants stated that students in GE settings with a full-time one-on-one aide would not be exposed to the social, academic, and behavioral expectations of the mainstream setting. Educators’ Attitudes and Beliefs Regarding Inclusion of Students With HFASDs Throughout focus groups and interview discussions, educators spoke in mostly positive terms about inclusive education. Specifically, participants declared that inclusion was a valuable practice that could yield positive outcomes not only for students with HFASDs, but also for GE peers and teachers. The most commonly noted benefits were: (a) inclusion accelerates the skill development of students with HFASDs through engagement in challenging academic tasks and new social situations, and (b) entire classes of students can benefit from class-wide implementation of behavior supports and teaching of social skills. Participants also provided insights on sources of educators’ resistance to including students with HFASDs. Inclusion Accelerates Student Development. Educator participants acknowledged that students with HFASDs are likely to need and benefit from access to typically developing peers who model age-appropriate skills. Several participants used a variation of the word “force” (e.g., “inclusion forces them to develop,” or “they’re practically forced to make progress”), suggesting that GE peers’ and teachers’ high expectations have a powerful impact on student motivation and provide numerous opportunities for skill development. Social skills and communication most often were cited as skills that increase dramatically in inclusive environments. For example, 1 participant noted that she had seen the “will for communication” increase when students with HFASDs found themselves surrounded by receptive communication partners. Similarly, a GE participant came to this realization after observing that her previously included student in a self-contained context (a summer program for students with disabilities) had regressed in some of his social skills without the opportunities for peer interaction afforded in his inclusive classroom. She asserted that this observation would be her single biggest reason for supporting inclusive education. Comments from educator participants suggested they attribute much of inclusion’s positive impact on students with HFASDs to peer modeling. The majority of participants believed that inclusive placements offer students with HFASDs the opportunity to imitate desirable behaviors (e.g., sitting quietly during instruction, making conversation, participating in reciprocal activities). In addition, peer models in the GE setting also were credited with helping to extinguish some undesirable behaviors. One participant offered a slightly different perspective, indicating that imitating others’ behavior is a skill that may or may not be present in all students with HFASDs. She asserted that when present, imitation is an asset in the inclusion setting; however, when absent, imitation can and should be taught directly as a part of social skills instruction. Class-Wide Strategies Can Benefit All. Educators consistently stated that the strategies often used for included students with HFASDs can be useful for GE students with similar difficulties and are best implemented class-wide. Participants further stated that class-wide strategies can assist in integrating the student with an HFASD into the GE environment by ensuring the student does not “stick out” from GE peers as the only child needing a particular support. In addition, participants noted that environmental (e.g., class-wide picture schedules), and/or behavioral supports not only establish a comprehensible and motivating environment for the student with an HFASD, but also may help the entire group of students know and understand expectations. For students in primary grades, many of the deficient skills requiring instruction or intervention for students with HFASDs (e.g., social interaction skills, mastery of classroom routines, independent work behaviors) also are still emerging in typically developing students. Psychology in the Schools

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Sources of Resistance to Inclusion. Although the educators in this study viewed inclusion of students with HFASDs positively, they also noted elements of resistance among their colleagues. Specifically, participants identified that teachers’ limited understanding of HFASDs was the single most significant barrier to successful inclusion. In general, participants stated that teachers receive inadequate training about HFASDs, and more than half of the participants (n = 8) also reported that the average educator with limited training and exposure to individuals with HFASDs harbors stereotypical or significantly limited definitions of the disorder. Participants suggested that GE teachers faced with the prospect of having a student with an HFASD in their classroom for the first time might rely on media portrayals of individuals with autism and/or might associate any diagnosis of autism with characteristics typical of lower-functioning individuals. In addition to a limited understanding of HFASDs, participants indicated that teachers new to inclusion might find their assumptions and expectations about traditional instruction and classroom management to be challenged. For example, delivering large-group instruction via lecture may be ineffective due to the weaker receptive language skills of some students with HFASDs. Similarly, several participants attested that possessing uniform behavioral expectations for all students within a classroom would be detrimental to success for a student with an HFASD who may have difficulty inhibiting off-topic comments or remaining seated for long periods. Beyond learning how to accommodate students with HFASDs, several participants indicated that some teachers find it unfair to do so (i.e., constitutes preferential treatment). Factors Impacting Placement Decisions for Students With HFASDs Although most participants emphasized the benefits of inclusion for students with HFASDs, they also clarified that inclusion is not necessarily the right choice for all students with HFASDs. Throughout both focus groups and individual interviews, educators’ decision rules for instructional placements focused on: (a) characteristics of students with HFASDs, (b) the impact of inclusion on typically developing peers. and (c) the availability of resources and personnel. Student Characteristics. Although participants described many potential benefits for students with HFASDs in inclusive education, they also identified certain characteristics that made some students with HFASDs better candidates for inclusion than others. Behavioral functioning. When asked to describe an ideal inclusion candidate in their individual interviews, the first response of more than half of the participants (n = 8) involved a student’s behavioral functioning, including emotional control and independence in classroom activities. Educators in both focus groups spoke at length about the impact that behavioral functioning can have on these decisions; one participant described behavioral functioning as “driving the success of inclusion.” Overall, three categories of behavior emerged: (a) desired behaviors seen as necessary for success in the GE setting (e.g., ability to work independently, problem solve or tolerate new/unfamiliar situations, meet basic classroom behavior expectations); (b) tolerated behaviors that were distracting or disruptive but could be managed in GE (e.g., off-task behavior, noisemaking, task refusal); and (c) unacceptable behaviors that, if chronic, could suggest the need for a more restrictive placement (e.g., self-injury, severe tantrums, physical aggression toward peers). Several participants maintained that physically aggressive or other significantly maladaptive behaviors should not preclude an inclusive placement for a student with an HFASD. The Inclusion Resource and GE teachers from one school described a student whose frequent and severe aggressive behavior was hindering his progress in the mainstream setting, but also acknowledged his need to receive academic instruction that matched his high intelligence and skills.

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Academic skills. Participants consistently suggested that the GE setting offered the most rigorous academic curriculum and opportunity for grade-level instruction. Although behavior was many educators’ first consideration generically, special educator participants suggested that a student’s excellent academic skills had been another important consideration when recommending the child for an inclusive classroom. Although several participants indicated that students with HFASDs do not need to understand everything to come into inclusion, a majority agreed that a minimum level of academic skills is necessary, even when instruction or assignments are modified. Participants varied in their expectations concerning how far below average a student with an HFASD could afford to be in a GE setting. For example, some special education participants (self-contained teacher and Inclusion Resource) expected that a good inclusion candidate must have at least kindergarten-level skills to be included anywhere in the primary grades (kindergarten through second grade), whereas a GE teacher and an Inclusion Resource from a different building suggested that students should be on grade level or close to it and able to keep up with the class. Notably, whereas one GE participant had defined inclusion as being “just another form of differentiated instruction” in the focus group setting, she later elaborated in her personal interview that children whose “educational level is far below, [so] that your instruction is affected” are less than ideal candidates for inclusion. Participants also observed that when classroom instruction is significantly above the level of the student with an HFASD, the potential for frustration and possibly challenging behavior increases. For this and other reasons, educators consistently stated that inclusion is generally easier to begin in the primary grades when the skill gap between the student with an HFASD and her or his GE peers is likely to be smaller. Communication skills. When it came to characteristics of good inclusion candidates, communication skills were discussed less frequently, but 75% of participants (n = 12) cited communication as an important ingredient in the success of an included child with an HFASD, particularly if the child is to be a full member of a GE classroom. Participants gave more consideration to a child’s expressive skills than to receptive skills in making placement decisions. One participant, a Behavior Specialist, stated that students in inclusion need “some way to let you know that they are having difficulties with it, other than screaming and throwing themselves on the floor.” Adaptive skills. Toilet training emerged as the single most significant self-care concern among educator participants. Of the 7 educators who discussed this issue, 5 asserted that students in inclusive settings need to be independent in the toileting routine. Two self-contained special education teachers who felt that the lack of toilet training should not keep a child from GE, and could in fact help promote development in this area, were in the minority. In reconciling the characteristics of students who make ideal or less-than-ideal inclusion candidates, several educators reiterated that all students with HFASDs should be included in some fashion, although students with more significant adaptive deficits may participate on only a part-time basis or may require additional adult support to be successful in the GE setting. Impact on Peers. Educator participants were clear that the inclusion of a student with an HFASD should not compromise the learning, safety, or overall well-being of GE peers. In large part, concerns about inclusion’s potentially negative impact on GE peers were tied to the degree of problem behavior exhibited by the student. Participants noted that the challenging behaviors of a student with an HFASD can be distracting or disruptive to the classroom environment and that many teachers worry about the impact these disruptions will have on other students’ achievement. Physical aggression or tantrums may pose a safety risk to the student with an HFASD and/or others in the setting. Finally, several educators indicated they struggle with the message that challenging behavior can send to GE peers and their parents. One participant commented, Psychology in the Schools

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if you have a kid who is physically aggressive and is going to hurt another kid, I don’t think it’s appropriate at all because I don’t think that’s the correct, um, message you want to send to kids that it’s okay.

Educators indicated that when GE students become fearful of an included child with an HFASD, they tend to share these concerns with their parents. Parents in turn voice their concern to teachers and administrators, and several participants noted that this may cause building administrators to be less receptive to including students with ASDs in the future. Availability of Resources and Personnel. Some participants indicated that when there are fewer support personnel available (e.g., having only one Inclusion Resource Teacher), educators are likely to face challenges, such as (a) conflicts among staff regarding which students need the most support; (b) conflicts with parents when requested services exceed the personnel or resources available in the building; (c) frustration among service providers who feel they are unable to adequately meet the needs of all the students on their caseload; and (d) an overall reduction in capacity for including students with HFASDs. In the latter circumstance, some students may need to attend a different school building to obtain an inclusive placement or may be recommended for a more restrictive placement, even when the team has evidence to suggest the student could be successful in inclusion with the appropriate support. Evaluations of Inclusion and Recommendations for Improvement Educators offered many personal experiences in inclusive education and suggested that they frequently observed positive outcomes for included students with HFASDs. Just over half of participants gave an overall positive evaluation of inclusion in the district as a whole (n = 8), but often referenced the degree of their own effort when making that evaluation. Their comments suggested that constant reworking and persistence are defining characteristics of effective inclusion on both an individual and system level. Participants used phrases such as “making it work,” “trial and error,” or “go back to the drawing board” to convey their ongoing efforts. Participants also indicated that the effectiveness of inclusion for any given child may fluctuate as a result of changes in life circumstances, new triggers, and overall development and that responsiveness to student needs is generally an important characteristic of effective inclusion. District-wide initiatives supporting inclusive education were noted as being critical to the success of students with HFASDs in GE settings, including the Autism Inclusion programs at four elementary buildings, two district-wide Inclusion Facilitators, and many in-service training opportunities on issues related to both inclusion and ASDs. The remaining participants (n = 7) provided conditionally positive evaluations of the district’s inclusion efforts (e.g., “inclusion is effective if . . .” or “inclusion is effective when . . .”). These educators referenced student characteristics as predictors of successful inclusion and suggested that inclusion can be effective for a student with an HFASD when the student is right for inclusion and when the necessary supports are in place. Although none of the educators offered evaluations of the inclusion efforts that were negative, many offered recommendations for improving inclusion at the building and district level. Several participants advocated for consistency in building and district-wide policies and procedures related to placement decisions and instructional support for inclusion. For example, several educators emphasized that some schools without autism-specific programming had referred new students with HFASDs to an “autism school,” even when the student’s neighborhood school had all of the adequate supports to meet that child’s needs in the GE setting. Participants felt that a consistent district policy regarding service delivery and inclusion would help to support the shared responsibility for educating students with HFASDs across all district schools. Psychology in the Schools

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Sansosti and Sansosti D ISCUSSION

Overall, participants in this study shared decidedly positive ideas about the value of inclusion for students with HFASDs and their GE peers. All levels of educators (GE, special education, support specialists, administrators) unequivocally agreed that inclusive education was necessary and beneficial for students with HFASDs who are especially likely to benefit from access to typically developing peers who model age-appropriate social skills and behavior. Specifically, participants in this study suggested that participation in GE “forces” children with HFASDs to develop new skills because of high expectations from peers and adults, clear standards of appropriate/inappropriate behavior, and availability of positive peer models. Such findings are consistent with prior research indicating that included students with HFASDs increase levels of engagement and social interaction (Bauminger, 2002; Dahle, 2003) and demonstrate less social isolation (Chamberlain et al., 2007). In addition, educators asserted strongly that inclusion could be beneficial for typical students by infusing additional curricular, environmental, or behavioral supports into the classroom and by helping them learn to understand and support their peers with learning and/or behavioral differences. Despite near unanimous agreement that some degree of participation in GE classrooms or with typically developing peers can be beneficial, participants also stated that full-time inclusion may not be appropriate for every student with an HFASD. Moreover, decisions about inclusion should be made on an individual, case-by-case basis. In general, two key considerations appeared to influence educators’ placement recommendations: (a) access to intensive academic curriculum (perceived as more available in less restrictive placements such as GE) and (b) access to intensive behavioral supports (perceived as more available in more restrictive placements such as self-contained classrooms). Given that intensive academic curriculum and intensive behavior support generally were seen as being mutually exclusive, children demonstrating a need for both were perceived by participants as the most challenging to place within inclusive environments for significant portions of the day. Educators in this study cited strong academic skills as the biggest impetus for recommending an inclusive placement; however, they further noted that significantly challenging behavior was the single biggest reason for discontinuing a child’s placement in a GE classroom. It is likely that the positive effects of inclusion (both actual and perceived) are reduced if a student with an HFASD cannot regulate his or her emotions and displays frequent inappropriate behaviors or outbursts. Violation of the rules within GE environments may result in peer rejection, leading to decreased social acceptance and willingness to interact (Myles, 2005; Swaim & Morgan, 2001). Moreover, teachers in GE classrooms may lack the appropriate enthusiasm, training, and/or support to accommodate the needs of a student with an HFASD who has difficulty regulating behaviors. Of particular concern, participants in this study placed far less emphasis on a student’s level of social skills deficits when making placement decisions. Given the high degree of variability in social functioning among individuals with HFASDs, failure to consider social skills difficulties as part of placement decision making is a significant liability. It may be that educators in this study were less familiar with the link between social–emotional skills, behavioral regulation, and academic progress, and may focus more on the topography of behaviors rather than underlying causes. Alternatively, such findings could be a reflection of the district’s limited knowledge and/or resources needed to deliver specialized social skill curricula for individuals with HFASDs. Schools that offer preventative instruction to improve the social functioning of all students, as well as targeted interventions for students with HFASDs or other social needs, are best positioned to prepare their student population for the complex social world (Sansosti, 2010; 2012). A similar concern exists in the manner in which participants narrowly focused on toilet training as the sole adaptive behavior concern of students with HFASDs. This suggests a misunderstanding of, and underserved need for, the supports students with HFASDs should receive within schools. Research indicates that the adaptive behavioral Psychology in the Schools

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functioning of students with HFASDs consistently appears to be depressed despite elevated cognitive and communicative abilities (Lee & Park, 2007; Myles et al., 2007). Failure to adequately identify social and adaptive skill deficits and develop necessary interventions as part of the decision-making process could impede the overall outcomes for students with HFASDs. Throughout the focus groups and individual interviews, general educators’ resistance to inclusion was a repeated concern. Lack of pre-service and in-service training and experience working with students with HFASDs emerged as the identified cause of resistance to inclusion. Educators reported that positive exposure to students with HFASDs was necessary, but insufficient, to prepare them for their own experiences in inclusion. Increased professional development prior to licensure, as well as ongoing professional development was seen as essential for all staff to meet the needs of students with HFASDs. In general, participants viewed the overall effectiveness of inclusion efforts within the district positively. However, their positive beliefs about inclusion and its inherently variable nature sharply contrasted with their recommendations for improving inclusive service delivery. Although educators asserted that the flexibility to make placement decisions for students with HFASDs on a case-by-case basis was key to the success of inclusion, they expressed discontent that the district did not provide a more prescriptive approach. It is possible this group of educators perceived that they are engaged in best practices with respect to inclusive programming for students with HFASDs and wished to see those practices replicated throughout the district; consistent district policies may also serve to validate these educators’ practices when conflicts arise with colleagues, representatives from other school buildings, or parents. Implications for Educational Practice The contextual findings of this study offer several implications for the refinement and improvement of inclusive education for students with HFASDs. Most notable is the need for professional development for all educators and support staff. Specifically, professional development appears warranted in three key areas: (a) general and thorough understanding of the instructional implications of HFASDs; (b) assessment strategies for analyzing the specific support needs of individual students with HFASDs; and (c) techniques known to be effective for improving the behavioral, social, and academic outcomes of students with HFASDs. Beyond these specific areas, professional development should focus on the realities of inclusion and provide necessary information about differentiated instruction and strategies with HFASDs. In addition to training, districts need to identify, evaluate, and implement the use of assessment methods that consider both a child’s functioning (e.g., abilities, skill deficits) and program characteristics (e.g., availability of social skills curricula, behavioral supports), as well as tools for progress monitoring. Limitations of the Present Study Results of the current analysis may be limited by several factors. First, the participating district may not be a typical entity in their approach to inclusive education for students with HFASDs. It is reasonable to suggest that the district’s supportive structure (e.g., Autism Supervisor, Inclusion Specialists, Autism Inclusion classrooms) is more likely to facilitate inclusive programming for students with HFASDs than in districts without such supports. Second, the participants may have represented a group of professionals who were more knowledgeable about autism and possessed a positive disposition about inclusion. Moreover, those who agreed to participate were those willing to attend a scheduled meeting over the summer, indicating an interest in the topic beyond that of their colleagues. As such, the extent to which the participants’ reports are representative of all educators in other locales is not known. Finally, with respect to data analysis, it is noted that only three of the Psychology in the Schools

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18 total transcripts (two focus group, 16 interview) were reviewed for accuracy of coding. A more thorough approach to data validation (e.g., external audit; Creswell, 2007) would provide additional confirmation of the high agreement observed in the sample transcripts selected for review. Recommendations for Future Research Future research may benefit from more direct observation or systematic analyses of the actual process of educational decision making within multidisciplinary teams. It also will be imperative to understand the perspective and considerations of parents of students with HFASDs as they participate in the placement decision-making process. Yell et al.’s (2003) finding that IEPs for students with ASDs tend to be the most frequently disputed and often contain procedural errors suggests that educators and parents may have markedly different views when deciding the educational placement of students with HFASDs. Future studies should also attempt to study the broad outcomes of included students with HFASDs. A quantitative group design study examining variables such as retention, performance on high-stakes tests, and postsecondary outcomes (e.g., employment, college enrollment) could help determine the impact of inclusion on major educational benchmarks. Controlling for relevant personal characteristics that likely contribute to these outcomes would be an essential part of such a study. R EFERENCES American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev.). Washington, DC: Author. Bauminger, N. (2002). The facilitation of social-emotional understanding and social interaction in high-functioning children with autism: Intervention outcomes. Journal of Autism and Developmental Disorders, 32, 283–298. doi:10.1023/A:1016378718278 Berney, T. (2004) Asperger Syndrome from childhood into adulthood. Advances in Psychiatric Treatment, 10, 341–351. doi: 10.1192/apt.10.s.341 Bogdan, R. C., & Biklen, S. K. (1998). Qualitative research in education: An introduction to theory and methods (3rd ed.). Boston, MA: Allyn & Bacon. Centers for Disease Control and Prevention. (2012). Autism and Developmental Disabilities Monitoring Network. Retrieved from http://www.cdc.gov/ncbddd/autism/addm.html Chamberlain, B., Kasari, C., & Rotheram-Fuller, E. (2007). Involvement or isolation? The social networks of children with autism in regular classrooms. Journal of Autism and Developmental Disorders, 37, 230 – 242. doi: 10.1007/s10803-0060164-4 Creswell, J. W. (2007). Qualitative inquiry and research design: Choosing among the five traditions. Thousand Oaks, CA: Sage Publications. Dahle, K. B. (2003). Services to include young children with autism in the general classroom. Early Childhood Education Journal, 31, 65 – 70. doi: 10.1023/A:1025193020415 Englander, M. (2012). The interview: Data collection in descriptive phenomenological human scientific research. Journal of Phenomenological Psychology, 43, 13 – 35. doi: 10.1163/156916212×632943 Krueger, R. A., & Casey, M. A. (2000). Focus groups: A practical guide for applied research (3rd edition). Thousand Oaks, CA: Sage Publications. Lee, H. J., & Park, H. R. (2007). An integrated literature review on the adaptive behavior of individuals with Asperger syndrome. Remedial and Special Education, 28, 132 – 139. doi: 10.1177/07419325070280030201 Locke, J., Ishijima, E. H., Kasari, C., & London, N. (2010). Loneliness, friendship quality and the social networks of adolescents with high-functioning autism in an inclusive school setting. Journal of Research in Special Educational Needs, 10, 74 – 81. doi: 10.1111/j.1471-3802.2010.01148.x Maxwell, J. A. (2005). Qualitative research design: An interactive approach (2nd ed.). Thousand Oaks, CA: Sage Publications. Miles, M. B., & Huberman, A. M. (1994). Qualitative data analysis: An expanded sourcebook (2nd Ed.). Thousand Oaks, CA: Sage Publications. Myles, B. S. (2005). Children and youth with Asperger syndrome: Strategies for success in inclusive settings. Thousand Oaks, CA: Corwin Press. Myles, B. S., Lee, H. J., Smith, S. M., Tien, K., Chou, Y., Swanson, T. C., & Hudson, J. (2007). A large-scale study of the characteristics of Asperger syndrome. Education and Training in Developmental Disabilities, 42, 448 – 459. Psychology in the Schools

DOI: 10.1002/pits


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National Research Council. (2001). Educating children with autism. Washington, DC: National Academy Press. O’Keeffe, S., & Henderson, J. (2010, April). Lifting the restrictions from the least restrictive environment. Paper presented at the 2010 Council for Exceptional Children Convention, Nashville, TN. Orsmond, G. I., Krauss, M. W., & Seltzer, M. M. (2004). Peer relationships and social and recreational activities among adolescents and adults with autism. Journal of Autism and Developmental Disorders, 34, 245 – 266. doi: 10.1023/B:JADD.0000029547.96610.df Sansosti, F. J. (2010). Teaching social skills to children with autism spectrum disorders using tiers of support: A guide for school-based practitioners. Psychology in the Schools, 47, 257 – 281. doi: 10.1002/pits.20469 Sansosti, F. J. (2012). Reducing the threatening and aggressive behavior of a middle school student with Asperger’s syndrome. Preventing School Failure, 12, 8 – 18. doi: 10.1080/1045988X.2010.548418 Sansosti, F. J., Powell-Smith, K. A., & Cowan, R. J. (2010). High functioning autism/Asperger syndrome in schools: Assessment and Intervention. New York, NY: Guilford Press. Starr, E. M., Foy J. B., & Cramer, K. M., (2001). Parental perceptions of the education of children with pervasive developmental disorders. Education and Training in Mental Retardation and Developmental Disabilities, 36, 55 – 68. Swaim, K. F., & Morgan, S. B. (2001). Children’s attitudes and behavioral intentions toward a peer with autistic behaviors: Does a brief educational intervention have an effect? Journal of Autism and Developmental Disorders, 31, 195 – 205. doi: 10.1023/A:1010703316365 U.S. Department of Education. (2010). Twenty-ninth annual report to Congress on the implementation of the Individuals with Disabilities Education Act. Retrieved from http://www2.ed.gov/about/reports/annual/osep/2007/parts-bc/index.html#download White, S. W., Scahill, L., Klin, A., Koenig, K., & Volkmar, F. (2007). Educational placements and service use patterns of individuals with autism spectrum disorders. Journal of Autism and Developmental Disorders, 37, 1403 – 1412. doi: 10.1007/s10803-006-0281-0 Yell, M. L., Katsiyannis, A., Drasgow, E., & Herbst, M. (2003). Developing legally correct and educationally appropriate programs for students with autism spectrum disorders. Focus on Autism and Other Developmental Disabilities, 18(3), 182 – 191. doi: 10.1177/10883576030180030601 Yin, R. K. (2003). Case study research: Design and methods (2nd ed.). Thousand Oaks, CA: Sage Publications.

Psychology in the Schools

DOI: 10.1002/pits

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