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I AM AMONG YOU,SIMILAR, DIFFERENT, EQUAL…

(For all those who have chosen the teaching profession)

Lidra Remaçka

Marina Ndrio

Florian Kulla

Tirana 2014

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The manual was prepared with the support of the organisation World Vision Albania, in cooperation with the “Association for the Protection of Persons with Disabilities” (MEDPAK) and the Ministry of Education and Sports

The following persons worked on drafting this manual and the progress of the project:

Florian Kulla, University of Tirana, Department of Social SciencesMarina Ndrio, University of Tirana, Department of Social SciencesZela Koka, MEDPAKPranvera Kamani, Ministry of Education and Sports (MES)Brisida Jahaj, World Vision Albania and KosovoRidiona Stana, World Vision Albania and Kosovo

Leader of the working group: Lidra Remacka, International Alliance “Sustainability Frontiers”

Project manager: Emiljano Kaziaj

During the drafting of the manual, groups of teachers, principals, students and representatives of Regional Education Directorates were consulted and gave their contribution in the districts:

Tirana: Ahmet Zogu School, Bathore; Emin Duraku School, University of Tirana, Planetary UniversityVlora: Hoshtime, Panaja, Trevellazer, Babice e Madhe, Babice e VogelDurrës: New School, Qemal Mici School, 14 Nentori School, Aleksander Moisiu UniversityElbasan: Murriqan, Polis i Vogel, Xibrakë

Editor: Nancy Verrall Warren, NVW Communications

Cover: Nimfa Jaço

Photographs: Photo Voice Charity Organisation, in cooperation with World Vision Albania, implemented the project ‘Able Voice‘in the area of Shushicë and Shirgjan in the region of Elbasan, in order to amplify the voices of young children with disabilities to discuss and make decisions on issues that affect their lives in their communities.

Graphic design: Rudina HoxhaPrinting: Gent Graik

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The publication of this manual was made possible by World Vision.

World Vision International is a Christian, humanitarian, development and advocacy organization, founded in 1950.

World Vision works to create sustainable change in the lives of children, families and communities living in poverty and injustice. World Vision works in 100 countries of the world. World Vision responds to community needs, in spite of race, gender, ethnic background and religious afiliation of community members.

World Vision began its program in Kosovo in 1998 and in Albania in 1999, as an emergency response to persons displaced as a result of the war in Kosovo.

These aid operations transformed gradually into sustainable development programs in Albania and a project (Children for Peace) in Kosovo.

This manual is being published in the framework of World Vision’s Education Project.

© All rights reserved. The contents of this document may be used or copied freely by education specialists for training programs or for the development of educational practices, but not for proit purposes, on the condition that any reproduction is accompanied by the acknowledgement of World Vision as the source.

The views of the authors of this publication do not necessarily relect the views of World Vision.

Tirana, 2014

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DEDICATION

This manual is dedicated to all Albanian teachers who have taught and who will teach and include students with special skills, talents and needs in their classrooms.

Through UNICEF, I have been part of global education, inclusivity and educational reforms of different countries for years, but the desire and passion to do this in my mother tongue has always attracted me. When World Vision International invited me to lead a working group of Albanian colleagues to write a teacher‘s manual, I felt great joy for all the opportunities and challenges that this project was going to present. Excited by recent visits to Albania, I believed that Albanian expertise in inclusive education had reached the proper maturity, diversity and passion to draft a manual worthy for teachers and all those who had become part of inclusive processes. From the desire to bring all of these elements together with the dedicated coordinator of inclusivity projects of World Vision Mr. Emiliano Kaziaj, as well as Dr. Pranvera Kamani representing the Ministry of Education and Science and one of the pioneers of Albanian inclusivity, we found ourselves in front of a working group divided in two, between the new continent, North America and the ancient one, Europe. Soon, our group was joined by Dr. Marina Ndrio, special education specialist at the Faculty of Social Work of the University of Tirana and Dr. Florian Kulla, well-known psychologist, expert in child psychology. Our frequent meetings in Tirana cafés, the monthly meetings on Skype, daily correspondence and visits to schools, inspired us to build the idea and draft the 11 chapters of the manual.

This manual was drafted by taking into consideration numerous experiences of many different researchers and teachers, especially the Albanian and Canadian ones. The manual investigates and develops the inclusive principles and practices, in the Albanian context of the 21st century and also provides practical and stimulating methods and advice to be implemented in inclusive classrooms.

International conventions and Albanian legislation are addressed as basic principles, which respond to the individual needs of every student. The manual addresses inclusive education and all of its dynamics as part of educational and social reform in Albania. Believing that inclusivity can be successful only if seen as a dimension, principle, or vision and above all, as a process and practice for all those who believe that every child has a right to obtain the best education, it is my hope that the use of this manual will be considered as such.

Toronto-Tirana 2013Lidra Remaçka


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List of abbreviations APA American Psychiatric AssociationCRPD UN Convention for People with Disabilities ICF International Classiication of Functioning, Disability and HealthIEP Individual education planIQ Intelligence quotientMCDWC Medical Commission for the Determination of Work Capability MOES Ministry of Education and SciencePECS Picture exchange communication system PEP Personalised educational planPKU PhenylketonuriaSPELL Structure, positive, empathetic, low arousal, linksTBI Traumatic brain injuryTEACCH Treatment and education of autistic and related communication handicapped children UNICEF United Nations Children’s Fund

WHO World Health Organization

ACKNOWLEDGEMENTSThis manual would have not been possible in its current shape without the precious contribution of all those who encouraged, supported and helped us in shaping this initiative. Everything has a start, yet nothing starts from scratch. In the case of this manual, it only ensured the continuation of the collection of previous knowledge and experience that we refer to in the manual.

The working group on the manual wishes to thank in particular all the teachers and Regional Education Directories that participated in the consultations carried out in four districts in Albania: Tirana, Vlora, Elbasan and Durrës. The active participation of teachers in these meetings assured us of “the voice of truth” that this manual should contain. We thank wholeheartedly all the teachers for sharing with us their successful work experiences with children with disabilities and all the challenges they face every day.

We also thank all the parents who had the kindness to give their feedback on inclusive processes. Their perspective and experience helped us immensely to give life to a project at the centre of which are children and their needs.

A very special thanks goes to Ms. Ridiona Stana, Child Protection Manager of World Vision Albania & Kosovo, who, with her dedication, became the initiator and drafter of Chapter 12, ‘Ethics and Protection of Children with Disabilities as a Right and Priority of Inclusive Processes.’ We would also like to thank wholeheartedly all the students (teachers in training) who participated in consultation meetings during the drafting of this manual. Their enthusiasm for the inclusion of children with disabilities in education inspired us and gave us optimism – and above all – hope for inclusive social reforms.

We hereby thank all the partner organisations and the local educational institutions, which shared with us their constructive impressions and critiques for further adapting this manual to the inclusive Albanian school of the 21st century.

Writing a manual for teachers is a responsibility and a privilege, but it would not have been accomplished without the support and good will of the entire staff of the World Vision Albania and Kosovo organization, MEDPAK and particularly the Ministry of Education and Sports.

– The Working Group

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1. Instead of an introduction• How to read the manual• Objectives• International standards

2. Legal framework in support of inclusive processes• Deinitions and categorisation

3. A time of dynamics, changes and inclusivity• All for inclusion• ‘Inclusive’ language, an indispensable tool for inclusive classrooms

4. Attention dificulties and hyperactivity• What is hyperactivity?• What are the main causes of hyperactivity?• What are the main traits of children with inattentiveness and

hyperactivity?• How hyperactivity affects the learning process

5. Children with learning dificulties• How to react to the diversity of learning dificulties in the classroom/

school?• Types and kinds of learning dificulties

6. Students with language and communication dificulties• What are speech and communication disorders?• Main characteristics of children with speech and communication

disorders• Main types of speech and communication disorders

7. Students with intellectual skill dificulties• What is considered an intellectual disability?• Main causes of intellectual disability• How intellectual disabilities are identiied?• Characteristics of intellectually disabled children

• Types of problematic behaviour

• Systematic manipulation of the environment

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8. Students with autism• Demystifying autism• What is autism?• What are the main causes of autism?• How is autism identiied?• Characteristics of students in the autism spectrum• What to consider when working with students with autism

9. Students with physical disabilities• What is physical disability?• Main illnesses of physical disability• Impact of physical disability on learning and development

10. Individual education plan (IEP)• Adjustment• Teaching through differentiated instruction as an inclusive strategy andPEP• Elements of differentiation

11. Competences, successful strategies and techniques• Rudina and art• Parents as partners in education• Communication

12. Ethics of professional communication, conidentiallity compliance and treatment with dignity• Advice for the teachers on the implementation of professional ethics

rules• How to identify and respond to cases of abuse of children with disabilities

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INSTEAD OF AN INTRODUCTION

1Welcome to a new ield, one of the most complex and most challenging in education: INCLUSIVITY!

Let’s go back in time to 2000 by relecting on a visit to the institution for students with special needs in Tirana. Understandably, we have forgotten many of the events that took place that year, but we do remember the confession of the school principal about an episode with one of his school students, a participant in the playoffs of Special Olympics for people with disabilities in Atlanta, U.S.A., in 2000.

…In one of the running races, that of 500 meters, one of the students, being the fastest, was inishing the race alone and leaving the other participants far behind. To the surprise of everyone, the “likely winner” slowed down his pace and waited for his “friends” to inish the race “together…” Meanwhile, the trainer/teacher failed in his efforts to encourage him to keep running and win. When asked why he stopped, the student, very preoccupied about the other friends he had left behind, replied, “I need to wait for them because we were all together when we started the race…”

This story may certainly be interpreted in various ways, but we would like to interpret it as a message, a metaphor, an appeal for more humanity and responsibility to all of us who run every minute without ‘waiting‘ for those who cannot ‘run’ as fast as we can, in order to engage together in the great race of life.

How to read the manual

First of all, we would like to express very openly our view about how to read, understand and use the manual I am Between You, Similar, Different, Equal, which is a source of national and international knowledge, strategies, methods, experiences and practices to help teachers who will be working with students with disabilities.

In the many years spent studying special education or inclusivity, we all agree that, similar to every other ield of study, there are many schools of thought or trends. When preparing this manual, the authors sought to include and collect the best national and international studies and experiences in this area on the basis of professional criteria, taking into consideration the conditions of Albania in the 21st century. We have tried to consider the advantages and disadvantages, experiences and methodology of every study, leaving up to you their selection and use, depending on the speciic needs and situation of your classes.

In the process of drafting this manual, the working group discussed, explored and above all was encouraged by the study of positive experiences in Albania and in the world in the very human area of inclusivity.

If, while reading or using this manual, you feel that it has raised many discussions about different deinitions or techniques used in teaching students with disabilities, we believe that we have achieved our goal in trying to cooperate with you. No doubt, you will ind an endless number of questions without answers; when we managed to answer a question, this process led to another question or even a set of different questions, possibly more intricate than the previous ones.

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Traditionally, this fact may be easily considered as lack of knowledge, an indicator of chaos or confusion, or an inability to respond to all the questions we have today or that may arise tomorrow in class. We have chosen to look at it differently, for two reasons: 1) as a continued state of evidence, questions, challenges and achievements that generates debate and the need for new solutions and choices or more like an indicator of change, success and progress; 2) as an open conversation in order for all of us to worry about responding to the questions and challenges that we will encounter.

The irst piece of advice we offer is that in every moment of success or failure you should never feel that you are alone or consider it as a personal problem. There are thousands of teachers, parents, psychologists, doctors, researchers, students, workers, journalists and more who every day face the challenges of ‘inclusivity’ in Albania and everywhere in the world. These people have shared their voices and experiences with you by assisting with this manual. This selection of accounts was created to more clearly present the message that the teacher is not only an object but also a subject in the process of drafting the manual, which was realised only by viewing him or her as a co-traveller, leader and a student in its use.

Our second piece of advice: Dare, try, admit and correct your mistakes; accept the chaos, the confusion and the failures that you, your colleagues, or the parents encounter as your best and most precious experiences and work with students with special needs. As Mahatma Gandhi said, ‘Freedom is not worth having if it does not include the freedom to make mistakes.’

Our third piece of advice: Have conidence that the very challenging nature of the area of inclusivity makes it even more special, attractive and meaningful by transforming your duty into a feeling of responsibility, respect and care for life in any form it is displayed.

It was precisely these children who inspired Italian educator and teacher Maria Montessori a century ago to lay the foundations of the most successful pedagogy and, with her philosophy, gave children the right and opportunity to achieve their full potential. These children also inspired the irst Albanian teachers, Fatime Kapo and Urani Dhima, who became the pioneers of inclusivity in Albania.


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Objectives

This manual seeks to:

help the professional development of teachers in working with children with disabilities and, therefore, facilitate the process of moving from their integration to their successful inclusion in Albanian mainstream schools

promote and spread awareness about the rights and protection of children with disabilities by following and applying international standards for teachers of inclusive schools with students with disabilities

offer a set of competencies and strategies of inclusive education to use in the classroom, including the IEP, as well as adaptation and modiication

help teachers recognise and understand the causes and nature of different disabilities and the behaviour as well as the characteristics of students with disabilities

help teachers implement the main techniques and methods for managing class behaviour of students with learning dificulties.

1. The basis of teaching and of inclusive schools

2. Development and the characteristics of the students (knowledge on the typical and atypical development)

3. Individual diversity in learning (knowledge on how to support students with disability to learn)

4. Teaching strategies

5. Inclusive teaching environment and social interaction in this environment

6. Communication

7. Planning the teaching process and guidelines

8. The evaluation of students with disability

9. Professional ethics

10. Collaboration

The international standards for teachers working in mainstream schools with inclusive education

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2LEGAL FRAMEWORK IN SUPPORT OF INCLUSIVE PROCESSES

In 2007, UNESCO published Human Rights-Based Approach to EDUCATION FOR ALL.

The United Nations adopted the Convention for People with Disabilities (CRPD) that went into effect on 3rd May 2008 and was ratiied by 20 states. The UN considered the CRPD as the ‘irst comprehensive human rights treaty of the 21st century.’ Koi Annan deined the new convention as ‘a historic achievement for 650 million people with disabilities in the world,’ including 200 million children with disabilities, most of whom live in developing countries.

Albania became a signatory state in the CRPD on 22nd December 2009 and ratiied it in 2013.

Article 3 of the CRPD:

a. Respect for inherent dignity, individual autonomy including the freedom to make one’s own choices and independence of persons

b. Non-discrimination

c.Full and effective participation and inclusion in society

d. Respect for difference and acceptance of persons with disabilities as part of human diversity and humanity

e. Equality of opportunity

f. Accessibility

g. Equality between men and women

h. Respect for the evolving capacities of children with disabilities and respect for the right of children with disabilities to preserve their identities.

In 2009, Save the Children published a user’s guide on the CRPD, called ‘See Me, Hear Me‘, which promotes the rights of all children. See Me, Hear Me is the irst book to look at how this Convention can be used to support disabled children, alongside the UN Convention on the Rights of the Child.

In 2012, World Vision enabled a regional study entitled ‘The right to inclusion of children with disabilities – Good Practices in the CEECIS region and recommendation to the Albanian government‘ and a national study that historically analyses the development of children with disabilities in Albania during the period 1945–2011. In June 2012, the Assembly of Albania passed Law no. 69 ‘On pre-university education in the Republic of Albania,’ which marks a signiicant achievement in sanctioning inclusive education, explicitly ‘Education for children with disabilities.’ In February 2013, Albania ratiied the CRPD, which reafirmed and stressed the rights of persons with disabilities and established new obligations to governments for their implementation and realisation.

The Albanian education legal framework guarantees the full right to public education for every child, independently of any special needs and it stipulates: The inclusion of children with disabilities in specialised education institutions is generally temporary. The inclusion and integration of children with disabilities in mainstream kindergartens and elementary schools shall be a priority. Furthermore, more than ever before, it ensures support and special resources to meet the individual needs of every child in order to give them quality education.

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Article 63. Principles of education for children with disabilities

1.The education of disabled children aims at the full development of the intellectual and physical potential and improvement of the quality of their life to be prepared for their full integration into the society and the labour market.

2.The placement of disabled children in specialised educational institutions is generally temporary. The inclusion and integration of disabled children in mainstream kindergartens and schools of basic education shall be a priority.

3.Students who have hearing or hard of hearing and sensory impairments shall be guaranteed their right to communicate in sign language, while the blind ones through the Braille alphabet.

Article 64. Educational institutions attendance by disabled children

1.Disabled children shall be guaranteed education in middle and highs schools, according to the criteria approved by the Ministry of Health.

2.Disabled students shall stay in specialised schools until age 19.

3.The local educational unit shall set up a commission consisting of doctors, psychologists, teachers and specialists for disabled children, which, following the request of the parent or the principal of an educational institution, shall grant the respective recommendations for the child to attend an ordinary or specialised educational institution.

4.Parents shall decide whether their disabled child shall follow a specialised or ordinary institution of basic education. The parents may at any time remove their child away from school, as long as they deem that he/she is not beneiting from the lessons or if he/she has other better opportunities.

5.The Ministry, in cooperation with the basic local government unit and upon consultation with the parents and the commission, shall provide for the education of disabled children in one of the two types of educational institutions, mainstream or specialised.

6.The local educational unit, in accordance with criteria and procedures established by joint order of the Minister and the Ministry of Health, shall provide the education at home for children who cannot attend an ordinary or specialised school of basic education.

Article 65. Organisation of education for disabled children

1.Disabled children shall learn in accordance with ordinary lesson plans and syllabuses adjusted speciically to their needs, or they will be provided with specialised educational material.

2.In mainstream educational institutions, the personalised syllabus for disabled students shall be drafted by a commission, composed of teachers of different subjects working in the school and psychologists. The drafting of this syllabus shall be done in cooperation with the parents and the students. Any amendment to the personalised syllabus within a local institution shall be determined by the commission in cooperation with the parents of the child.

In other words, Albanian legislation now guarantees the full right to public education to every child. Above all, the implementation of the new law shall be successful and useful only if it is understood as a process, concept, principle and most importantly, a teaching practice in inclusive schools and classes through adjustments, modiications and continued improvements.


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3.Disabled students shall be provided with a teaching assistant and rehabilitation service, in accordance with the criteria set out by the Minister. Educational employees of institutions attended by disabled students shall be certiied in training programs for the treatment of these students.

4.The respective basic unit of the local government shall provide appropriate teaching and learning environment for disabled students, in accordance with the standards established by the Ministry.

There are no oficial statistical data on disabled children or people in Albania. Also, according to UNICEF, research and data on child disability are scarce, hindering the development of effective policies and programs.

According to INSTAT data of 2011, the number of children with disabilities enrolled in compulsory education is 2,400. This number represents only 0.5 per cent of the general number of children enrolled in compulsory education1.

According to the Ministry of Education and Sports, the following categories of disability stand out: mental, physical (mobility), mental and physical, visual, hearing, speech disabilities and autism.

As may be observed in the above table, the general number of children with disabilities enrolled in the country’s ordinary kindergartens and schools is 3,678, 511 of whom are in kindergarten and 3,167 in nine-year schools.

Statistical data on children with disabilities in kindergartens and nine-year schools in Albania

General number of children with disabilities in kindergartens and schools

Deinitions and categorisation

General number of children

with disabilities

Number of children with disabilities in kindergartens

Number of children in

nine-year schools

Total

Number of children with disabilities compared to the number of the rest of the children

511/10,34920.49%

3,167/47,2891

0.64%

3,678/ 57,6383

Total number of children with disabilities

13.89%

86.11%

100%

1 www.instat.gov.al

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This is how Dr. Pranvera Kamani, representative of the Ministry of Education and Science, describes the new law: ‘The spirit characterising Law 69/2012 “On pre-university education in the Republic of Albania,” particularly the chapter “On the education of disabled children,” is visionary in terms of restructuring, step by step, inclusive educational services, in order to create conditions for the full development of the potential of disabled children.‘Law 69/2012 “On pre-university education in the Republic of Albania,” sanctions the creation of a new multi-disciplinary evaluation system for children’s disabilities in order to better orient educational services that should be offered to children.

‘On the other hand, structuring the institutional evaluation system for children’s disabilities in Albania is an inclusive process that requires the engagement of several state institutions, such as those of the health, labour and social affairs, social state, justice, education and other services. This is a process that is already underway and seeks to project the creation of a functional evaluation system to directly help disabled children on the one hand and, medical, educational, psycho-social and rehabilitating personnel on the other, which will offer at the same time appropriate services for disabled children.

‘In order to ensure the most thorough evaluation possible of the disabled child’s health and functioning situation, the institutional evaluation system that is being created intends to rely on the:

International Classiication of Functioning, Disability and Health (ICF), developed by the World Health Organization (WHO). This classiication is a reference system that deines the level of functioning and the potential for the development of disabled children and it contains a detailed report on:

the nature and situation of the disability

the health and educational needs and services that have arisen as a result of the disability

appropriate services that aim to meet these needs

the period during which the child’s situation should be re-evaluated.

‘The ICD-10 system of evaluating disability establishes four levels:

mild

moderate

severe (and/or combined diagnoses)

extreme.

‘Aside from the above cases, Law 69/2012 “On pre-university education in the Republic of Albania” sanctions education at home when the child has long-term damages that prevent him or her from attending ordinary or specialised schooling.

‘As a conclusion, it may be said that the law, like never before, has sanctioned inclusive education of disabled children. The completion of this law, with the drafting of bylaws that will orient and instruct about its concrete implementation, will open the way to establishing the inclusive system of education for disabled children.’


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3A TIME OF DYNAMICS, CHANGES AND INCLUSIVITY

A long time ago, in the ancient symposiums of Aristotle, who greatly impacted Western thought and philosophers, disabled people were considered as ‘senseless and incapable of reason.’ (Bennett, S., Dworet, D., Weber, K., 2008). We are living in times of fast change and often we ind ourselves involved in this whirl of new dynamics, unprepared for our role as educators and agents of inclusive change.

‘In France, forms of care and special education for disabled individuals date way back. 1793 is considered a symbolic date for the start of rehabilitating reforms towards this category of individuals. It is the year when Doctor Philippe Pinel obtained permission from the Paris Commune to release 89 “insane people” from their chains. Until that time, the “insane” had been mixed together with other convicts and criminals. For the irst time they were considered “ill” and deserving treatment and care and that change in behavior marked the start of modern psychiatry, which was about to spread throughout Europe.’ (Bouissou, 1967, Ndrio, M., 2012).

The process leading to integration of disabled people in society began in the 1960s and it appears stronger and more indispensable than ever in our day. If we were to look attentively at legislation for disabled children, it has been historically expanding, becoming more deining, speciic and, above all, stressing the responsibilities of every institution and link in the educational system chain.

The main reason is clear: the number of disabled students is growing. It is also true that more children with disabilities are being identiied than ever before and society – particularly the school system – is the main body responsible for respecting children’s right to quality education. Since the previous isolation and mentality – according to which people with disabilities were ‘away from the eyes of the world’, it has taken a lot of work and effort to come to a new approach: ‘I am among you, different, similar, equal.’

Many might ask whether the Albanian society and schools are ready for inclusion. We will leave the answer to this question to your discretion, after you have read and used this manual in your classes.

We are all aware of the goal of the pre-university education system, which is to train every individual and, in the case of disabled students, to encourage independence through the development of interpersonal, self-assisting and self-estimating skills with the goal being independent thinking and acting, inclusivity, integration and the development of the full potential of the student inside and outside the school. The response you would ind in unison from all researchers, national and international specialised institutions is ‘inclusivity.’

One of the teachers of the special class at Luigj Gurakuqi School, opened in 1979, said in an interview that they “had to send several requests to the school directory to change the time of the long break so that disabled students would not have to be around the other children at the same time and in the same premises. This would avoid discrimination and disdain towards them to some extent, while it would undoubtedly open the way to their separation and segregation.’

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All for inclusion

From inclusive education to inclusive society

According to UNESCO’s guideline (Article 1) for inclusion, ‘People with disabilities include those who have long - term physical, mental, intellectual, or sensory impairments which, in interaction with various barriers, may hinder their full and active participation in society, on an equal basis, with others.’

Our understanding of ‘disability’ is based on the social model, which values inclusion as a dynamic approach to responding positively to pupil diversity and of seeing individual differences not as problems, but as opportunities for enriching learning. Also, the Council of Europe, social model considers obstacles created by the environment, which includes the way the society behaves, culture, prejudices, myths and maltreatment. State policies in the educational and health system also take up an important part. In this context, inclusivity is not only the integration of disabled students in schools, but also the transformation and reform of the whole society. We believe that inclusive school as an education centre has in itself the potential to serve as a relection institution and model for transforming the community and the entire Albanian society into a more inclusive one.

According to the National Education Strategy, the Albanian government supports ‘education for all’ (MES 2004). In the international framework, Marie-Pierre Poirier, regional UNICEF director for Central and Eastern Europe says: ‘Inclusivity has been deined in Salamanca as a factor promoting the indispensability of working towards a “school for all,” which includes and appreciates change and supports education based on the needs of each individual…’ (Poirier, MP, 2012).

‘Inclusivity is a right that the Albanian society and, more speciically, school is seeking to welcome children with special needs by opening the classroom doors hospitably. Inclusivity is a precondition for the development of equal opportunities, democratic education and social involvement.’ (Radoman, V., Nano, V., Closs, A., 2006). Copied by the authors.

According to UNESCO guidelines prepared to help globally with the process of inclusivity, ‘inclusivity‘ has been considered the moral, ethical, social welcoming of diversity that all students without exclusion beneit from. Furthermore, inclusivity means equality in rights and access and use, depending on the individual needs of every student.

Along the same lines is the deinition given by Save the Children. ‘Inclusive education encourages particularly respect for the rights of children with special needs and is one of the steps, perhaps the most important, for creating an inclusive society… Inclusivity is closely linked with the concept of citizenship and seeks to put an end to differences in access and status among citizens into “irst hand and second hand” and into “capable and incapable” citizens.’

We believe that inclusivity is a process, energy, movement, effort, cooperation, challenge, test, integration, acceptance, equality, right, responsibility, opportunity need, lexibility, liveliness, diversity, intervention, access, combination, signiicance, capability, focus, inluence, culture, civility, dream, teaching, learning, deinstitutionalisation, freedom, identity, independence, inclusion…

Inclusivity is based on the principle of education without prejudice or social exclusion. The only thing it excludes is prejudice. Scientiically, prejudice expresses itself, according to social psychology, in regressive forms and protectionist mechanisms that complement or replace lack of knowledge with myths and wrong concepts that do not relect the truth, scientiic facts or research (Gordon Willard Allport).


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‘The concepts or pedagogies of “exclusion, distance, division, separation, categorisation of social boundaries” contradict and harm inclusive processes in education separately or, worse, altogether, because they encourage discrimination and infringe upon the fundamental right for equal opportunities for all students.’ (Bennett, S., Dworet, D., & Weber, K., 2008). Furthermore, the observers, the indifferent, the merciful and, even worse, the deniers, have nothing in common with inclusivity. ‘Mercy is the anteroom of disgust,’ the parent of an autistic child says in his interview in January 2013 in Tirana.

Theoretically, inclusivity is based on the theory of the development of social impact compiled by Russian psychologist Vygotsky. ‘Social interaction and cooperation play a decisive role in the full development of cognitive capability. Every function of the development of the child appears twice, irst through interaction between social beings and later as an internal development of cognitive capabilities. This equally applies to the formation of attention, logical memory, as well as in shaping concepts. All other functions of a higher or complicated interaction level derive from relations between individuals.’ (Vygotsky, L.S., 1978, p. 57).

Also, the concept of the formation of the ‘zone of proximal development‘ by Vygotsky explains how this ‘zone‘ grows and develops assisted or stimulated by interactive social cooperation, participation and communication. It is precisely here that all principles carried by every student rely upon.

What I can’t do

What I can do with help

What I can do

Zone

of proximal

development

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‘Inclusive’ language, an indispensable tool for inclusive classrooms

From the series of “Poems for Gesi” 2013

Handicapped

Handicapped, handicapped,

A word as sharp as a sword,

…

An injured life without deadline,

Why do they call you handicapped …

Why do they say to you...

Why? Why?...

– Edmond Tupja, parent

Language plays a leading role in creating the warm and hospitable environment in schools and society. The term ‘child with disabilities’ is theoretically used for those students who have been identiied and evaluated as such by the specialised institution called Medical Commission for the Determination of Work Capability (MCDWC).

Furthermore, the National Strategy for People with Disabilities says that ‘disability does not lie within the individual; what the individual has is the harm.’

My name is Ben. I know they call me autistic. I like the term ‘neurotypical’! No label will ever do justice to a human being. We are all too complex and awesome for a single word to capture our essence. At best a one-word description of any human is but an invitation to explore what makes each of us unique. Neurotypical is a word that invites autistic people to explore this strange world full of awesome people who think differently from us.

– Autistic high-school student, Ontario, Canada

Establishing disability has to do with the deinition: ‘People with disabilities’ are those individuals whose physical functions, mental capacity, or psychological condition tend to shift for over six months from a typical condition for the relevant age, which leads as a result to limitations on their participation in social life. (National Strategy for Persons with Disabilities, p. 6).

Before the 1990s, children/individuals with disabilities were labelled with disdainful epithets, adjectives and qualiiers with negative and excluding connotations, such as: retarded, bad student, weak, idiot, abnormal, stupid, ugly, sick, insane, handicapped, mentally deicient, unlike the proper and normal and beautiful ones. ‘The use of these terms derived mostly from the medical model of treatment of disability, given that commissions for determining disability operated with the same deinitions.’ (Ndrio, M., 2012).


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Given the fact that language, as the most important part of social interactions, relects the processes of change and, more narrowly, connections with social norms, it will deinitely linguistically relect the new elements of new inclusion processes. So, language and its laws will follow and support the process in all of its elements, both in form and in content. Inclusive language, vocabulary and a new attitude will gradually replace the labelling of excluding categorisations. The experience in the area of education has shown that new inclusive labels are connected with more open, accepting and compassionate behaviour and attitudes of the school community and beyond.

Research on the ‘linguistic impact on societal developments’ has shown that language itself has been recognised as a development tool with powerful potential, which can convey welcoming, compassionate and inclusive messages or, on the other hand, can suggest a divisive and excluding attitude.

Changing this excluding and prejudicial mentality becomes even more challenging for the inclusive school and the teacher especially when these images, stigmas and prejudices have unfortunately taken root in the ethics of Albanian society. Often, these prejudices take place passively and unintentionally, so ‘It is indispensable that every individual intervene actively, challenge and object to personal and institutional behaviours that perpetuate oppression.’ (Ikonomi & Sula, 2012).

For that to happen, all educators should be open to and accept the change, celebrating the diversity and encouraging equality. Accepting change means learning. It is the duty of the school to create an environment for the teachers where they can all learn from one another. Examples show that the teacher who considers himself/herself a ‘student’ in his/her own class and learns from and relects upon experiences, whether successful or not, is more effective in teaching and in achieving expected results from students.

Numerous Albanian (Ndrio, M., 2012) and foreign (Pomplun, 1997) researchers have considered the example and model displayed by kindergarten children who use ‘non-labeling’ language, accept and demonstrate a behaviour of care and lexibility towards their friends with different skills, an indicator of the fact that discrimination and exclusion are behaviours learned from society, which mostly appear in these children only when they grow up. Therefore, it is very important to understand inclusivity as a language and culture of the entire educational system and community, as a linear whole that has no age or time or space limits. Every school should embrace, adjust and adopt inclusive vocabulary, inclusive strategies and practices that welcome and include and do not exclude.

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Readings and references

• Bennett, S., Dworet, D., & Weber, K. (2008). Special Education in Ontario Schools, Sixth edition.

• Bradley, M.R. (2001). Positive Behaviour Supports: Research to Practice. Special issue, Research to practice. Beyond Behaviour, 11(1), 3-26.

• Fletorja zyrtare. (2012). Ligji Nr. 69/2012, nenin 63, 64 dhe 65.

• Friend, M. (2007). Special Education; Contemporary perspectives for school professionals. (3rd Edition).

• Ikonomi, E. & Sula, G. (2012). Manuali i gjithperfshirjes. Unpublished.

• MASH (2004). Ministria e Arsimit dhe e Shkences e Shqiperise; Strategjia kombetare e arsimit, 2004–2015.

• Ndrio, M. (2012). The Right to Inclusive Education for Children with Disabilities – Analysis of the history of educational development of children with disabilities in Albania during 1945–2011.

• Nicholson, Ian. (2003). Inventing Personality: Gordon Allport and the Science of Selfhood, American Psychological Association.

• Pomplun, M. (1997). When students with disability participate in cooperative groups. Exceptional Children. Council for Exceptional Children, Vol. 64, Issue n1.

• Radoman, V., Nano, V., & Closs, A. (2006). ‘Prospect for inclusive education in European countries, is emerging from economic and other trauma; Serbia and Albania’. European Journal of Special Needs Education, Vol. 21, No. 2.

• Remacka, L. (2002). Gjuha dhe edukimi global; Revista pedagogjike 2, 2002.

• Save the Children, (2010). Nje shkolle per te gjithe. Pervoje pune me femijet me aftesi te kuizuar ne shkollat e zakonshme.

• Tupja, Edmond. (2013). Vargje per Gesin, Poeteka, 25.

• Vygotsky, L.S. (1978). Mind in Society. Cambridge, MA: Harvard University Press.

Links

www.childinfo.org/disability_challenge.htm

www.unicef.org/ceecis/UNICEF_Right_Children_Disabilities_En_Web.pdf

http://unesdoc.unesco.org/images/0014/001402/140224e.pdf

wvi.org/sites/default/iles/Raport_Rajonal_1_Alb_Web.pdHYPERLINK “http://wvi.org/sites/default/iles/Raport_Rajonal_1_Alb_Web.pdf”f


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4ATTENTION DIFFICULTIES AND HYPERACTIVITY

Some students in the classroom make huge effort and spend energy to be comfortable in the required position, e.g. to stay seated in the table. They move around the classroom constantly, talk without permission and do not manage to complete their assignments. They have very little concentration and often create tension in the classroom. These are the hyperactive students.

The essential feature of student with attention deiciency and hyperactivity is the constant lack of attention and, or hyperactivity–impulsiveness that is more frequent and severe than in other children with the same development and age. These children have very little concentration during an assignment or activity. They tend to get bored very soon in a game they are playing and `move to the next activity or game. They have dificulty in self-organizing and often do not mange to inish their tasks or the activity assigned to them (Benito, Y. Moro, J. & Alonso, J.A. 2007). These kids are always in movement and seems like they are constantly in a hurry to go somewhere. They have trouble sitting still and it gets even more dificult when the teacher insistently asks them to do so. It seems like the hyperactive kids are not able to think before they act. Their desire to do something comes in a natural or impulsive way.

What is hyperactivity?

In a summarized way, hyperactivity is a behavioral and development dificulty which is typically noticed in pre-school and school-age kids, characterized by problems related to attention and focus, and to being overactive. This dificulty clearly interferes in the behavior of the child and his activity. Hyperactivity is deined as an excessive and uncontrolled movement, a dificulty for the child to react to environment impulses, and to make “the necessary iltering”, for different types of impulses etc.. Benito, Y.; Moro, J. & Alonso, J.A. 2007).

The child’s case

Endri is my class mate. He sits next to me in the same table. He is a good-looking boy and dresses very nicely. Endri is also very hard-working, always adjusting the stand and the tables which are not in order. Even so, it seems to me that he receives less praise from the teacher than the rest of us. Often even us, his friends, reuse to play with him. Sometimes he says bad words, and moreover he also violates the rules we have put in place in the class. Every day, the teacher draws his attention for him not to move, and stay seated. He always gets negative marks for his tests and homework, talks before his turn and always forgets his tools at home

Being different, is not a barrier any more, it should rather be considered as a value.

Teacher, Hungary

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What are the main causes of hyperactivity?

Genetic causes

Inattention and hyperactivity are caused by a damage of brain tissues. When the electronic mechanism which control the body movements change they trigger an unusual stimulation of the muscles, and hyperactivity crises is caused. It is related to an evolutionary defect in the area of self-control. These children do not manage to control their reaction to the environment.

Non-genetic causes

Premature birth, mother’s abuse with alcohol and smoking, excessive level of lead in the child’s body during early childhood or impairments/ accidents of the brain

Environmental causes

The environment (the social context where the child is raised, the family environment, the raising and education practices, the social environment where the child establishes relations with the others) is not a direct cause of this deiciency, but aggravates the situation of the kid, and can be considered a contributing factor.

What are the main traits of children with inattentiveness and hyperactivity?

Hyperactive students have the risk to abandon school compared to the other students, because they have poor performance in schools. Even though they have an average or higher intelligence level, their dificulty to stay focused and increased movement, obstructs them from reading or listening, and giving the expected result.Even social relation between the hyperactive kids and their peers are quite impaired since due to the aforementioned reasons they become very bothersome and unbearable for their class mates. These kids have:

attention deicit, trouble staying focused,

their attention is drawn easily by external impulses; they give the impression not to listen very well; they fail to follow the instruction or fulill the school assignments on time or the responsibilities of the task,

inadequate organizational skills, forgetfulness, lack of attention to details, los of items necessary to fulill a task,

hyperactivity, high level of energies, dificulty to sit still, speaking at laud voice, impulsivity,

hard time waiting for their turn in group situations, blurt out answers before the question is inished, interfere in others’ personal matters,

frequent negative, destructive, or aggressive behavior to demand attention, a tendency to engage in dangerous activities,

hard time accepting responsibilities for their actions, projecting the fault to the others, failure to learn from experiences, low self-esteem and deicient social skills.


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Strategies to help teachers

Adjusting the environment

Have the student sit in the irst line,

Make him sit in a special place and allow him to move.

Establish and maintain good social relations with the other students of the class.

Behavior management

Allow him to seat in the desired position.

Be lexible because not necessarily all students should apply the rules related to the position, movement.

Use a type of signal to reorient the child to the task (e.g. clamp you hands, knock on the table following a certain rhythm, etc.)

Provide more time to complete the task. Make frequent positive comments for the work he is doing.

Change the situations to make the child feel more comfortable.

Be creative and open to new ideas.

Be patient and dedicated to the work with the hyperactive kids.

Keep regular communication with the parents of the kid and school psychologist.

Be patient.

Reward, regularly and according to the importance of the behavior, positive behavior.

Be regularly demanding and keep clear position regarding negative behavior, but not towards the student.

Cooperate with the school psychologist to refer the child to specialized centers in order to assess whether the child really has dificulties related to the hyperactivity and attention.

Discuss with the parents about the characteristics of this disorder and the need for close cooperation with them.

Establish a successful reward and punishment system, which promotes positive behavior and prevents negative behavior.

Establish clear limits to the child, e.g when the friends are talking they should not be interrupted.

Enhance the child self-esteem by increasing his positive statements for himself and participation in extra- curricula activities.

Teaching strategies

Divide the task in small steps.

Organize extra-curricula activities which improve the social skills of the child and strengthen his tights with his peers.

Often call his name, draw his attention and eliminate as much as possible the things that could draw his attention.

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Repeat the instructions. MUESIN

Ask the child to often give comments on the assignment he is performing

Provide the child with self-control strategies. Ask him to Stop-Listen-Think before acting.

Ask the child to revise the learned materials regularly, to read the questions twice, to recheck the assignment that he has completed.

Identify rewards or incentives which motivate the interest of the child.

Establish cooperation with the psychologist and the parents of the child, a personalized education plan.

Try to maintain his attention and focus for longer periods of time.

Improve the control of impulses, by engaging them in activities, tasks which they like and desire.

Aim at improving his school achievements, by appreciating also his efforts, if the success is not achieved.

Give fewer assignments in writing.

Cut the parts where the child is supposed to write.

Give questions, with alternative answers e.g., (yes, (no) whether the kid can circle one of them.

Accept also one word answers.

Accept that the parent or the friend has helped him to copy the assignment.

Do not punish the kid due to bad handwriting.

Extend the time of the assignment.

Divide the assignment in small parts.

Allow oral answers.

How hyperactivity affects the learning process

How do these children write?

Given that they cannot stay in the right position when they write and are under constant physical stress due to muscle tension their handwriting is messy, not the desired one and hard to read.

While writing, the kid is tensioned and sometimes cries due to frustration. He does not manage to complete the assignments in writing. Some kids, in order to relax their hands, drop their pen an in this way it seems that they are detached from the reality of the classroom. In such a situation the teacher may react in a negative way (Ndrio, M. &Amursi, E., 2009).

How do these kids read?

Some of the characteristics of the hyperactive kids in reading are similar to those of dyslexic kids, only that the dyslexia of hyperactive kids can be cured. Reading and pronunciation of the hyperactive kids seems similar to that of dyslexic kids, given that also with them it is noticed th changing of places, the overturn of numbers, letters, math symbols, and side (left, right) problems as well as dificulty in placing the items in line one by one, likewise with the dyslexic kids.


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The hyperactive kid confuses e.g letters p and b, p and q, numbers 21 and 12. The problem of letter overturning, of non accurate reading of the numbers and symbols are related to laterality or bias, which is not stabilized in these kids. The hyperactive kids have problems with placement of the items or objects according to their order, e.g. the puzzles, cubes etc.

Hyperactive kids in math class

The kid copies the assignments in the wrong way from the table or the text. He is not able to write within the format of the notebook, but goes to the next page of it.

Usually miss places the numbers in a math action, e.g the centigrades below the tenners. Sometimes the numbers they write are very big, while other times they are very small. They do not manage to keep the line when they write. Similarly, the problem of overturn of the numbers and their exchange has a clear impact on the test results.

Bibliography

• Benito, YAlonso, J.A.Guerra, S. & Moro, J. (2007), Diagnosis of Attention Deicit HyperactivityDisorder (ADHD) in gifted children. Empirical study of the use of Brickenkamp’s d2 Test and ofConners’ Continuous Performance Test II (CPTII V.5) in the diagnosis. Ideacción 26, ISSN 1695-7075. Edited by the Spanish Center of Support for gifted children’s development. http://www centrohuertadelrey.com (30/12/10)

• Benito, Y.Moro, J. & Alonso, J.A., (2007), Diagnosis of Attention Deicit Hyperactivity Disorder(ADHD) in gifted children, 2007 WORLD CONFERENCE, August 2007, University of WarWick(U.K.), World Council for gifted and talented children.

• Brickenkamp, R.,Aufmerksamkkeits – Belastungs-Test (Test d2). Conners, K. and MHS Staff:Conners’ Kiddie Continuous Performance Test CPT (K-CPT V.5). Conners, K. and MHS Staff:Conners’ Continuous Performance Test II (CPTII V.5)

• Ndrio, M & Amursi, E., ( 2009),To know and understand the dificulties in learning, Save theChildren, Tirana

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5CHILDREN WITH LEARNING DIFFICULTIES

“Not all students learn the same!”

– Teacher in Korçë

How to react to the diversity of learning dificulties in the classroom/school?

Every child is special. They differ from one another in capacities, skills, interests, desires, learning styles and intellectual, emotional and physical development. In the educational environment, children acquire knowledge, gain new experiences and develop their skills in different areas. This process does not happen in the same way or at the same pace in every child. Some children display dificulties in learning.

The term ‘learning dificulty’ is used to describe dificulties in speciic learning skills and concepts learned by children who learn and act without dificulties in other areas. It is an umbrella term to describe a variety of problems related to the learning process.

These dificulties cause a series of problems for children in their schooling achievements, in speciic subjects or areas (Haxhiymeri, E., 2006). Their existence is not related to a retardation in mental development or to various physical, sensory problems that some children present, such as those related to sight or hearing. They are not caused by emotional problems or problems related to motivation. Furthermore, these dificulties should not be mistaken for other dificulties or disabilities such as autism, intellectual disabilities, behavioral disorders, etc. From this standpoint, it appears that learning dificulties have a physiological origin and derive from the way the brain receives, processes and interprets or uses information. Skills most affected by this phenomenon are reading, writing, hearing, speaking, reasoning and conducting math actions.

Demystifying learning dificulties

Myth

• Children with learning dificulties are retarded, less intelligent than their peers.

• Children with learning dificulties are lazy and don’t like to learn.

• Learning dificulties are an issue that pertains to the school, the educational environment where the child learns.

Fact

• Learning dificulties are not an indicator of the intelligence of an individual.

• In some cases, children with learning dificulties are discouraged and lack motivation due to the results they have achieved. This behaviour should not be interpreted as laziness.

• Learning dificulties affect one or more areas of learning but affect all areas of life: work, family life, social relations, etc.

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How to support children who have dyslexia

How to identify learning dificulties

A child with learning dificulties displays:

Ana’s teachers and parents do not know about her learning dificulties; indeed, they have not yet discovered that she is affected by dyslexia.

Ana is upset when the teacher asks her to read a paragraph out loud. She does not read well and the teacher always points out the mistakes. The parents at home never forget to remind her every time not to pause while reading. She does not view school as her favorite place.

Sometimes she feels as if ‘she’s in a ight’ with the school, the homework, with teachers and with her friends. She is afraid of reading out loud; she hesitates when she has to create a written composition and she refuses to engage in resolving a math problem or in analysing an exercise. She has dificulty with her homework, taking an endlessly long time to do it and is often labelled as ‘slow,’ ‘delayed,’ or ‘lazy,’ etc.

Ana doesn’t like to go to school as she knows that in every class she will have to listen to the teachers’ complaints about her incomprehensible writing and typos. She has begun to tell herself that she is probably not as smart as her friends, that she won’t be able to do anything good, that she is not capable, etc. Often she feels sad, as she has no ready solution for this problem. Recently, she has discovered that she likes to imitate the movements of singers or other characters in the art world and seems to be good at it. Within a very short period of time, she turned into the little school ‘artist’, who, with her skills and incredible talent in imitation, represented the school in the concert that took place at the end of the year.

Characteristics

• Short-term attention, slowness in learning new skills

• Impulsiveness, hyperactivity

• Frequent change of emotional condition

• Damaged visual memory

• Motor problems (dificulties in running, hitting a ball, writing, cutting with scissors)

• Dificulties in speaking and listening

Displayed signs

• Dificulties in learning the alphabet, rhyming words, or connecting letters with corresponding sounds

• Mistakes in reading out loud and frequent pauses when repeating words and phrases

• Lack of understanding of what they are reading

• Problems with spelling and syllables

• Writing messily, dificulties in holding a pencil

• Dificulties in expressing ideas in writing

Behaviour challenges

• Self-isolation, closing

inwards

• Lack of interest in the

world around

• Behaviour problems

• Dificulties in expressing feelings

• Feelings of inferiority

• Low self-esteem and

self-conidence

• Fear of failure,

frustration


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• Speciic school dificulties (reading, writing, math actions)

• Dificulties in respecting social rules in a conversation, eg, taking turns in speaking

• Poor coordination, unused to environment, inclined towards accidents

• Dificulties in connecting sounds with letters or identifying little differences between words that have a similar sound

• Dificulties in following instructions

• Don’t know how to start homework and continue it

• Lack of initiative to engage in new experiences

• Poor social and emotional skills

These dificulties are often very vague and often the origin of their causes may raise questions and discussions about the child’s emotional health, his/her family life, motivation or level of development. Independently from the potential sources of help available both inside and outside the school, it is very important that teachers cooperate with school psycho-social personnel and interact closely with parents or siblings, who are the ones who know the child better than anyone else and are a precious source of information to identify dificulties, needs and priorities that the child has and to support the work with the children.

Keep in mind that some of these characteristics may be displayed by children without learning dificulties. So, be sure to show care in assessing a child as having learning dificulties. Also, please remember that two children with learning dificulties will not have the same proile. One of the common factors in their proiles is that their dificulties are signiicantly greater than those of their peers.

Types and kinds of learning dificulties

Reading dificulty (dyslexia)

It is important to see or treat dyslexia not as a disorder, but rather as an alternative way that children use to perceive or process the world around them, with its advantages and disadvantages.

Dyslexia is a dificulty in reading skills; it has to do with mistaking letters with one another and their distorted perception, dificulties in reading sounds one after the other.

Dyslexia is one type of reading disability. There are children with other conditions or disabilities who experience reading dificulties.

This kind of labelling refers to a sustainable dificulty in identifying, understanding and reproducing written symbols verbally (McWhirter, J.J., 1977). Dyslexia derives from the combination of two Greek words: dys, which means irregularity, harm or upset and lexis, which refers to language or word. Dyslexia should be seen and treated as a complex problem, not as a conined, detached problem that the child may have.

The main characteristic of this dificulty is that reading (eg, accuracy, speed, or understanding of reading, measured by standard testing), is visibly under the expected level, considering chronological age, measured intelligence and the child’s schooling cycle in comparison to his/her age). This reading dificulty has a visible impact on school achievements or on daily life activities that require reading skills. Problems resulting from damaged sight or hearing in children should be avoided and if the teacher notices these signs, he/she should recommend to the parent to do specialised visits and tests.

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How to identify reading dificulties and dyslexia

How to prevent dyslexia

Primary prevention:

It is important to arouse children’s interest in the world of books from a very early age. Read to them tales, stories in order for them to get pleasure out of reading.

Not only parents, but also pre-school and school institutions should cooperate with neighbourhood libraries and institutions working with children’s literature.

First and foremost, early identiication/diagnosis and getting professional help as early as possible is most helpful. Exposing children to reading at an early age is helpful and might minimise (but not prevent) children from having dyslexia.

Secondary prevention:

Teachers of pre-school institutions and pediatricians should identify from early childhood age dificulties in speaking or in using expressed language in children and encourage them to go to a specialist as soon as possible.

Characteristics

• Oral and silent reading is characterised by distortions, replacements or deiciencies; slowness and mistakes in understanding.

• The child has upside down perceptions of letters, objects. He/she has a vague, unclear description of the relationship between written language and spoken language.

• Letter combinations, words are overlapped by sentences and made incomprehensible in the child’s mind.

• The child inds it dificult to inish tests and homework within permitted deadlines.

• The child may not remember what he/she read.

Displayed signs

• Mistakes letters and puts them in the wrong place.

• Dyslexia may appear as morphological confusion, affecting symmetrical letters or ‘mirrored‘ (dificulties in distinguishing letters that have little differences between them), especially those similar in shape, such as b and d, or p and q, m and n.

• It may appear through phonetic confusion, which is related to lack of knowledge of distinguishable differences between retrolex syllables (s, z), or velar (t-d, k-g, etc.).

• Dyslexia appears in the form of gaps, such as dropping a inal syllable or eliminating consonants, such as r or l.

• Dyslexic children may have problems with pronunciation as dyslexia shows a dificulty in processing spoken or written language.

Emotional experiencing

• Sometimes cannot swallow his/her failure and other times accepts it surrendering.

• He/she may be subdued and even deny his/her dificulties, or experience them with feelings of shame, guilt or persecution.

• Time after time, he/she may display passiveness, have little autonomy and on other occasions may intentionally be aggressive, ignoring or challenging the authority of the parent/teacher.

• Displays fear and anxiety while reading different parts of the text in class or at home.

• Has low self-esteem, dificulties in interacting peers.


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Tertiary prevention:

Parents have a need to be oriented so that in daily life, reading activities will take a privileged and priority place. The consequences of stable dyslexia may be minimised if children are encouraged to explore other means to enter into the world of culture (especially audiovisual ones), which the child accepts easily and even prefers. From kindergarten age, children should have conversation experiences with adults who are creative and willing to have in-depth conversations with them, in order to develop their linguistic capabilities (Ferrari, P., Epelbaum, C., 1993).

Strategies to help teachers:

Keep in mind that most dyslexic children have an average or above-average intelligence!


Ensure that the classroom is a quiet, welcoming and personalised place (with personal photos, drawings of the child and family) to realise activities that involve reading or conversation on the topics that the child has managed to understand from the learning and reading.

Build and develop a positive environment during the exercise of reading as it boosts interest in reading and books.

Create positive dynamics in the classroom as it visibly improves the child’s situation.

Give alternative educational support (parents and children may beneit from in-school psycho-social services, such as counselling or referral).

Adjusting the curriculum

Make any necessary adjustments to the curriculum content.

The text that the child will read should not contain many lines (depending on the class the child is in), typically not more than 10 to 12 lines. Make the necessary adjustments. Tell the child how many lines he/she will be required to read before reading begins. If the child inishes reading the text and is not yet able to point to the words he/she has read wrong, show the child the wrong words and give the opportunity to correct them. This will encourage the child’s independence and sense of responsibility.

Managing behaviour

Establish a positive relationship with the child; this is very important.

Identify each child’s strengths, that is, his/her skills in sports, arts or creative solutions to different situations or problems.

Encourage the student’s motivation by inding the right reward tools, such as a set of pencils, work tools or a favourite book.

Conduct periodical and structured meetings with the parents to tell them how to motivate their children to read.

Avoid criticism and tension created in the classroom and don’t constantly draw the child’s attention.

Avoid the use of this type of expression with the parents, “Your child is without motivation; has no desire—if he/she did, he/she could achieve anything.” “Your child has an opposing character,

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won’t sit down to read,” etc. In these cases, the situation of the dyslexic child can become even more dificult after the parents’ demands increase in requesting the “impossible” from the child under the teacher‘s pressure.

Never divert attention from your goal of increasing the student’s self-conidence and self-esteem. Developing children’s positive view of themselves is the teacher’s challenge. Trying to increase children’s conidence by evaluating the smallest effort or the most microscopic success is worth more than telling them what and when they did something wrong.

Teaching strategies

Give children additional time to carry out the assigned tasks. Working with children begins at any level at which they can achieve success.

Create opportunities for children to listen to different stories or situations.

Build a personalised educational plan (PEP), focusing on work to improve the child’s reading skills by using relevant strategies.

Use alternative tools, such as a simple tape recorder; this enables the child to listen to the content of the part he/she will read on tape, thus enhancing it. Also, using certain techniques (such as reading the text aloud, giving additional time in exams, taping the lesson or using other technologies) can help the child’s situation.

Photocopy parts of the text but in larger letters or with greater spacing between lines.

Allow alternative learning formats (such as igures, cutting and pasting magazine pictures, photographs, plays or sketches) to show the content of the part that the child has read.

In the higher grades, the child may also use a computer, which should come with programs enable the child to listen to text read aloud rather than reading it from the computer monitor. To ensure

this capability, you may request assistance from community resources, such as parents, school social workers or psychologists.

Allow the child with reading dificulties to practise reading different parts of a text with a friend he/she trusts and feels supported by.

Create small groups of four to ive students and divide tasks; create opportunities for children with reading dificulties to receive support and help through group work. In these efforts, you should

seek to improve reading accuracy (if children can listen to themselves reading, they will be able to correct their mistakes).

After that, you may encourage the student try to increase his/ her reading speed, even slightly, explaining that during this class they will read in a different manner. While the child is reading, he/she accompanies lines with a inger or a wood pointer on which the teacher has written the student’s name with a crayon. As the child is reading, the teacher measures the time it took; after the child repeats this action, the teacher tells the time difference and gives a reward when the reading time is shorter, even by seconds. If the child manages to read the piece 10 seconds faster than the irst time, give a prize of a label with a coloured clock drawn on it.

Meanwhile, the teacher should try to have the speed the child has gained in reading keep pace with reading accuracy. Of course, this requires more engagement by both the teacher and the student. The child is continuously instructed to follow the line with the index inger or the wood pointer prepared for this purpose.

Establish control/monitoring systems for every phase of the reading session so the child learns to understand mistakes; for instance, draw a little inclined line symbolising a sun ray on the


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letter or word that the child irst read wrong, but then corrected and a raindrop on the letter/word that the child has not succeeded in correcting. In the end, collect the drops and lines to see how many sun rays and how many raindrops are in total. If all the lines can draw a pretty sun, do that and give it to the child as a gift, offering encouragement and praise.

Students should always understand what they are reading so that their skills can improve. For this purpose, it is helpful to assign a friend to work in pairs. Make sure you take into consideration the students’ similarities in pace and accuracy of reading. The student should feel that he/she has an active role and that the teacher is a passive listener. The friend you’ve assigned for the child and the child follow one another’s reading, being careful and paying attention to ind and correct any mistakes. At the end of the reading, they make those mistakes known to one another.

Through group games, students with reading dificulties may have visible improvements in correctly pronouncing or reading words. Divide children into small groups of four to ive children and assign some tasks that look more like games. For instance, children are asked to write in green all the names of fruit that come to their mind within two minutes. Always praise children for the work they have done and then ask them to tell you the similarities and differences between some fruit.

Ask students to write the phrase “golden sun” and then ind words that begin with a ‘g’ and an ‘s’ within one minute.

Examples that may be useful in your work: students write within one minute the names of cities that come to their mind and then are asked to speak and describe the cities they know of or have heard about; they may express their feelings and emotions if the cities or places mentioned are where they were born, have grown up, spent holidays in, or have other memories of. Students are asked to mention in two or three words the tools that symbolise the professions they will choose when they grow up and improvise the movements or actions personiied by these professions.

Writing dificulties and dysorthography

Dificulty related to written language is otherwise known as dysorthography. This refers to the dificulty children have in writing the language they speak. It may come as a result of language dificulties, or lack of skills in visual and listening perception. Dysorthography is the dificulty in correctly translating the letters that make up words in graphic symbols (McWhirter, J.J., 1977).

Dysorthographic children may:

be confused when phonemes sound similar. The child mistakes alphabet letters that sound similar when pronounced, such as F and V, P and B, T and D, Z and C, K and G and so on.

be confused when graphemes are similar. The child has dificulties recognising alphabet letters that are similar in shape, for instance: b and p, m and n, a and e.

forget parts of the word, for instance when the word has double consonants, vowels in the middle of the word or middle consonants.

may swap the place of letters in a word, such as teapot – teatop.

Often, as a result of dyslexia, the child who has reading dificulties also displays writing dificulties. Mistakes often overlap those made while reading. The child similarly encounters the same dificulties in analysing phonemes and their transcoding into graphemes (letters). Dysorthography is often hard to distinguish from dyslexia.

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The main characteristic of dysorthography is that writing skills (measured according to tests or evaluation of the functioning of writing skills) are visibly under the generally expected levels, considering chronological age, measured intelligence and the child’s schooling cycle vis-à-vis his/her age. This dificulty in writing skills has a visible impact on school achievements or daily life activities that require writing abilities. If a sensory problem is present, dificulties in writing skills become even more complex.

Dysorthography has to do with the physical writing activity or the mental activity of understanding and synthesising information. The child has dificulties expressed in physical inability to form words and letters during the writing process. The dificulty of written language demonstrates the child’s struggle in organising thoughts on paper.

The child is not stable in his/her writing skills.

The child has dificulties in correctly copying letters and words.

The child makes orthographic mistakes, has dificulty in organising writing.

Graphic functioning dificulty (dysgraphia)

Dysgraphia is the damage of graphic functioning. It is a learning dificulty that affects writing and requires a complex set of motor and information processing skills. Dysgraphia makes the act of writing dificult. Children with dysgraphia may have dificulties in organising letters, numbers and words in a line or page (Ferrari, P., Epelbaum, C., 1993).

This may be partially due to:

visual-spatial dificulties: trouble processing what the eye sees

language-processing dificulties: trouble processing and giving meaning to what the ear hears.

Dysgraphic children do not discern letter shapes and write letters backwards or distorted/inclined. Their writing is unreadable; they may write combining hand letters and print letters. As they write, they pronounce words. They have dificulty following the line and their writing doesn’t follow the same direction. They may not inish the sentence or create empty spaces. As with any other kind of learning dificulty, dysgraphia is a challenge that lasts for the life of an individual – although the way it is manifested may change with time.



Sit the student at the irst desk.

Eliminate the things that may distract the student’s attention from school tasks.

Ensure a quiet learning environment.


Organise curricular and extra-curricular activities that improve the child’s social skills and strengthen ties with peers. Adjust various parts of the contents, the pedagogical corpus and illustrations in textbooks.


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Managing behaviour

Call the student often by name.

Give frequent positive feedback and frequent rewards for the work the child is doing and encourage parents to do the same.

Establish rest breaks.

Provide rewards or incitements that motivate and preserve the child’s interest.

Encourage parents to establish a daily routine that assigns time for the child to learn, time to play and time to be spent with the family.

Reward positive behaviour regularly and in proportion to the importance of the behaviour.

Punish negative behaviour regularly and in proportion to the importance of the behaviour.

Communicate regularly with the child’s parents and the school psychologist/social worker.

Advise the parents to have their child examined by a physician to rule out potential problems related to their hearing, sight or any other health issues that may interfere with their learning skills.

Discuss with the child’s parents the characteristics of their child’s learning dificulty and the need for close cooperation with them.

Teaching strategies

Work to reeducate dysgraphia, (children’s writing) by encouraging ine motor development of ingers/hands; for example, children may cut with scissors following a line that has different directions, work with play dough or clay, making different forms and letters, put beads of different sizes on a thread, engage in different games in the open.

Divide into some phases the process for learning one or more tasks.

Teach the child problem-solving techniques, such as problem identiication – inding different alternatives for solutions, choosing an option, implementing and evaluation.

Dificulties in math skills (dyscalculia)

Dyscalculia is the dificulty in learning math functions and logical reasoning. Dyscalculia has to do with the inability to carry out mathematical actions, which creates many dificulties for the child in the school environment. These children have dificulty classifying objects from the largest to the smallest or classifying objects by their characteristics. Problems with numbers or basic concepts appear earlier, while problems with reasoning may appear in the following years (Ferrari, P., Epelbaum, C., 1993).

The main characteristic of this dificulty is that mathematical skills (mathematical reasoning or calculation, measured according to individual standardised tests) are under the expected level, considering the chronological age, measured intelligence and child’s schooling cycle in relation to his/her age. This dificulty in mathematical skills has a visible impact on school achievements or daily life activities that require mathematical skills. If a sensory problem is also present, dificulties in math are numerous and complex.

The child that displays this dificulty may mistake mathematical symbols and read numbers wrong. Basic dificulties are related to understanding numbers and their different functions, integrating the decimal counting system and the realisation of the simplest mathematical operations. The child may have dificulty operating with numbers/igures rationally, even if he/she knows and reproduces them. The

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child may change the order (may write the number 12 as 21), place them randomly, not differentiate between units and wholes, etc. Sometimes, the child may fail in conducting deductions (later divisions) or may not understand the use of zero (Pennington, F. Bruce. Diagnosing, 2009).

Children with dificulties in mathematical skills often lack luency and accuracy in deciphering numerical information from one form of expressed language to another, the written language. This process, called ‘transcoding‘ occurs when, for instance, a student is asked to write the number ‘7‘ after he/she has heard the word ‘seven‘ before. Children who have dificulty with mathematical skills need more time to translate a word given to them into a number because they need more time to think before writing.

Such children have trouble remembering numbers; they also ind it dificult to organise numbers, signs of math operations, such as confusing operations that have similar igures (such as 5+5 = 10 or 5x5 = 25). Also, children with mathematical dificulties may have problems with the rules and principles of counting, and may start counting from number 2 or number 5. The time of carrying out actions or mentioning the sum or result of a math operation is another challenge for these children.



Organise well the class and preserve his/her attention.

Choose all the tools and create learning conditions for these children.

Create a supporting environment.

Change class routine to help children with learning dificulties.

Preserve his/her social relations with other class students.

Prepare the other children in the class, in order for them to understand the situation of the child that presents learning dificulties, at an appropriate level for their age and according to the nature of the problem.


Try to understand the learning characteristics of students and plan appropriate instructions based on the program.

Use every part of the curriculum to help the student.

Managing behaviour

Communicate expectations for good behaviour.

Observe and evaluate the child’s learning dificulties.

Stress successes more than failures.

Model the right behaviours.

Communicate with children positively, sensitively and encouragingly, using humour as well.

Know the children’s strengths, reward them and encourage each child in areas of interest, even outside of school.


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Show the child you have believed in him/her, that with efforts and the right assistance, he/she will overcome the challenges.

Talk with the child about learning dificulties.

Cooperate with the psychologist/social worker of the school or other specialised centres to psychologically test the child, to determine whether the child has learning dificulties or mental retardation, attention deiciency disorders, hyperactivity, etc.

Together with the psychologist/social worker and the child’s parents, create a personalised educational plan for the child.

Encourage and preserve interest, initiative and motivation in school activities and increase the performance level based on intellectual skills.

Establish realistic expectations for the school achievements of children with learning disabilities.

Improve the child’s self-esteem by encouraging positive afirmations about him/herself and participation in extra-curricular activities.

Eliminate the child’s harmful or negative behaviours that require attention, when he/she is faced with frustration and dificulties during the learning process.

Establish a successful reward and punishment system that enhances positive behaviour and discourages negative behaviours.

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6STUDENTS WITH LANGUAGE AND COMMUNICATION DIFFICULTIES

“Involving Deni in the class was a challenge that helped me improve my teaching methods.”

Teacher, Tirana

Child case

Deni is a second-grade student. He is a healthy child, very nice and friendly with his classmates. He is the best goal scorer in the class when he plays football during P.E.; the entire class cheers for him in other sports events. Oten Deni feels bad in class and sometimes begins to cry. He speaks with a monotonous voice, makes long pauses and needs to try hard to pronounce sounds, syllables and even certain words. Initially, his parents found it diicult to accept Deni’s challenges, but, eventually, they had him evaluated by a language therapist, who diagnosed Deni with apraxia. his is neurological condition characterized by loss of the ability to perform activities that a person is physically able and willing to do. Now the teacher works with Deni based on the individual educational plan the school commission has drated for him, in cooperation with the therapist and his parents.

Speech development is often linked with the child’s physical maturation, cognitive development and social skills. We are concerned about the child’s speech development when we encounter dificulties, obstacles in this very natural process of his/her development.

Impairments in using speech often cause problems in communication. In order to communicate or exchange ideas, different forms may be used, such as: words, phrases, or body movements. When a child has dificulties in exchanging information, his learning ability is impaired and socialisation is impeded. (Bennett, S., Dworet, D., & Weber, K., 2008).

Although communication and speech may be two separate entities, they are treated and analysed in close connection with one another. Speech has its function – it is one of man’s most developed cognitive skills.

Many children are identiied as having speech and communication disorders after they enroll in the school system. What teachers should do as they identify child dificulties is cooperate effectively with parents, in order to refer the child to specialised evaluation.

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Demystifying speech and communication disorders

Myth

• Stuttering is part of the child’s typical speech development.

• Stuttering stops in adulthood. It happens only in early childhood.

• Children have problems in communication because they are shy.

Fact

• Stuttering is a speech dificulty and is not part of normal speech and communication development.

• Stuttering does not stop in all children, without some special therapy or assistance. Often, specialised therapeutic intervention is required.

• Family and school environment may or may not favour the child’s communication.

What are speech and communication disorders?

The term ‘speech and communication disorders‘ includes a wide variety of speech, speaking and hearing problems. Speech and communication disorders include problems in articulation, disorders related to voice, vocal luency (such as stuttering), aphasia (dificulty in using words, usually as a result of brain injury) and delays in communication or speech. Speech and communication disorders impact the way the child communicates, understands, reads, writes, analyses and processes information

(Ferrari, P., Epelbaum, C., 1997).

Main causes of speech and communication disorders

There are various causes of speech and communication disorders, including loss of hearing, neurological disorders, brain injuries, intellectual disabilities, physical injuries, accidents and abuse or misuse of the voice. Other speech and communication disorders can be caused by learning dificulties, cerebral palsy, mental retardation, etc.

It is important to differentiate between a speech disorder and a communication disorder.

Speech

Speech is an arbitrary code or system of symbols used to convey thoughts. Speech is a complex function gained during childhood, in connection and cooperation with all other areas of development. Speech (speaking) fulills a number of functions in a child’s life:

The function of interaction. Through speech, the child conveys his/her thoughts and tries to realise speaking. From the start, speech takes part in the expression of all feelings related to the relationship of the child with the world around him.

A function of self-afirmation and to express personal experiences.

An informative and representative function of the outer world.

An abstracting function related to the thought process.


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Speech reaches us in two forms; receptive speech and expressive speech. These two forms are realised through communication. Communication is a broader notion. Communication is the formation of sequences of oral linguistic sounds, which we use luently as we speak.

Receptive speech is the speech received through communication. It is what we receive during a conversation.

Expressive speech is the speech that conveys the thought; what we speak.

Speech development is generally related to physical maturity, cognitive development and social skills of the child. The speech learning process depends on brain development and speciically its functioning, thus speech disorders are sometimes the result of brain disorders and the way to compensate for that dysfunction can be learned. Speech disorders may also be the result of improper learning. Speech may be analysed as a relationship related to the way information is processed.

Speech is based on linguistic rules and disorders may be described as the failure of using these rules in message coding and decoding.

Speech itself is one of the cognitive skills so disorders come from problems related to thinking and learning.

Likewise, speech is developed from the need to communicate, so disorders may derive from impairments in this skill.

Speech disorders also include active language (spoken language, written language) and passive language (heard and read language).

Speech disorders include the child’s inability to hold meaningful conversations, understand others, resolve problems, read, express thoughts through written or expressed speech (Greenspan, S., 2004).

Main characteristics of children with speech and communication disorders

A child with a speech and communication disorder may display a variety of characteristics, including the inability to follow instructions, speaking slowly and incomprehensibly, inappropriate use of words and their meaning, inability to express ideas, improper grammatical patterns, limited vocabulary, marked dificulties in syntax construction of sentences and their articulation. Such disorders have various causes and may vary from bad pronunciation of the sound, letter, or word, to their repetition and up to complete loss of the ability to use speech to communicate effectively.

The child with speech disorders has problems with recognising, understanding and formulating what he reads, what others say, or even those things the child wishes to say (Turnbull, et al., 2004). This dificulty may inluence the way the child interacts in school, in the family, or in the society. Speech disorders are also related to other disorders, such as hearing damage, autism, cerebral palsy, etc. Any child may display a unique combination of these features, which requires a wide range of interventions, diagnosis, and work strategies and techniques, adjusted to the child’s speciic needs.

Speech and communication disorders may have different characteristics.

1. Phonetic: (Phonology is the manner of combining sounds to form words, that is, the system of sounds and rules governing such combination.) Dificulties of a phonetic character have to do with the child’s dificulty with sequencing and combining sounds to form words.

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2. Morphological (Morphology is the system that guides word structure. It has to do with the singular and plural of nouns, verb tenses, sufixes and composite words). When the child has a poor vocabulary, when sentences have an irregular morpho-syntax structure, then we have dificulties of a morphological character.

3. Syntax (the way words are placed in a sentence). When the child builds sentences incorrectly from a syntax standpoint and often without meaning, we may have dificulties of a syntax character.

4. Semantics (the entire meaning of the word or sentence). When the child inds it dificult to understand words and sentences, we have dificulties of a semantic character.

5. Socio-linguistic (linguistic use of social and civic norms). When the child has dificulties in the social aspect of communication, we have dificulties of a pragmatic character.

Speech and communication disorders may also cause behavioural disorders in some children. This happens because children with speech and communication disorders may have dificulties communicating and interacting with their friends, playing with them or solving problems. These problematic behaviours include physical aggression, lying, hyperactivity, impulsive behaviour and frustration. These children interact with their peers less than other children who do not present these disorders, due to the frustration deriving from the dificulty communicating freely with others (Huaqing Qi & Kaiser, 2004).

Main types of speech and communication disorders:

I. Speech disorders

are related to speech injuries. The child has dificulties expressing his/her needs, ideas or thoughts and/or understanding what others are saying.

Speech disorders may include:

a disorder related to expressive speech (dificulty in expressing ideas or needs, dificulty in using words together, limited vocabulary, or inability to use language in an socially appropriate manner)

a disorder of perceptive speech (dificulty in understanding what the others are saying)

a mixed linguistic disorder (which includes both of the above categories).

These dificulties have to do with the child’s inability to understand, use, or write words and/or other systems of symbols, such as gestures or sign language. This type of disorder includes any possible combination of the following (Broomield, J., & Dodd, B., June 2004):

1. form of speech, phonology (arrangement, right combination of sounds)

2. structure of words (morphology), syntax (order and combination of words in a sentence)

3. content of language (semantics, meaning of words and sentences)

4. function of speech in communication (pragmatism, combination of language components (phonology, morphology, syntax and semantics) in appropriate functional and social ways).

Disorders in linguistic development are characterised by slowing down or lack in development of linguistic skills.

1. Simple linguistic delay has to do with disorders in the syntax and morphological organisation of the sentence, also related in general with disorders of understanding language. This does not have anything to do with mental retardation, hearing disorders or marked personality disorder (Hirst, E., & Britton, L., 1998).


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Linguistic delay may be accompanied, not in all cases, with articulation disorder or delays in speaking, such as:

little or no problem with understanding language, but anomalies with expression

major scarcity in vocabulary, expressed in rudimentary language, sentences formed by a simple union of words without much connection, disorders in putting words in a sentence

delays in capturing different grammar notions (verb tense, cases, person, pronouns, etc.)

confusion of words

presence of many deformed words.

2. Aphasia/dysphasia is a communication disorder that has to do with the loss of acquired linguistic skills, usually resulting from a brain injury. It is manifested through spoken language dificulties.

Both terms refer to the complete or partial loss of verbal communicative skills, due to injury or deformation of brain linguistic cells. Dysphasia/aphasia is the most severe and most serious form of language delay. In terms of its nature and signiicance, it is different from simple language delay. Dysphasia/aphasia in children should not be mistaken for simple language delay, which is less severe in nature and evolution, or other speech disorders that may be encountered in children. The diagnosis of dysphasia may only be conducted, after conirming the absence of deafness and mental retardation. The main feature of this dificulty is the inability to comprehend language and to speak it.

This has to do with dificulties in understanding or producing spoken language (to tell a story verbally or to communicate with someone, to speak luently, to understand correctly words, instructions, tasks, etc.). Dificulties in expressed language interfere with academic achievements and other extra-curricular activities, as well as with the child’s social communication. (Ferrari, P., Epelbaum, C., 1993).

In all cases of dysphasia/aphasia, a specialised evaluation into potential dyspraxic disorders must be conducted.

Characteristics of symptoms of this aphasia/dysphasia

Children with dificulties in expressed language (Ciocci, S. R., 2002):

have limited vocabulary

have marked reading dificulties, accompanied by marked academic retardation

make mistakes with verb tenses

have dificulty inding words or forming sentences of length and complexity proportionate to their age and development

have a normal intellectual level, although in some cases may display mild intellectual retardation during psychometric tests

may not be able to retell a story in the correct order

may mispronounce or use a wrong word that sounds like another word they have learned or read before; may have poor, inaccurate and limited vocabulary

make numerous semantic mistakes while their syntax structure is very primitive (use of other elements, aside from the subject and predicate is dificult)

may have dysphasia accompanied by dificulties relating to dyspraxia (non-functioning of bucco-facial movements, which enables speaking

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make inaccurate articulations, produce deformed words, make discussions that are not well structured grammatically, which makes the execution of language dificult, thus making language too modiied and dificult to understand.

In order to be understood by others, the child uses a gesture language that in some cases may become his/her primary way of communication. Though the child may be subjected long therapy, it may happen that his/her ability to comprehend and express remain limited.

3. Speech and communication disabilities:

Muteness is deined as the disappearance of speech in a child who previously had developed the skill of speech. No causes of an organic nature or factors that may cause aphasic/dysphasic condition are noticed. In the majority of cases, muteness is involuntary and is subjected to a subconscious mechanism. Muteness may be transitory, total or partial.

Total muteness

is generally transitory and disappears after a few weeks but, sometimes, it may last longer and resist therapy. Its disappearance may be followed by a long period, during which the child speaks in a low voice and stutters. It may be accompanied by other behaviour disorders, especially encopresis (involuntary fecal soiling). Total muteness, in the majority of cases, is the result of a situation of great emotional stress for the child (death, separation, violence, etc.).

Total muteness, otherwise called emotional muteness, may testify to a dificulty or inability of the child to speak about the situation he has just gone through, due to the traumatising character of the experience.

What should be done? This form of muteness solely requires the psychotherapy conducted by relevant specialists. This is done to allow the child to express his feelings and the meaning of the experiences he/she has faced.

Partial muteness

Partial muteness may appear in the extra-family context, usually at the time school begins. The child does not speak either with friends or his/her teachers. On the contrary, he/she can preserve very good academic eficiency in all written subjects. This muteness may lead to the child’s isolation, risking academic retardation, although the child possesses good intelligence and a desire to study.

Very often, muteness is a manifestation of aggressiveness and objection, unconscious and hardly accepted by the child, towards the people around him/her; the latter may engage very quickly in a force test to force the child to speak. Generally, muteness expresses in the child marked self-blaming of the act of speaking, provoking a deterrence of oral activity, a desire for self-restraint and for controlling speaking (Ferrari, P., Epelbaum, C., 1993).

Communication disorders

Communication disorders include clarity of speech, voice quality and the luency of speaking. They are characterised by damage to the voice and articulation of sounds or impediments to luency.

We distinguish:

Articulation disorders, which have to do with damage to speaking and are characterised by the child’s inability to form or connect sounds, letters or syllables. The child replaces one letter with another, omits letters, doesn’t include letters or syllables and this leads to deformation of words


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or their mispronunciation Examples include dificulty with the articulation of certain letters/sounds, such as ’L’ or ‘R’ to the extent that others cannot understand what the child is saying.

Apraxia is a motor communication disorder, characterised by mistakes in speaking. The child understands more than he/she speaks, inds it dificult to engage in a spontaneous conversation and may be incomprehensible to a stranger. Apraxia may be developmental, or may be caused by external factors. Some of these latter factors include a blow, various tumors, or an injury to the head. Children with this dificulty have problems with the use of words or long sentences, especially in situations that provoke anxiety and tension (Turnbull, et al., 2004).

This does not come as a result of bucco-facial motor muscle weakness or paralysis but rather is due to the fact that the child’s brain inds it dificult to organise the movement of the body parts (lip muscles, jaws) that are necessary to speak. The child knows what he/she wishes to say, but his/her brain struggles with coordinating the movement of muscles necessary to say those words.

Communication luency disorder has to do with damage to the speaking by the interruption in the low or pace of the word/sentence, characterised by hesitation, repetition or prolongation of sounds, syllables, words or phrases. Stuttering has to do with the speed and pace of speaking and eloquence.

Stuttering should be considered as a disorder of oral communication originating from a rational dificulty that often becomes the source of a social problem. In this context, stuttering or stammering is a disorder that includes the repetition of words, sounds, syllables, hesitation to speak, or impediments/blockages, while the children are speaking. This occurs because ideas/thoughts come to the child’s mind faster than his/her ability to express them, especially if the child is nervous, stressed or agitated. Some children may begin stuttering in response to stress, exhaustion, aggravation or harassment. The pressure a child is be under may also cause stuttering.

Stuttering may be:

clonic stuttering, which causes irregular and marked repetition of a consonant at the beginning of a word

tonic stuttering, which causes a blockage resulting in an interruption of the normal phrase low, sometimes at the very start of it.

Stuttering is never permanent, but varies depending on the circumstances in the child’s life. It is related to communication situations especially when the child is emotionally distressed (affective situation of the subject, nature of interlocutor, or of the given message). It may fade away and even disappear during reading, singing, or when the child is alone or is not addressing a person directly. Stuttering always implicates two people – the stuttering child and his interlocutor, as the child sees him/her. When stuttering appears later, it comes with an immediate emotion. In this case, its occurrence should be related to the child experiencing a traumatic situation. Cases that occur early sometimes disappear spontaneously, while others continue for a long time. Some stuttering children do not seem to be bothered by this phenomenon and do not devote importance to their dificulty. Stuttering in them may occur in intervals and not harm their emotional development or existence. On the contrary, for some others, this situation is very disturbing and affects their behaviour and how they organise their relationships with the society (Ferrari, P., Epelbaum, C., 1993).

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Disorders related to the voice.

This kind of disorder has to do with damage to speech caused by injury and is characterised by unusual voice (very high or very low, unchangeable, interrupted by long pauses), problems with the quality of the voice (hoarse, harsh, very soft, noisy, nasal, accompanied by whistling), or problems related to voice intensity.

When interacting with a stuttering child,

Keep in mind the following:

The attitude of the child’s teacher and friends is very important. A negative environment at school or in the family, wrong interventions, or a lack of interest can be very harmful. It is important to build an accepting and supporting environment. Some children, out of fear of being ridiculed by friends, avoid verbal contact and isolate themselves from society.

Tips:

Avoid correcting or interrupting the child when he/she is speaking; ask others to do the same. Listen patiently to every word the child is saying. Maintain eye contact – don’t interrupt the child. Ignore the stuttering and give lots of love to the child. Don’t ask the child to repeat what he/she has said, or to slow down the pace of his/her speaking. Speak to the child slowly and clearly. Give the child the necessary time to inish what he/she is trying to say. Try to reduce stress and situations that cause or aggravate stuttering.Support stuttering children and show them you accept them just as they are and just the way they speak.


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Make the necessary arrangements/modiications in the classroom. The physical environment in the classroom is very important for the learning process for students with dificulties in speech and communication.

Sit the student at the irst desk so he/she is close to the teacher and is able to understand questions and instructions (Dockrell, J. E., & Lindsay, G. 2001).

The material used is an integral part of the classroom. Didactic material and tools may be adjusted to the speciic needs of students; use schemes, images, other visual tools to communicate with children.

Managing behaviour

Encourage other children to be compassionate when children with speech dificulties are speaking.

Learn more about dificulties in speech and communication.

Encourage child self-conidence.

Teaching strategies

Establish a system of signals with the child; this will help the child communicate to you when he/she needs help without distracting class attention.

Gain the child’s attention so he/she can listen to you before you speak, by looking the child in the eye and tapping on his/her shoulder;

Give clear and well-organised instructions; ask frequent questions and solicit feedback. Encourage children to initiate and direct conversations with their peers, by challenging the insecurities and the hesitation they feel in engaging in conversations.

Be patient; let the child inish his/her words and sentences. For a child, having dificulty with speech and communication may be extremely frustrating; ask questions about something you did not understand and the child can tell you in short sentences, or tell the child about the part you have understood.

Replace oral tests with written tests.

Enhance and reward the child’s positive linguistic developments often.

Maintain frequent contact and collaborate with the parents, psychologist and speech therapist.

How do we approach students who have speech and communication dificulties?

Children with such dificulties should be referred to specialists for a linguistic evaluation.

Psychosocial evaluation is also necessary and teachers should recommend this to the parents.

A PEP should be drafted for these children, in cooperation with the speech therapist, school psychologist and the parents.

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Bibliography

• Broomield, J., & Dodd, B. (June 2004), ‘The nature of referred subtypes of primary speech disability,’ Child Language Teaching and Therapy, 20(2), 135-15.

• Bennett, S., Dworet, D., & Weber, K. (2008), Special Education in Ontario Schools, Sixth Edition.

• Ciocci, S. R. (2002), ‘Central Auditory Processing Disorders,’ Ofice of Educational Research and Improvement.

• Dockrell, J. E., & Lindsay, G. (September 2001), ‘Children with Speciic Speech and Language Dificulties – The Teachers’ Perspective. Oxford Review of Education, 27(3), 369–394.

• Greenspan, S. (2004, January/February), ‘Working with the Child who has Delayed Speech,’ Early Childhood Today, 18(4), 22.

• Hirst, E., & Britton, L. (1998), ‘Specialised Service to Children with Speciic Language Impairment in Mainstream Schools,’ International Journal of Language and Communication Disorders, 33(Suppl), 593–598.

• Huaqing Qi, C., & Kaiser, A. P. (2004, June), Problem behaviours of low-income children with language delays: an observation study. Journal of Speech, Language, & Hearing Research, 47(3), 595–609.

• Ferrari, P., Epelbaum, C., (1993), Psychiatrie de l’enfant et de l’adolescen, Paris, Médecine-Sciences/Flammarion.

• Law, J., Lindsay, G., Peacey, N., Gascoigne, M., Soloff, N., Radford, J., & Band, S. (June 2002), ‘Consultation as a model for providing speech and language therapy in schools: a panacea or one step too far?’ Child Language Teaching and Therapy, 18(2), 145–163.


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7STUDENTS WITH INTELLECTUAL SKILL DIFFICULTIES

‘The tragedy is not my child with mental disability, but the way our society responds to him.’

Parent

Elvi is a student in my class with limited intellectual skills. Although I try to work with him independently, he has major dificulties in most subjects. He speaks slowly and not clearly, because he can’t manage to pronounce part of the letters, especially nasal consonants. He has poor vocabulary and speaks loudly. He knows the letters of the alphabet and numbers up to 10, but can’t manage to write for long as his hand gets tired. His writing is full of errors and very disorderly. Elvi has a lot of dificulties in all tasks that require movement and coordination. He loses attention very easily, while doing homework. Any time he asks for something and doesn’t get it, he gets very nervous. Occasionally, he does indecent acts that often make all of us laugh and sometimes disturbs us because we don’t know how to react. I never leave him alone and accompany him everywhere in the school; when I can’t, I ask other students to help. I often worry about him as there are situations in which I don’t know what to do.

Third grade teacher

Do this child’s features and challenges sound familiar? Have you ever had direct experience with children with these characteristics in your class? Have you had questions that still don’t have answers? If so, this chapter is for you.

This chapter was written to help you familiarise with the nature and needs of students with limited intellectual skills in order to be help you organise the teaching process with these students. Here, you will ind, summarised in two main sections, rich and thorough information about students with limited intellectual skills.

The irst section offers general knowledge about identiication, causes, main types and characteristics of students with limited intellectual skills. The second section seeks to equip teachers with information about methods, strategies and principles of educational work to support these students in ordinary school environments.

Demystifying intellectual disability

Myth

• Students with intellectual disability are violent and become criminals when they grow up.

• Children with disabilities behave like babies and will always remain that way.

Fact

• Disabled children are not more violent and do not have more potential to become criminals than other students.

• Children with intellectual disabilities are capable of behaviour compatible with their age.

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What is considered an intellectual disability?

‘Intellectual disability, otherwise known in some countries with the term intellectual impairment, is characterised by considerable limitations in intellectual functioning and adjusting behavior, expressed in conceptual, social and adjustment skills. This impairment appears before the age of 18’ (AAIDD, 2002). Initially, intellectual or cognitive disability was known as mental retardation. In some countries, such as Great Britain, this category is known as serious learning dificulty or disorder (Gulliford 1992). In our country, the legal term still used for this category of disability is ‘mental retardation.’ Intellectual disability is not an illness of medical or mental character. This disability is a special condition of functionality, which begins in childhood and is characterised by limitations both in intelligence and adjustment skills. Intellectual disability relects compatibility between the individual’s abilities and the environment expectation structure (AAMR, 1992).

International research shows that individuals with intellectual disability represent about 3 per cent of the world population (Prater 2007). In fact, individuals with this disability represent a very heterogeneous group, including both a small number with a very low level of functionality and the majority who have less serious dificulties, which are identiied only when the child begins school. Statistics vary from country to country but, in general, about 85 per cent of children with intellectual disabilities worldwide belong to a category of people whose disability is not severe. This group used to be known as ‘educable.’ They are only slightly below average in terms of learning new skills and information. Some of them are diagnosed only when they start school. When they grow up, these individuals can have an independent life.

The remaining 10 per cent of people with intellectual disability has an intelligence quotient of under 50 (the average IQ is 90 to 110). They have more dificulty at school, at home and in the community. The more profound their intellectual retardation is the more urgent the need for support. However, no matter how serious the speciic situation is, every individual with intellectual disability is capable of learning, developing and growing. Thus, students with an IQ between 35 and 40 and 50 and 55 are included in the light intellectual disability category. Students in this category (once known as educable) represent about 5 per cent of all individuals with intellectual disability and attend ordinary schools in many countries.

Students with serious and profound intellectual disabilities (as a rule, with an IQ of less than 35) need continued support and generally are more dependent upon others in many of the areas of practical life skills. This is the smallest group of students with intellectual disabilities (less than 2 per cent).

In most countries, students in this group attend special schools or other rehabilitation institutions. Nevertheless, in some developed countries, they attend inclusive schools.


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Main causes of intellectual disability

Although to some readers, the explanation below may seem entirely unnecessary and maybe unethical, in order to provide answers for some teachers, we believe it is necessary to emphasise:

Intellectual disability is not an illness or infection. Therefore, there is no medical treatment for it. Of course, people with this disability cannot infect individuals nearby.

Research shows that there is a large number of causes for intellectual disability, which may be summarised into:

genetic causes (considered the most frequent cause)

problems during pregnancy

problems during labour

other general health problems (of the mother and/or child) (AAIDD 2010).

Genetic causes are among the leading causes of intellectual disability. This may be the result of abnormal genes inherited from parents, misplacement in combination of certain genes, or other problems related to genes. Some of the most known genetic syndromes are Down syndrome, Phenylketonuria (PKU) and Klinefelter syndrome.

The term ‘syndrome’ indicates a series of characteristics that tend to appear together. In general, all genetic syndromes that result in intellectual disability cause distinguishing physical features.

Down syndrome is one of the most common disorders related to chromosomes accompanied by mental retardation. Children with this syndrome have 47 chromosomes instead of 46. Usually, an additional chromosome is attached to the 21st pair of chromosomes. As a result, instead of two chromosomes, the 21st pair has three (Berne-Smith, M., Patton, J. R., & Kim, S. H. (2006).

Individuals with Down syndrome have a characteristic physical appearance. They usually have a smaller stature than their peers who are not affected by this syndrome. Some of the distinguishing characteristics are: round face, long and thick tongue usually sticking out, oval eyes and lat nose bridge, small head that is lat on the back, short neck and ears, short and wide limbs, motor retardation and poor harmonisation of muscles. In general, these individuals suffer from heart disturbances and dificulties and problems related to sight, the respiratory system and hearing.

Klinefelter syndrome is a combination of physical anomalies deriving from sex chromosome disorders – pair 23 (males have an extra x chromosome). These anomalies become more visible during or after puberty and may include the development of secondary female characteristics, undeveloped testicles, scarce hair growth and mental retardation.

Williams syndrome is caused by the lack of material in the seventh pair of chromosomes. Individuals with this syndrome have an IQ that varies between 40 and 70. They also tend to have heart problems, oversensitivity to sounds and characteristic facial features.

Fragile X syndrome is the most frequent inherited cause of intellectual disability. (Taylor et al., 2005). It is related to chromosome x in the 23rd pair of chromosomes and it appears twice as often in males. Some of their physical features are a big head, big open ears, narrow long face, protruding forehead and wide nose. Although this syndrome often results in mental retardation, some individuals have less intellectual limitations than others and especially females have normal intelligence

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Praeder-Willi syndrome is inherited from the father and is marked by an absence of genetic material in the 15th pair of chromosomes (Dykens, 2000). Their biggest medical problem is obesity, while other accompanying medical problems are heart defects and sleep disorders. The level of mental retardation in these individuals varies from mild mental retardation to individuals with normal intelligence (Taylor et al., 2005).

Phenylketonuria is an inherited genetic metabolic disorder, which lacks the necessary enzyme for the metabolism of phenylalanine, part of the protein that is a component of many foods. Unlike the above syndromes, people with PKU do not display obvious physical features. If not treated, the lack of this enzyme causes high levels of phenylalanine in the blood and could impact brain development and learning.

Problems during pregnancy and birth

Intellectual disability may come also as a result of underdevelopment of the fetus. Also, drinking alcohol during pregnancy, or rubella during pregnancy could cause intellectual disability in the baby. During birth, the baby may be damaged if its brain does not get necessary oxygen.

Health problems

Illnesses such as whooping cough, measles and meningitis can cause intellectual disability. Other causes leading to intellectual disability are extreme malnutrition, inappropriate health care, or being exposed to poisons such as lead and mercury.

How intellectual disabilities are identiied

Years ago, (although this practice is still used in our country), people were subjected to an intelligence evaluation in order to identify whether they had any intellectual disability. If a person’s IQ was under 70 and the person manifested dificulties in adjusting behaviour and functioning independently, the person was considered to have mental retardation. In many countries, this practice is changing towards emphasising the evaluation of the individual’s ability to function independently and the level of support required. (Batshaw et al. 2007).

In our country, medical commissions consisting of doctors specialising in these areas as well as other specialists, diagnosis of intellectual disabilities is done by evaluating two main areas: intellectual functioning and the child’s adjustment behaviour.

Intellectual functioning is the individual’s ability to learn, think, resolve problems and understand the world. Intellectual functioning in general is measured through intelligence tests – for most people, the average score is 100. Individuals who get a score of less than 70 to 75 points are believed to have intellectual disability.

Another area the commission evaluates is the child’s adjustment behaviour, which is known as the adjustment function or an individual’s ability to learn and apply life skills, in forms that allow him/her to live independently. In other words, it is a summary of conceptual, social and practical skills that help the individual to function in daily life. In order to measure adjustment behaviour, professionals consider what the child is able to do, compared to others of the same age. They observe adjustment behaviour in three areas:

Daily life skills: does the child dress and feed him/herself, go to the toilet unassisted?


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Communication skills: does the child understand what has been said and is the child able to respond?

Social skills: does the child interact positively with peers, family members, adults and others?

As a rule, upon initial diagnosis, professionals should also take into consideration the child’s strengths and weaknesses. They should consider how much support and assistance the individual needs in order to live at home and to function at school or in the community.

Characteristics of intellectually disabled children

The most distinguishing characteristic of intellectually disabled students is the serious dificulty in learning new practices, which other students assimilate easily. Main indicators of intellectually disabled students include learning at a slower pace than their peers and delays in many other areas of development: cognitive, physical, behavioural, communicative and academic. However, it is worth stressing that slowness in learning does not automatically indicate an inability to learn. In general, these children are less ‘mature’ than their peers. They display typical behaviours of younger ages. Their behavioural patterns, their general knowledge and skills are related more to their mental age than their biological age.

Problems in the cognitive area lead intellectually disabled students to have dificulties in generalising and conceiving information. Interpreting information, thinking, reasoning and solving problems are very dificult processes for them. They may have limited short-term memory and dificulties in distinguishing, listing and identifying analogies.

Many students have dificulties in storing information in long-term memory. This dificulty comes not only because the student doesn’t focus on tasks, but also because he/she does not use the necessary cognitive strategy to facilitate the process of memorising information. They function mainly at the concrete level and have dificulties in capturing abstract concepts. They understand and remember better events that are directly related to their experiences and that is why they should be taught using concrete elements. These limitations in the cognitive area are considered the main cause of their dificulties in the academic ield.

Marked limitations in intellectual functioning means that students will be slower at learning and will develop at a slower pace than most of their peers because they have dificulties with:

• focusing attention on tasks

• forming accurate perceptions of events and information

• processing thoughts and giving them meaning

• generalising information

• accurately comprehending information.

Marked limitations in appropriate behaviour means that students will have less-developed coping skills required to take care of themselves and communicate with others. They may have dificulties with:

• language and communication

• care for themselves and organisation

• interpersonal and social skills

• initiative and self-direction

• health and safety

• technical skills.

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Students with intellectual disability have dificulties in most subjects. Some of the most frequent problems these students are limitations related to attention, organisational skills, asking questions, following instructions, monitoring time and other skills for coping with challenges at school. Their attention tends to focus on unimportant details, such as when the teacher is demonstrating how to write, instead of focusing on the instruction the student will focus on the pen noise while writing in the notebook. This tendency easily distracts them from a task. However, various authors have noted that their attention and memory improve when the task is interesting, when the student is asked to be active and when the task receives positive and corrective feedback from the teacher.

Another speciic area in which students with intellectual disabilities encounter dificulties is language. Some of them don’t manage to develop spoken language; most of them have various dificulties in communication and expressing themselves. Their vocabulary is poor and their sentences are short.

In the physical area too, most students with intellectual disabilities have a number of limitations. Most of these students have dificulties in walking and other movements. They are slow in making moves that their peers ind easy.

In the area of behaviour, researchers cannot identify social and emotional features that are present in all students with intellectual disabilities. The presence or absence of these social skills is closely related to the opportunities they have had to socialise at home and in other environments.

However, students belonging to this category manifest inappropriate behaviour and are immature socially and emotionally. Research shows that peer rejection has more to do with irritating behaviour that these students manifest, rather than with their disability. More concretely, behaviour in the classroom such as aggressiveness, yelling, bursts of anger, etc. make social acceptance of these children more dificult.

To eliminate such behaviour and replace it with pro-social ones, intervention is necessary. Work with these students should focus on how to make friends and have long-term friendships or to be accepted by the group. This requires training their social skills. It is just as important to teach them such skills and behaviours to protect themselves in order to reduce the possibility of falling prey to violence from others. Limitations in social skills, in coping with and managing dificult life situations make these children often complain that they are sick. It often happens that they distract other students in the class, isolate themselves or engage in activities not related to class. Some students with more severe retardation have dificulties in independent life skills such as getting dressed, feeding, toilet training and personal hygiene.

Intellectual disability may be a secondary condition that coexists with another disability or dificulty. There is considerable overlapping of characteristics found in students with intellectual disabilities and dificulties attributed to students with learning or behaviour disorders/dificulties. For instance, students with intellectual disabilities and those with learning disorders may display attention, memory, motor and information-processing deiciencies. Just like students with behavioural disorders, they may be anxious, explosive, aggressive, distracting, dependent or impulsive. As a result, it is impossible to identify characteristics that are universal or common to all students with intellectual disabilities. So, working with these students means addressing the speciic challenges and problems, case by case. ‘Repeat it once again – louder – and more slowly.’


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When working with students with intellectual disabilities, you should make:

environmental adjustments (make space to allow them to work with concrete material; reduce noises; personalise space for learning with clear signs and igures; ensure space for these children to work quietly with a volunteer or helper)

resource adjustments (ensure the availability of numerous information sources such as magazines, posters, tapes, videotapes; collect and preserve material from previous years; use the computer for further practice of concepts and skills; use technology and aids; use peers, volunteers, etc. for co-teaching strategies; give clear instructions; give time to answer.


What you need to know regarding adjusting the curriculum for students with intellectual disabilities

Normative provisions (2013) stress that students with intellectual disabilities have the same curriculum as all the other students. This does not mean that the students should be taught the same objectives that the rest of the class learns. This also does not mean that since they have disabilities in intellect, they are not able to have the same school results and quality teaching. The teacher’s challenge is to combine objectives described in the student’s IEP with the curriculum (programs, texts). However, the following suggestions are work practices that will guide you in this process.

Many students with intellectual disabilities may participate in the same learning activities as the others, with slightly differentiated work. This help may involve focusing on key learning aspects and adjustment of teaching and evaluation strategies.

For some other students with intellectual disabilities, this disability will impact and limit their access to some aspects of the curriculum. For these students, the curriculum will be the same, but reduced to a simpler level. For instance, in an Albanian language class, students are required to write stories; while other students will write two pages, the student with intellectual disability may be asked to put in order three igures and write an event corresponding to these igures. Another method that may be considered for such students is the connection of objectives with other areas of the curriculum. For instance, in a biology class, the student may work with an objective of communication in linguistic learning.

Sometimes, in order to achieve the student’s school objectives, the lesson may be organized in another location, outside the classroom.

Other times, learning lesson objectives may require a demonstration, particularly with objectives related to increasing the student’s ability to participate in the school. For instance, learning cooperative behaviour, learning values and care with others, learning how to manage emotions and stress, etc.

Managing behaviour

Discover the student’s strengths and interests and emphasise them. Create opportunities for success. You can make a big difference in the child’s life.

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Place the student in locations or situations where inappropriate behaviour has less chance of occurring.

Focus on the rest of the class and give positive encouragement to the students who are behaving properly (modelling has a strong impact).

Plan activities that take into consideration the student’s level of attention. For example, it would be more effective to plan some brief sessions on doing a task rather than one long session.

Try to establish what the student needs at the time the behaviour occurs. Can the student’s need be met without having to walk out of the classroom with him/her? For example, does the student need a glass of water, need to stretch a bit and move in the classroom, need some appreciation or positive feedback from the teacher?

Change student behaviour by changing the activity, tone of voice or emotional conditions within the classroom.

Ask other students in the class to engage in inding a solution and give suggestions about how to manage the disturbing behaviour.

Establish whether the child needs a break from the class routine and think of a plan to do that (with someone else’s assistance).

Give encouragement and suggestions to enable the student to own every step of the task.

Work in cooperative groups in order for students to learn the necessary skills to perform teamwork.

Continuously praise the student’s achievements against program objectives.

Use instruments and other teaching aids that facilitate your teaching (volunteers, helpers, etc.).

Engage parents in the education program as often as possible.

Don’t lower your expectations towards these children.

Managing problematic behaviour of students with intellectual disabilities in your class

Many teachers may be anxious when faced with unknown situations in which they feel unable to react. Most teachers we have consulted think that managing the behaviour of students with intellectual disabilities and autism is among the most dificult aspects of their work. Therefore, we suggest the following advice:

First, when faced with such a situation, try to keep in mind that every behaviour is a form of communication. Of course, students behave ‘badly’ to communicate a need that they have because in the past, that behaviour had a function for that student. Frequently, some behaviours are learned so well that the student forgets their primary purpose and turns the behaviour into a communication pattern.

Try to not lose patience. A harsh or explosive reaction by you may enhance that behaviour instead of alleviating it. If the student’s behaviour is very aggressive and self-injuring, act quickly, but smartly so that nobody gets hurt.

Don’t forget that all students should be treated with respect and dignity. The use of physical


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interventions should follow instructions issued by the educational directory and should irst be discussed and agreed upon with the parents. A manual of procedures is being drafted by the Ministry of Education and Science (MOES) to help you. All procedures and circumstances when physical coninement is used with the child should be written in his/her IEP.

There is no intervention model for managing behaviour that is useful in all situations. If what you’ve tried has not yielded results, don’t hesitate to ask for advice not only to someone in the teaching staff, but even to experts in the educational directory, or other resources in the school community.

What is behavioural function analysis?

One of the main techniques of work in managing the dificult behaviour of these students is what is known as “behavioural function analysis.” In order to conduct behavioural analysis, irst the teacher must conduct the behavioural function analysis, which is the process of establishing why a student engages in inappropriate behaviour and how that behaviour relates to the environment the student is in. This is a process of determining the cause or function of behaviour, before building an intervention plan. Intervention is done based on evaluation data. This evaluation provides us with information to develop a hypothesis, such as:

why the student presents that behaviour

when the student is more likely to demonstrate that behaviour

situations in which this behaviour is less likely to occur.

Why conduct behavioural function analysis?

Failure to base interventions on the speciic cause of behaviour often results in conining, ineffective and unnecessary procedures and techniques. For instance, consider the case of a student who has learned that screaming is an effective way to avoid unpleasant tasks. Taking this student away from the class is precisely what he/she wants the most (avoiding the task) and will likely aggravate the problem, not improve it. Without a proper behavioural function analysis, we can’t understand the real function of that behaviour and, as a result, will ind an inappropriate intervention plan.

Types of problematic behaviour

Problematic behaviour generally falls into three categories:

(a) behaviour that causes attention and desired events (interactive toys, activities he/she likes, etc.)

(b) behaviour that gives the child the opportunity to avoid or escape from tasks and requirements, or events, that are undesirable for him/her

(c) behaviour that occurs due to his/her feelings (removing pain, feeling good, etc.).

Consequences are analysed carefully to see what function that behaviour fulills. Problematic behaviour may serve even more than one function, complicating things even more, as a consequence. The interview, together with direct observation of behaviour, is the best way to determine the function of the behaviour.

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Systematic manipulation of the environment

In some cases, direct observation does not give us a clear overview of the functions of behaviour, so systematic manipulation/imitation of different environments becomes necessary. The most common way to use systematic manipulation of the environment is to place the student in different situations and then observe the change in behaviour.

For instance, in order to determine the purpose of the child’s scream, we should pay attention to how often he/she screams. Besides, we may leave and leave the child alone and listen to how many times the screaming occurs. If the screaming is more frequent when the child receives attention, we have the hypothesis that the behaviour occurs to attract attention. If the screaming is more frequent when we ask the child to stop, we have the hypothesis that he/she uses the behaviour to avoid tasks. If the screaming is more frequent when we leave the child alone, we may suppose he/she is not feeling well. The third method should be reserved only for situations in which the function of behaviour is not clear through the irst two.

Conducting a Behavioural Function Evaluation (Example)

Date: 25 September, 2012 Observer: Teacher Jona

Student: Elvi Who: Teacher and some class students

What: During reading Where: Before the class

When: 9:05 – 9:52

What precedes the behaviour

1. Jona presents the story to the students and asks them to foresee the event, based on the title and main questions. S. asked students whether they have pets that have embarrassed them in public.

4. J. gave other information to the students and meanwhile asks Elvi to read.

7. J. reads the irst three words and asks Elvi to read the word after.

10. After the reading is over, J. asks whether anyone can tell what the problem in the text was.

Behaviour

2. Elvi raises his hand and speaks of something that happened at home.

5. Elvi ‘reads‘ by inserting words that are not in the text.

8. Elvi steps back, crosses his arms and refuses to read.

11. Elvi raises his hand talks about Himarë.

Consequence

3. Jona and the students laugh.

6. Friends laugh. Jona asks him to stop reading.

9. J. tells him his turn is over and turns to the next student to read.

12. J. says that Elvi should wait until the teacher tells him that It is his turn. Then she tells the next student that It is his/her turn.


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HYPOTHESIS is drafted by the teacher. Based on other observations, I see a similar behavioural pattern: avoiding reading aloud.

PLAN: Lower the dificulty of the task by asking the same desk student to read the task aloud to Elvi before the lesson begins. Then, in the reading class, call Elvi’s name and ask him to read the paragraph that he and his friend read during the break. If data show a reduction of inappropriate behaviour, increase the number of paragraphs to be read. Then, ask him to read words he has not read with his friend, accompanied by words he has read.

Teaching strategy

Divide the task into smaller steps

Students with intellectual disabilities learn more slowly; so, tasks should be divided into smaller parts and with clear requirements and more time. Verbal instructions should be accompanied by clear demonstrations and visual support, such as cards with drawings.

What you should consider when teaching students with intellectual disabilities

We should begin by emphasising that children with intellectual disabilities can and will learn, if helped through an appropriate program and teaching methods oriented towards their individual needs (Howard et al. 2010). ‘When we use the right teaching strategies, these students learn much more than we can imagine.’

Students with intellectual disabilities may make good progress in school, but generally need help individually. This help is based on the student’s IEP/PEP, which describes the student’s clear needs and services required to meet these needs.

Students with intellectual disabilities need help when it comes to assimilating skills and contents, which their peers can do more easily. Most of the activities suggested as appropriate for assimilating basic academic skills by students with learning disorders and those with language and communication problems are appropriate also for this category of students.

Use teaching based on concrete objects and linked with daily life

Students with intellectual disabilities function mainly at the cognitive level of concrete operations. As a result, they learn better when actively engaged in the learning process and when given tangible situations and materials. This viewpoint is known as ‘learning through experience.’ The more concrete a situation, the more these students will learn and remember (Hardman, 2007).

The main priority in teaching students with intellectual disabilities is building an education program/plan that is based on things that are concrete and tangible for them. These students need to experience the things they learn and to have someone interpret these experiences. While in the phase of concrete operations, the leading principle should be ‘learn by doing.’ This type of learning results in an improved ability to generalise and in a better transfer of knowledge and skills, compared to lessons focusing on notebooks and books. For instance, instead of teaching concepts such as numbers and money, or having them write various exercises in the notebook, the student is sent to the store regularly to buy items that may be used in class, is asked to measure objects, count and group different objects, collect data and compare different quantities. Reading skills may be developed and practised using real books, instruction cards, real recipes, brochures, illustration books, games, etc.

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Use direct instructions

Aside from learning based on reality, information and content should be conveyed with clear instructions and in small steps so that the learning process will be as successful as possible. Giving clear instructions means modelling and demonstration by the teacher of a skill or strategy, the structured opportunity of students to practise and apply skills and knowledge that have just been learned under the direction and instruction of the teacher and the opportunity for feedback. Instructions based on these principles are very effective for students with disabilities, especially with learning basic math skills and writing and reading. This direct and clear instruction is one of the most studied methods and has been proven to be more effective than the models based on independent learning by the student. Teaching or direct instruction involves giving information and instructions in a direct manner. This type of learning is very effective when the student has to learn a new skill, or when the activity is personalised for the disabled student.

Strategies involving direct instructions with students are modelling, encouragement, enhancement, correction, shaping and fading.

Modelling. The teacher begins by irst focusing the student’s attention (it is my turn, look at how I do it) on what he or she is doing and then performs the irst part of the task while the student watches. Then the student copies the teacher’s action. This procedure continues until the task is accomplished.

Encouragement consists of every element that we add to the task to help the student accomplish an objective. Encouragement could be verbal, visual, physical, with signs (put the index inger on the lips to say ‘calm down.’).

Enhancement is a consequence of desired behaviour. Enhancement should be done immediately, as soon as the student displays the desired behaviour so that he can make the immediate connection between action and enhancement.

Correction involves trying to draw the student’s attention to the mistake and giving him/her information on how to repeat the task without mistakes (Eva is going in the wrong direction).

Shaping or rewarding the student as he/she approaches the goal. Initially the teacher rewards the behaviour coming close to the targeted objective and using reward step by step, achieves the objective of the task. For example, a student who has just learned how to write, does not write the number ‘3’ correctly. In the initial phase, the teacher will reward that effort although the writing is far from perfect. Gradually, after every repeated attempt by the student to write correctly, he/she arrives at the proper way of writing this number.

Fading involves the teacher gradually and systematically removing assistance for the student, thereby making the student work more independently.

A method commonly used with these students is that of providing ‘extra time.’ According to this method, the student becomes familiar with an input, such as a number or word on a piece of paper) and is asked to respond by saying the number or word. The teacher waits a long time for the student to think and respond, before making an intervention or correction. In fact, it is suggested that this method be taught to classmates so that they may use it when helping classmates with intellectual disabilities (Jameson et al., 2008).


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Use the cognitive strategy exercise method

Exercising cognitive strategies (which means teaching the students different strategies to focus on tasks) could be effective with students with mild intellectual disabilities (Mitchell, 2008; O’Brien, 2005). However, application of the strategy might cause problems for students with more severe intellectual disabilities, as it requires a certain level of self-regulation and metacognition, which these students do not have.

In general, effective teaching for students with disabilities should take into consideration the following elements:

analysing tasks in order to divide it into achievable steps for the child

delivering instructions based on the student’s giving frequent responses

giving frequent suggestions and instructions to help students achieve an academic objective

continuous and frequent use of enhancement, correction of errors and giving feedback

teaching that seeks stimulation of the student so that they may learn and transfer knowledge to other situations outside the classroom

frequent evaluations, not only to check the student’s progress, but also to see what may need to be adjusted and changed in following instructions

adjustment of planning (rely on IEP to make the curriculum accessible to everybody in the class)

adjustment of teaching (make a lesson plan of main points you want to teach that stresses the key concepts that should be learned; increase the opportunities for the student to assimilate the acquired skills and concepts; use teamwork in small groups; use materials that organise learning such as visual aids, tables, labels with igures, etc.; reduce the dificulty of material and texts; divide the task into compartments; teach behaviour routines and expectations; use modelling and concrete examples)

adjustment of evaluations (use tools such as photography; taping to take note of the student’s work; collect parts of his work; use friends’ assessments; evaluate quality not quantity; look at quantity, time and style of evaluation; evaluate using concrete examples from daily life and environment; give opportunities to demonstrate what they know and what they can do with what they know)

adjustment of reporting (according to formats contained in school procedures manual).

In addition: Ask for a copy of the student’s IEP – objectives and goals established therein will be helpful. Ask for assistance from school specialists who may help you identify effective methods to teach the student, recommend adjustments in the program and other instructions about how to achieve IEP objectives in the classroom.

Try to be as concrete as possible. Demonstrate what you want to say instead of giving verbal instructions. Tie new information verbally but show them a igure. Aside from igures, enable different materials and opportunities to try things.

Give the student immediate feedback, as soon as he/she inishes the task or requirement (or required step).

Teach the student life skills and social skills; engage him/her in group activities that allow exploration of the surrounding environment.

Cooperate with the student’s family and other school personnel to create and implement a good educational plan in order to meet his/her needs. Exchange information regularly about the student’s progress in the school and at home.

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Why and how to use the group to help teach students with intellectual disabilities

Teachers should use group work to increase the chances of learning and further encourage active participation of all students in a given activity. Commonly used methods of group work that have been proven to support students with disabilities are cooperative learning and peer or adult supervision. In the case of cooperative learning, students with different skills work together in smaller groups to achieve individual tasks in groups. All of the students are responsible both for themselves and for the others in the group. You may need to teach students with intellectual disabilities certain skills of group work, such as negotiation, group planning and task accomplishment, in order for them to be able to take full part in group tasks. On the other hand, you’ll need to teach them some basic curriculum elements, such as key words in a language task. Students in the class should also be instructed on how to support students with intellectual disabilities in their groups.

In the case of using other students as supervisors (guides) to help students with disabilities, based on the principle that children learn more from one another than from adults, a trained student with the proper skills works together with a student with disabilities, in an activity or task structured by you. When the student with intellectual disabilities possesses good knowledge, he/she may assume the role of guide and teacher of the other student.

Don’t forget: Effective teachers working with these students establish high expectations and focus their instructions on activities conceived to encourage success and that are related to real life (designed in such a way as to make the student successful in daily life).

Why change in attitude is essential

It is hard to call into question that there is a negative, almost universal, response by human beings towards other human beings who are perceived as different. Intellectual disability is no exception; in fact, it may be considered the most reviled minority.

Unfortunately, teachers try to meet mainly the cognitive needs of disabled children rather than the affective needs. They mostly seek help on how to assist these children in various subjects, rather than obtaining information on how to help these children build new friendships in the classroom and thereby improve their social integration (Guinagh, 1980).

The teacher’s attitude towards diversity in the classroom is an essential factor in the quality of teaching. The way teachers think of every student and the way they will build a relationship with them is inluenced by these attitudes. Also, teachers are good models for other students in the school, who are very attentive to the most minute details to understand the real attitudes towards other students. So, a welcoming attitude and professional commitment to solve emerging dificulties could become a positive norm for the entire class.

Therefore, a change in attitude is absolutely essential. This change in attitude should begin by admitting that differences between people should be extolled and everyone’s dignity should be respected. These students are not objects – they are individuals with the same needs that everyone else has. The truth is that they have the same pains, fears and joys, although they are not able to express them clearly due to their limitations. So, efforts should be made to help them realise their potential, similarly to every other individual in society.

An essential element for success in inclusive ordinary schools is the attitude of the teachers and academic staff in general. Therefore, please make continued efforts to help build positive attitudes towards children with disabilities in the school environment by:


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sharing with others the disabled student’s successes

demonstrating a positive attitude

focusing mostly on what they can do, rather than on what they cannot do

expecting that all students can develop and advance

allowing students with intellectual disabilities to cope with challenges

promoting the rights of all students

enabling diverse experiences for all students

encouraging friendship between students.

Bibliography

• American Association on Mental Retardation, Deinition, Classiication and Systems of Support, Washington D.C., 1992.

• American Association of Intellectual and Developmental Disabilities, Intellectual Disability: Deinition, Classiication and Systems of Support, 2002.

• American Association of Intellectual and Developmental Disabilities, Intellectual Disability: Deinition, Classiication and Systems of Support (11th Edition), 2010.

• Kirk S., Gallagher J., Coleman M., Anastasiow, N., (2009), Educating Exceptional Children 12th edition.

• Prater, M. A., (2007), Teaching Strategies for Students with Mild to Moderate Disabilities. Boston: Allyn & Bacon.

• Allen, K. E., & Cowdrey, G. E., (2009), The Exceptional Child: Inclusion in Early Childhood Education, 6th edition, Clifton Park, N.Y., Thomson-Delmar.

• American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders: Text Revised (DSM–IV–TR). Washington, D.C., APA.

• Beirne-Smith, M., Patton, J. R., & Kim, S. H. (2006), Mental Retardation: An Introduction to Intellectual Disabilities (7th edition). Upper Saddle River, N.J., Pearson-Merrill-Prentice Hall.

• Cohen, L., & Spenciner, L. J. (2005). Teaching Students with Mild and Moderate Disabilities: Research-based Practices. Upper Saddle River, N.J.: Pearson-Merrill- Prentice Hall.

• Algozzine B. & Ysseldyke J. (2006) Teaching Students with Mental Retardation, SAGE.

• Hickson L., et al. (1995) Mental Retardation: Foundations of Educational Programming Allyn and Bacon.

• Gulliford R. (1992), Special Educational Needs London.

• Closs, A., Nano, V. dhe Ikonomi, E., Unë jam si ju” Botim i SAVE THE CHILDREN. Tiranë, 2003.

• Save the Children, (2010) Një shkollë për të gjithë, përvojë pune me fëmijët me aftësi të kuizuar në shkollat e zakonshme, Tiranë.

• Ikonomi, Estevan, Hartimi i politikave dhe praktikave për përgatitjen e mësuesve për arsimim gjithëpërfshirës, 2010.

• Ndrio, M. Vlerësimi faktorëve që kontribuojnë në zbatimin praktik të arsimit gjithëpërfshirës, World Vision Tiranë 2012.

• Tupja, E. (2013), Poezi per Gesin. Poeteka, #25.

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My home is my safety


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8STUDENTS WITH AUTISM

“I know your job as a teacher is dificult. But his job is not easier.”

Parent

Children with autism are part of ordinary schools like never before. Teachers see work with autistic students as very dificult and consider their involvement in regular schools as a major step. This paper, although it does not manage to cover all of the issues related to the education of autistic children, seeks to describe the main ideas, methods and strategies in working with these children in regular schools. The material was carefully selected to respond to some of the most important questions that our team encountered in numerous meetings with teachers across the country, who for years have been trying to integrate children with autism in their classes with success, in spite of dificulties.

Demystifying autism

We often see children with autism and autism in general, as fascinating, surprising, but also intriguing. There is something in this condition that spurs the curiosity of not only professionals, but also teachers and parents. Autism in many cases is seen as a big enigma, accompanied by and strongly relying on two generally opposing attitudes.

The irst attitude is represented by those who believe that all individuals with autism have something unusual, wonderful, a great talent that shines through their peculiarity and that amazes us. This attitude, which is actually loosely founded, at least for the largest number of children with autism, leads many people who take this approach to separate autism from other disabilities.

The second attitude is the opposite of the irst. According to those defending this attitude, this disability is seen as total isolation from the world. In this case, the created image, that of a child isolated in his own world, unable to connect with the others, is terrifying.

Child case

D., a boy with blond curly hair and blue eyes, was one of the most beautiful children in the neighbourhood. His parents were concerned, because they saw something was not right with him. He didn’t speak, didn’t pay attention to other children or even to family members. He played strangely with his toy truck. (Children with autism have their rituals even in play. They may use toys differently from their peers.)

When he wanted something, instead of asking for it, he took his mother by the hand to where the object was. Doctors had seen him and said that physically he was ine and suffered from no illness. However, the doctors advised the family to go to more specialised evaluation centres. The team found out the child was autistic.

His parents were full of questions they had no answers for. What was this word? What had caused autism? Could it be cured? They wanted to know whether schools could treat children with this disorder, or whether they had to send him to a special school.

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Since we are all social beings, the idea of a person that has no possibility of connecting with other human beings is scary and almost terrifying. After all, we all create relationships; we all need others to feel accomplished. The pleasure we get from relations with others is just as natural as the air we breathe. From this standpoint, the idea of such great isolation is stressful. As a result, the desire to break these communication barriers with these children is enormous. Failure to achieve this breakthrough worries us and makes us hopeless. It is believed that the majority of people with these attitudes have not had the opportunity to get to know someone with autism personally.

What is autism?

Widely known as autism, the scientiic deinition is actually ‘autism spectrum disorders.’ These disorders appear when the brain develops differently and has dificulty processing, abstracting or even giving meaning to life.

Autism is a permanent development disorder, which keeps people from understanding what they see, hear or feel. This impediment leads to serious problems in relationships with people, in communication and in behaviour.

The diagnosis and statistical manual DSM (APA 1994) deines autism as a development disorder that is characterised by:

damages in communication and social interaction

repetitive behaviour, interest and limited and stereotypical activity patterns.

Deinitions of autism are numerous and vary constantly, which indicates the numerous indings regarding this disability over recent years. We have decided to select two deinitions:

Autism is a very complex neurological non-progressive disorder that lasts for life and typically appears before age 3. Another deinition sees autism as ‘a development disorder that affects verbal and non-verbal communication and social interaction, which is visible before 3 years old and impacts the child’s performance’ (IDEA 2002).

The symptoms of autism may be present in a variety of combinations and may accompany other

Demystifying autism

Myth

• Children with autism don’t take care of others.

• Children with autism prefer self-isolation.

• Children with autism (when they grow up) can’t have an independent and successful life.

• All children with autism are ‘geniuses’ in a certain area

Fact

• Children with autism often care greatly about others, but they lack the ability to develop empathy spontaneously.

• Children with autism often want to create relations but lack the ability to spontaneously create social relations; once they create them, they live independently.

• Many individuals with autism are successful and make great contributions to society.

• The majority of disabled children are not geniuses in a certain area.


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disabilities. Some individuals with autism may have normal levels of intelligence, but most have intellectual disability that varies from mild to severe. This variation in intelligence makes us refer to autism as high-functioning autism (when the IQ is high), or low-functioning autism (when the IQ is low).

One of the most evident dificulties in individuals with autism is language and communication. According to various research studies, about 50 per cent of people with autism cannot develop what is known as ‘functional’ language. Even for those individuals who manage to express themselves, they have unusual qualities and limited communication skills.

All individuals with autism have dificulties in social interaction and behaviour, but their type and level may vary. No individual with autism is the same as another, just like every other person is unique.

International statistics show that autism affects boys more than girls, in a 4:1 ratio. Some people with autism may reach a stage when they can live independently, while others need support throughout their whole lives. Only 2 per cent of the people with this disability, known also as ‘geniuses,’ may have a special talent in areas such as math, music and arts. There are suggestions that the number of such people is growing, but research shows that this is a mistaken conclusion, as there is growing awareness of this disability, also due to the use of a broader deinition of different forms of disability that are included in the autism spectrum (Holborn, 2008).

Parents of children with autism usually say that everything was going well with their child’s development, at least until the end of the irst year and then, by the 12th to 15th month, the child begins to regress, becoming more sensitive to some sounds and touches, does not understand basic words and signs anymore and becomes increasingly withdrawn, without any obvious purpose in his actions and is more isolated and closed in (Greenspan, 1992)

What are the main causes of autism?

To date, no single cause has been identiied for autism; however, it is generally accepted that it is caused by problems in the brain structure or function. Researchers are exploring a large number of theories, including:

a. connection to heritage

b. medical or genetic problems

c. environmental factors (such as pollution).

The latest research studies indicate that the structure and shape of the brain in children with autism is different compared to children without autism.

In many families, there seem to be signs of autism or other similar disorders, supporting the hypothesis of the genetic foundations of this disorder; however, in many cases, this happens even when nobody in the extended family has displayed similar dificulties before. While no gene has been identiied as causing autism, researchers are searching for irregular genetic code segments that these children may have inherited. Meanwhile, other researchers are exploring the possibility that, under certain conditions, a group of unstable genes may happen to interfere with brain development and result in autism. Yet other researchers are exploring problems that are related to pregnancy or the birth process or other environmental factors such as viral infections, metabolic disorders and being exposed to chemical material in the environment.

Autism tends to appear more often in individuals with certain health conditions such as: Fragile X syndrome, measles, untreated PKU, etc.

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How is autism identiied?

The diagnosis of autism, like other disabilities (such as intellectual ones), is conducted by a multi-disciplinary team. The team, after a complete and broad evaluation process, determines whether the child displays symptoms of autism, whether he or she presents abnormal development in the areas of linguistic, cognitive and social development before age 3. These symptoms are different in terms of frequency and intensity. In general, these commissions take into consideration the DSM and ICD criteria in their evaluation.

Individuals with autism have this disability at different levels and not every child diagnosed with autism displays all of the above characteristics.

Some children with mild autism are almost normal in many expressions of behaviour, while others, with more severe forms of autism, function at a much-reduced level, in terms of cognitive development, self-regulation and relationships with others.

Some children with a severe form of autism often sit for hours at a time, displaying unusual repetitive behaviour (known as stereotypical behaviour). For instance, they pretend to be twisting something or make light repeated body movements, clap hands in front of their face, etc. Some of them demonstrate self-hurting behaviour, such as self-biting. It is believed that such behaviour may be spurred by anxiety or the need for additional sensory stimulation (Joosten, 2009). In general, these children demonstrate higher levels of anxiety than others, especially when faced with changes in usual routine.

Children with autism have been identiied across the world, which indicates that this disability does not have anything to do with certain cultures. Although autism has been identiied in individuals with any level of intelligence, 75 per cent of children with autism have an IQ of under 70 and therefore have a need for intensive special education and behaviour management.

Distinguishing features/behaviours in diagnosing autism

dificulty in understanding and using language reduced ability to learn, especially through observation and imitation lack of interest in creating relationships with others or creating emotional relationships avoiding eye contact unusual forms of play (or lack thereof and in its stead repeated and stereotypical movements and

rituals, such as clapping hands) obsessive interests lack of imagination and initiative resistance to changing daily routines excess sensitivity towards environmental stimuli (loud noise or strong light)

(Hegde, 2008).


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Autism is one of ive disorders that are categorised as permanent development disorders, a category of neurological disorders characterised by ‘severe and sustainable injury in some areas of development’ (DSM-IV-TR). The ive disorders of this category are as follows:

autism disorder

Asperger disorder

disintegrative childhood disorder

Rett disorder

unspeciied.

Each of these diagnosing criteria has been deined in the DSM-IV-TR manual of the APA.

The autism diagnosis does not change the uniqueness of an individual. The term ‘autism’ describes a speciic group of dificulties that someone experiences, but does not deine the whole individual. Individuals with autism display different skills in social relations and behaviour. The level of challenge they experience in each of these areas will be speciic for every individual.

In our country, diagnosing is conducted by a large group of professionals that include doctors of different specialties, such as pediatricians, psychiatrists, neurologists, psychologists, therapists, etc.

One of the irst signs of autism is delay in linguistic development in the irst years of life. This delay in language is often linked with a low IQ. For that reason, every pre-school child with delays in language should be evaluated for potential signs of autism. If the teacher notices such signs, he/she should consult the school commission to develop appropriate recommendations for the parents.

Characteristics of students in the autism spectrum

• All students with autism have marked tangible dificulties in social relations; this is an essential characteristic in all of these students. Many students with autism are resistant to contact with people and social relations. These students often do not look you in the eye and may appear even uninterested to come into relationship with others. For instance, a typical student in a classroom would request the teacher’s attention when achieving something by saying, “teacher, look,” thus getting the attention of the teacher and of the other students in the classroom. Instead, a student with autism may not use these cases for social interaction. These students ind it dificult to understand the other person’s perspective and do not manage to understand that by talking about things of interest to others, although they themselves may not like them, they are part of the social relationship.

• Another reason these students experience dificulties in social relations is the challenges they face in using verbal and non-verbal communication (Meltzoff, 2006). These students generally have delayed linguistic development, but even if they have good language skills, they have major dificulties in holding a conversation with someone else. In her diary, a known researcher in this ield who is affected by autism herself, Temple Grandin, says: ‘I simply didn’t have the words to communicate and often ended up screaming… I saw the others but didn’t know how to become part of them.’ (Grandin, 2006). Unlike Temple Grandin, who was able to express herself through written books, many of the students with autism cannot write or communicate about their experiences and therefore use behaviours instead of words to express their desires and needs. If they don’t learn new alternative behaviours, they may hit a friend as a way to say ‘good morning,’ or run out of the classroom instead of saying they don’t like the task the teacher has given them.

• Some students with autism have echolalia in speaking, which means they repeat what the others have said instead of producing their own original phrases appropriate for the situation. So,

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helping them build good communication is the main part of the work with these students in the classroom.

• Another characteristic is the display of interest in a limited number of things. For instance, a student likes television and excludes everything else; another may concentrate for some time only on history and how to become an expert in that ield. In their area of interest, they may spend hours and hours exploring the ield. They may get upset and bothered by any other issue or activity, unless it relates to the ield of interest to them. Of course, such behaviour has an impact on relations with friends, as they are unable to understand that others are not interested in what interests them. However, a number of research studies are trying to explore how to use the ield of interest as a way to encourage social and communication development (Winter 2007).

• Another speciic of these students is the dificulty in coping with stress. Changes in the classroom, tasks or activities may be dificult for them to handle. Noises or smells in the environment around them may be very disturbing and stressful for them. Often they respond to stress with stereotypical responses, with repeated actions and movements; for instance, they may fall frequently off the chair; they spin an object endlessly or swing their arms. They may need some minutes to get ready to complete a task, because they irst need to ix the notebook and pen, make sure all books are properly stacked, etc.


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Impacts of autism spectrum on various areas in the student’s school life

Impacts of autism spectrum on various areas in the student’s school life

Positive impacts and possible strengths:

• special ields of interest

• good long-term and visual memory

• abide by rules and instructions

• learning and visual thinking

• correct understanding of concepts

• decoding text

• precise and detailed

• sincere and true

• focused.

Impacts on communication

• dificulty understanding language compared to its expression (may explain all the steps of the synthesis process while having dificulty interpreting simple instructions)

• dificulty in understanding non-verbal language (such as when the teacher looks at him/her to scold)

• dificulty in abstract or symbolic language (use of metaphor, sarcasm, etc.)

• delays in assimilating language

Impacts on behaviour and limited interests

• can see environments as confusing and uncomfortable

• dificulty understanding learning activities in class

• changes in routine and environment may cause anger, fear, irritation and stress that may be interpreted as lack of cooperation

• obsessive behaviour regarding certain interests, objects

• insisting to do things the same and resisting when asked to change

Impacts on sensory processing

• different sensitivity towards the environment (noises, light, movements, aromas)

• delayed reaction or response

• reactions of anger, stress or anxiety

• impacts on auditory system (emanates sounds to express he/she doesn’t like the noise)

• impacts on visual system (sensitive to pulsation of class light bulb)

• impacts on tactile system (avoids touching or contact with certain surfaces)

Impacts on social interaction:

• dificulty creating and keeping social contact (including with friends)

• lack of empathy – lack of sensitivity towards the feelings and needs of others

• inappropriate facial and body language

• unclear about personal space (stays too close, touches inappropriately)

• dificulty in interpreting non-verbal language (body language, facial expressions)

• lack of eye contact

• inappropriate and naïve social interactions (isolates self during games, tries to engage in the game but does it inappropriately, corrects friends)

• lack of ability or dificulty in expressing affection

• dificulty understanding consequences of own actions.

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• unusual language features (rhythm, intonation)

• echolalia – repeating expressions

• dificulty starting and continuing conversation

• dificulty listening to and following instructions when given to the entire class (hears main words, but not complementary ones that give full meaning to the request).

• ritual behaviour (takes the same route to different corners of the classroom)

• damaged imaginary creative games

• inappropriate connection with objects

• non-articulation of the need for help.

• impacts on taste system (eats only some types of food)

• impacts on smelling system (doesn’t like strong smells such as perfume)

• impacts on vestibular system (balance, gravity), is afraid of heights)

• impacts on motor system (uses a lot of force when holding something, walks accidentally over objects).

What to consider when working with students with autism

We should begin by stressing the fact that children with autism can and will learn if helped with an appropriate program and teaching methods oriented towards their individual needs and proper support (Howard et al., 2010). ‘When we use the right teaching strategies and learn how to communicate with them and how to manage their behaviour, the possibility for positive change is great.’

Students with autism generally need individual assistance. This assistance is based on the IEP/PEP, which describes the special needs of the student and the necessary services that meet these needs. Most of the activities suggested as appropriate for assimilating basic academic skills by students with learning disorders and those with problems in language and communication, are appropriate also for the students of this category. Therefore, on such issues, you may go back to the previous chapters of the manual that address these activities more extensively and that you may adjust for children with autism. In this part of the manual, we will stress those methods and strategies that are more speciic for children with this kind of disability.

How can we help a child with autism in our school?

First, realise and accept that these characteristics are a natural consequence of the disability, not a choice to act in an inappropriate manner. Understanding the impact that this disability has on the student’s behaviour will help you improve the chances for the student with autism to learn to behave in more appropriate ways. Of course, this does not mean accepting the inappropriate behaviour, but it means keeping calm and understanding the situation as you try to help the student manage him or herself and build a repertoire of appropriate behaviours.

Main factors having a positive impact on teaching students with autism in the classroom:

supportive and inclusive environment (physical, emotional and social)

adjusted or modiied curriculum realised through teaching strategies set in the IEP

strategies ensuring positive behaviour and success.


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Early intervention

Some of the most successful programs that seek to improve opportunities for education rely on well-planned early interventions in the child’s life. These interventions have been drafted carefully to improve communication and social interaction and to reduce stress. These will also be the main goals for this child in school.

Encouraging independence

All of the strategies and ideas below serve what should be considered the long-term objective of our work as teachers, at school and in other services in general, which is to encourage and support independence in these students. In order to achieve this objective, it is necessary to draft strategies that rely on knowing well the dificulties and strengths of the child with autism, in the linguistic, social and cognitive areas. This certainly requires a lot of creativity, knowledge and lexibility on your part.


In this part of the manual, we will present some instructions on how to communicate with these students as well as different strategies that you may use to help students with autism to develop skills and to learn. They may be selected and adjusted to the age and ability of the students in your class.


Rules are an important element in inclusive schools and classes. School rules may be unclear and too general for students with autism and they should be described clearly for them, so that they know exactly what is expected of them. For this reason, make the rules understandable and visible (putting them on cards, on the desk, in other visible places). Use appropriate formats for these students (photographs or paintings, images, icons, etc.), teach them explicitly, demonstrate and model each of the rules to give these students the chance to practise them through role play – and meanwhile, use this time to teach them consequences if they don’t follow rules; use positive enhancement when the child follows the rules.

The most important thing is to always take into consideration the role that the environment (not only the physical aspect but also the people in it) plays on the manifestation of challenging behaviours. Problems may get worse or improve and that depends on how we have managed previous events. Remember that the teacher does not have the capacity or the possibility to change the students’ inner conditions and therefore it important to adjust our behaviour, the class and the school environment. Do not forget that behaviour has a communicative function. Carefully studying what his or her behaviour is, through communicating with the student, may lead to direct solutions. However, during the process of managing the behaviours of students with autism, we have the duty to relect on our work practices. And above all, let’s ask ourselves frequently what we may do differently, in order to meet the needs of these students in the classroom.

Provide a stimulant-free environment. Children with autism can beneit considerably from an environment free of stimulants that disturb them and draw their attention. The teacher can ix a quieter area without stimulants that would draw the child’s attention, or build quieter areas for them on the school premises.

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Managing behaviour

It is important to keep in mind that every student with autism is an individual and that the characteristics of this disability will be displayed differently in every student. Understanding and supporting not only the dificulties, but also the strengths in every student is essential, so that they may achieve their potential during school years.

Be patient. In certain cases, it may seem as if these students are saying or doing things that threaten your authority at school. Try not to take it personally, but deal with them calmly. Their dificulties are the result of biological changes in brain parts that regulate social behaviour and their understanding of the situation.

Take measures to plan in advance the measures that you will take to remove the student with autism from the classroom, if he or she shows dificulties in ixing behaviour, such as a room or quieter corner where he or she can go if the stress level is higher.

Avoid direct confrontation if the student is angry or upset, by not raising your voice or entering into a debate. They are sensitive to noise. A loud voice does not help a student with autism understand what he or she needs. Use a neutral tone of voice, don’t shout and don’t expect the student to understand the expression on your face. Try to channel the situation.

Keep in mind:

Social skills. Some students with autism like activities such as play, acting or role play, which may be used to learn social skills such as greeting, taking turns to speak, waiting for your turn, etc.

Circle of friends. The teacher chooses ive to eight volunteers, in order to create a circle of friends for the child with autism. Through regular meetings, they can help the child express his or her feelings and reduce anxiety levels. This may lead to better social integration and a better level of contact with peers.

Close friend. Finding a close friend, preferably of the same age and class, may help this child increase self-conidence. The child will have someone to go to if he or she has different social dificulties.

Mentor. More grown-up children may beneit if they have a mentor, who may be an older student, a teacher or a school staff member.

Monitoring cards/break cards/go to the toilet cards. In many countries, children with autism use coloured cards to show that they are anxious, need monitoring, need to go to the toilet, etc., thus facilitating the communication of their immediate needs.

Avoid bullying. Children with autism and all other children with disabilities are often victims of bullying (ridicule and harassment by friends that occurs repeatedly and goes as far as physical threats and injury to the child). Try to be attentive to this phenomenon and take measures to avoid it.

Coping with transitory times. For some children with autism, times such as breaks between classes or the lunch break are dificult as they are unstructured and noisy. It is important to have alternatives to manage such moments to overcome such problems.

A quiet place. It is very important to ix in advance a place for children with autism where they can go when they are very anxious or angry or there’s nobody else (friends, mentor, friend) who can help him.

Support team. Most schools have a support team (psychologist, social worker). They may help with consultations and speciic training for certain children. Don’t hesitate to ask for their help.


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Close cooperation with parents. Regular contact with the family of children with autism will have mutual beneits. Of course, parents want the best for their children, but the school staff can offer different perspectives.

How to manage problematic behaviours of students with autism in the classroom

Students with autism may demonstrate some unusual and challenging behaviours, in the face of which many of our disciplining methods wouldn’t ‘work.’ In the part of the manual that addresses managing the behaviour of students with intellectual disabilities, we analysed more in-depth methods and techniques necessary for managing the dificult and challenging behaviours they manifest. Many of the suggestions given for them are perfectly valid for children with autism, so now, we’ll deal with some key elements to avoid repetition.

• First, realise and accept that these characteristics are a natural consequence of the disability, not a choice to act in an inappropriate manner. Understanding the impact that this disability has on the student’s behaviour will help you improve the chances for the student with autism to learn to behave in more appropriate ways. Of course, this does not mean accepting the inappropriate behaviour, but it means keeping calm and understanding the situation as you try to help the student manage him or herself and build a repertoire of appropriate behaviours.

• These students have a lot of dificulty coping with stress so changes in the classroom, tasks, or activities may be dificult for them to handle. You should be careful and aware of these stressful situations. For these reasons, it is necessary to prepare these students for these situations, speak in advance with them, assign another student to help them and ask for the help of specialised teachers or other professionals. If the behaviour of a student with autism is very aggressive when he is stressed out, consult other professionals in the school or educational directory to resolve the problem. In some cases, it is necessary for the student with autism to spend part of the day in more structured and less stressful environments, such as the school library or other similar places.

• One of the most discussed issues is supporting students with autism with their behaviour. Numerous studies have focused speciically on the spectrum of their typical behaviours. We have said before that behaviour is a form of communication and inappropriate behaviour by a student in the autism spectrum is often the sole way they know to communicate a desire or need. Establishing the cause of the behaviour is a key factor in understanding the behaviour and what he or she is trying to communicate. Finding the cause of the behaviour may also be considered the irst step in drafting a proper intervention and replacing inappropriate behaviour with another more appropriate one. For this reason, students with autism need to receive your help (and not only yours) to learn the skills that will help them reduce stress and irritation, improve communication skills and develop new, more appropriate, behaviours. Every school should have described in the relevant manual the policies and techniques that are permissible for managing behaviour at school. As teachers, you should become familiar with this manual. Of course, on the other hand, every teacher has his/her own philosophy for managing behaviour. This will be clearer in the way they teach and manage their class.

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Teaching strategies

Choosing the right support for these children is important. Below is a series of approaches that may be used according to the student’s needs.

Use visual teaching aids. Children with autism ind it easier to understand messages through visual aids. For instance, you may use a clock that shows time through simple drawings so that they know exactly what to do and when. Many schools in different countries use computer programs to provide such visual aids. Use lists, objects, calendars, photos, etc. that may help them understand the necessary steps to be followed and foresee what will happen afterwards.

Picture Exchange Communication System (PECS) is a system used to teach children with autism who have considerable delays in linguistic development. Teachers use the photos of this program to teach children with autism the names of different objects.

Social stories. Students with autism who are able to read may be taught how to cope with different situations through the technique of social stories. The teacher writes stories with the student in mind; the student is told through words and simple photos, step by step, what will happen in situations where he or she may feel anxious and how to cope with dificult situations. For example, a social situation may be used to teach what a student should do on the street, bus, with friends, etc.

TEACCH (treatment and education of autistic and related communication handicapped children). This is one of the models most applied in special schools, but recently is being successfully adjusted in ordinary schools. It is based on changing the environment and using visual materials such as times, photos, to help the child have a structured routine. This routine reduces stress by making clear what should happen during the day and improve understanding. Children are given instructions about every phase of activity mainly visually.

SPELL (Structure, Positive, Empathetic, Low Arousal, Links). This model recognises the individual’s special needs and stresses that the entire planning and intervention be organised on this basis.

Adjust language to the student’s level.

Use visual forms and means as ways of communication with them.

Be clear and say precisely what you want to. For example, ‘Can you sit down here?’ ‘Can you take that sheet of paper and put it on the desk?’

Use direct language, avoiding words with double meaning, sarcasm, ridicule, complex questions, jokes if you are not entirely sure that the student understands. Make sure you have his or her attention before communicating with him or her. Call the student by name, but don’t expect him or her to necessarily look you in the eye, as that is dificult for such students.

Speak slowly and give the student a few seconds to process new information and then respond or repeat the request once again.

Verify whether the student has understood what he or she is do in the classroom and which tasks to complete. The fact that he repeats the instruction you gave him does not mean he understood it. Processing verbal information is dificult, so visual aids may help.

Make sure the student understands what is expected of him or her in school, such as where to sit in the classroom or in every class, where to go during the break, etc.


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Bibliography

• APA (American Psychiatric Association), (2000). Diagnostic and Statistical Manual of Mental Disorders: Text Revised (DSM–IV–TR). Washington, D.C.: APA.

• Ashcroft, W., Argiro, S. and Keohane, J. (2010). Success Strategies for Teaching Kids with Autism, Waco, Texas: Prufrock Press.

• Grandin T. (2006). Thinking in Pictures: Expanded edition. Vintage.

• Smith, D.D. and Tyler, N.C. (2010). Introduction to Special Education: Making a Difference (7th edition), Upper Saddle River, New Jersey: Pearson-Allyn and Bacon.

• Moyes A. Rebecca (2003). Addressing the Challenging Behaviour of Children with High-Functioning Autism/Asperger Syndrome in the Classroom a Guide for Teachers and Parent. Jessica Kingsley Publishers, London and New York.

• Closs, A., Nano, V. dhe Ikonomi, E. Unë jam si ju Botim I, Save the Children. Tiranë, 2003.

• Save the Children, (2010). Një shkollë për të gjithë, përvojë pune me fëmijët me aftësi të kuizuar në shkollat e zakonshme, Tiranë.

• Wing, L. (2002). The Autistic Spectrum: A Guide for Parents and Professionals. Constable and Robinson, London.

• Farrell, M. (2012). The Effective Teacher’s Guide to Autism and Communication Dificulties. 2nd edition, Routledge, London.

• Stacey W. Betts, Dion E. Betts, (2007). Asperger Syndrome in the Inclusive Classroom Advice and Strategies for Teachers Jessica Kingsley Publishers London and Philadelphia.

• Vicky Spencer (2009). Teaching Children with Autism in the General Classroom: Strategies for Effective Inclusion and Instruction. Prufrock Press, Texas.

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9STUDENTS WITH PHYSICAL DISABILITIES

“I would give all of my dolls if I could run just once.”

Student

Child case

L. is a little boy in third grade. He has been diagnosed with cerebral palsy. During the day in school, he sits in a wheelchair. He is often late to school and is frequently absent. Fortunately, our classroom is on the irst loor; otherwise, I don’t know what we’d do to bring him to the classroom. Even his toilet has been ixed by his parents.

He has poor control of ine motor skills (all the small muscles, such as inger muscles, mouth muscles, etc.) and so can’t write with an ordinary pen. L. is capable of doing a few things with his hands; he can push large buttons and has fun working on the computer his brother has sent him from England.

L. has a strong personality. There’s always a smile on his face. He always greets everyone as he enters the school corridor in his wheelchair. He likes to listen to and tell anecdotes.

He has a lot of dificulty speaking and he speaks slowly. At irst, it was hard for me to understand him, but now I understand him perfectly. He loves school and all the classes a lot. He tries hard to be part of the class and have an active role in it. As his teacher, I think he has beneitted a lot from being in such an inclusive environment, in spite of the dificulties we have encountered. If we had received help from everyone, we could have done many more things for him.

Students with physical disabilities represent one of the most diagnosed groups in our schools. Limitations in this category vary from dificulties that have little or no impact on learning to conditions that may include serious neurological injuries that affect all areas of development, cognition and communication and social and motor development. The level of intelligence in these children includes the entire intelligence spectrum, from students with very high intelligence to those with intellectual disability. Most of these students attend ordinary schools successfully, if the right auxiliary strategies and means are used in working with them. The peculiarity that is worth mentioning, particularly in working with these students, is the help that you, as teachers, can give in their physical access to school premises, education and class experiences.

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Demystifying physical disability

Myth

• The Physical condition of students with physical disabilities cannot be ixed or improved.

• Conditions such as epilepsy indicate mental illness.

• Medical science is reducing the number of incidences of physical disabilities.

Fact

• In most cases, their physical condition can be improved considerably.

• Individuals with epilepsy are neither less nor more predisposed than others for mental illnesses.

• The number of children with physical disabilities is growing.

What is physical disability?

The term ‘physical disability’ includes a series of natural and acquired conditions and injuries and is used to describe a number of physical diagnoses or impairments. Physical disability is any injury that limits the physical functioning of one or more limbs, or of the ine or major motor skills (all large groups of muscles, such as limb muscles). Impairments of this group vary from very severe to almost hidden. What one usually notices as a main barrier for a student with physical disability is access (Howard et al., 2010).

Main causes of physical disability

Physical disability may have a large number of causes and may be permanent, with interruptions, or temporary. The causes of physical disability may be summarised into:

Pre-natal causes – which include those disabilities caused before birth. These include illnesses that may have harmed the mother during pregnancy, accidents in the development of the embryo or fetus, or genetic diseases.

Peri-natal causes – which are related to those physical disabilities that are caused during labour. This could be due to prolonged lack of oxygen, or the obstruction of the respiratory tract, damage to the brain during birth, or the baby being born prematurely.

Post-natal causes – which are related to those disabilities acquired after birth. These include accidents, infections, or other diseases.

Main characteristics of children with physical disabilities

Physical characteristics of students with this kind of disability may include one or a combination of the following:

paralysis

low muscle tone

functional weakness of the senses

walking dificulty (insecurity)

dificulties requiring alternative types of mobility

loss of or impossibility to use one or more limbs


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poor motor control (ine and major motor skills and muscles of the mouth).

Often, students of this category also have other disabilities such as hearing or sight impairments and intellectual disabilities. They need equipment and other assisting materials to modify and adjust the teaching environment in order to meet their speciic needs.

Main illnesses of physical disability

Cerebral palsy

Cerebral palsy may be deined more simply as a disorder of movement, irregular gait and muscle tone, which comes as a result of injury to motor areas in the brain and appears before, during or immediately after birth (Howard, et al. 2010).

Cerebral palsy is one of the most common physical disabilities, with an international prevalence of two cases per 1,000 live births (Hegde, 2008).

This illness appears in different forms and levels, from mild to severe. The type and level of its appearance are closely related to the areas of the brain that have been damaged and how much the damage has spread.

Cerebral palsy is not curable, but its impact on the person’s physical coordination, movement and capacity to learn and communicate may be reduced through therapy, training and appropriate education.

The most common form of cerebral palsy is the spastic one with 75 per cent of the cases. The main characteristics of this form are involuntary contractions of muscles that have a great impact on body control and coordination. Other less common forms include ataxic cerebral palsy, which affects about 15 per cent of individuals and is characterised by poor coordination, balance and posture.

The athetoid form is characterised by uncontrolled shaking or involuntary motions of the body, especially in the arms, neck and head (Hegde, 2008).

Technology and auxiliary aids play an important role in educating these children to facilitate their movement, participation and communication. This technology varies from the simplest tools such as mobile boards, handle pencils, modiied scissors, adjusted desks and seats, to adaptations of high-level technology such as electric wheelchairs, controlled by head motion or air pressure through breathing, modiied computer keyboards, touch screens, etc.

Many individuals with cerebral palsy have average or above-average intelligence, but some have a degree of intellectual disability that varies from mild to severe (Turnbull, et al., 2007). It should be emphasised that some individuals with this disease have very high intelligence and may not be understood to their full potential due to their inability to express themselves. It is important that these individuals are assured of alternative communication methods.

In many cases, these students also have other disabilities. Over 10 per cent of them have damaged sight and hearing. Some have epilepsy and numerous crises; those with more severe forms cannot develop the ability to speak, although they perfectly understand spoken language.

Spina biida

Spina biida is a congenital development disease caused by the incomplete closing of the embryonic neural tube in the spine, when one or more vertebrae remain open during development before birth. It appears in three main forms, from mild to severe.

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The Spina biida (occulta) is the most common and, at the same time, the mildest form of this disorder. This form has nothing visible and can only be seen through X rays.

The meningocele form is more serious and it involves the protrusion of a sac in the spine illed with cerebrospinal liquid. This form is repaired after birth and most individuals have no major dificulties.

The most severe form is mylemeningocele, which appears as a protruding mass that contains nerves and extensions of the spine. This type often results in irreversible disability, causing paralysis of the lower limbs and visible dificulties in sphincter control. This form is accompanied by hydrocephalus, which is an enlargement of the head, due to the accumulation of cerebrospinal liquid in the brain, which if not diagnosed and treated, over time, causes brain damage.

Muscular dystrophy

Muscular dystrophy is an inherited progressive condition, in which muscles weaken progressively, leading to loss of function and premature death, usually in late adolescence or early adulthood (Farrell, 2006).

There are several forms and variations of muscular dystrophy, but the most frequent one is called muscular dystrophy Duchenne that mainly affects boys. Intelligence in these students is normal and so they do not need special teaching methods, except for cases when they also display other development problems.

On school premises, these students should be helped with auxiliary technology and other physical adjustments in the academic environment. Due to the progressive nature of the disease, good planning and careful adjustment of the environment should be made. Among others, emotional counselling and support are recommended to help the individual cope with the reality of death at an early age.

Traumatic brain injury

The term traumatic brain injury (TBI) is used to describe any brain injury caused by different events in life, such as accidents, major falls, head injuries, injury from sports activities, suffocation, violence, etc.

TBI may cause serious consequences in the student’s cognitive, emotional and physical well-being. Some of the main consequences of TBI are dificulties and problems with memory, dificulties in concentration, slower information processing, inability to solve problems and plan strategies, damages to spoken language, damages to motor behaviour, epilepsy, sight problems, serious headaches, sudden and strong changes in emotional state, etc.

Usually, these students get considerably better during the irst year after the injury, but after that, progress is slower. For some of them, there is a slight decline in intelligence, in skills related to reading and math, causing various dificulties. Frequent dificulties encountered in remembering words or information leads them to slow down their speaking, which causes them a lot of stress. Many get irritated as they know the answer but cannot say it right away. For these reasons, in most cases, they need specialised assistance in the school environment.

Due to the high number of students with epilepsy in our schools, as well as the need for teachers to learn how to manage students with epilepsy, we will focus little more on informing you about this condition.

Epilepsy is not a disease, but is mostly seen as a symptom of a brain injury that leads to seizures. There are several kinds of (epileptic) seizures, the two most frequent ones being the tonic-clonic seizure and the absence seizure. In the case of tonic-clonic seizure, the individual loses consciousness, has convulsions, may fall to the ground and may not be able to breathe for a short period of time. After


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a few minutes, he or she may regain consciousness but may be confused, have headaches, or pass on to deep sleep. Absence seizures, on the other hand, are brief and often go unnoticed. They may appear several times during the day and are characterised by ‘consciousness blanks,’ during which the person’s eyes are ixated on emptiness, or the hands move unintentionally.

Impact of physical disability on learning and development

Students with physical disabilities may have common characteristics, but they are different and manifest different needs. It is important for you, as teachers, to understand that disability affects learning and development only in some people. In fact, there are cases of serious physical injury that do not have an impact on intellectual ability.

In such cases, you should aim at creating possibilities for the fullest possible participation in educational activities in the classroom and out of it. Education of these students should focus on enabling access to rich academic and social experiences. In order to achieve this, adjustments in the environment need to take place, in terms of the space, academic methods and resources you will be using.

In the case of students with mild forms of disability and those with average or above-average learning skills, there is usually no reason why they should not attend ordinary schools.

When working with students with physical disabilities in ordinary schools, teachers should conduct not only task analysis (to simplify an academic activity into simpler steps), but also situation analysis with regard to the academic environment (Best, et al. 2010).

It is important to take into consideration necessary adjustments in the academic environment, to increase student opportunities for participation (carpeting, access and movement paths and use of available resources).

It has been noticed that some students with physical disabilities tend to present a lack of conidence in their self-eficiency. These are more passive students, who need more work to be motivated (Konings, et al., 2005). Teachers should take into consideration this characteristic when working with

How to manage a tonic-clonic epileptic seizure in the classroom

Do not try to hold the student by force.

Move away from or try to protect the student from desks and sharp objects.

DO NOT put anything between the student’s teeth by force.

After the seizure, roll the student over to one side for the saliva to low out.

Release the student’s neck from tight clothes.

Put something soft under the student’s head.

Don’t offer anything to drink until he or she is fully awake.

Let the student rest after the seizure (he or she will often fall asleep).

If you know the student has epilepsy, you should be prepared. Keep items that may help, in the classroom, such as a pillow or blanket.

If the seizure lasts for more than ive minutes, or when they are repeated and the student doesn’t regain consciousness, you should ask for assistance to handle it as a medical emergency.

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these children. They need a lot of encouragement to express their potential. They also need other therapeutic services outside the school, such as counselling and other therapies, to function better and for better quality of life



What you need to consider when working with students with physical disabilities:

For students in wheelchairs, or those who use crutches or walking sticks, it is necessary to arrange the class (mainly desks) in such a way that makes access easier for them and provides more room for movement.

Some students with physical disabilities may be absent for long periods of time, so teachers should work independently and sometimes go to their homes.

Some students may have epilepsy. Check to see whether they have taken their medication and report all cases of seizures to the parents.

Be meticulous in applying safety procedures, but don’t overprotect these students. When the opportunity arises, encourage these students to participate in activities together with the other students. In physical training class, teachers should know how to adjust physical activities in order to include these students in class activities. It is important that they do not stand by like spectators.

Some students with physical disabilities will need to use modiied desks or chairs. It is the responsibility of the teacher to make sure the student uses these items.


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Managing behaviour

For students with physical disabilities, self-image is very important. Teachers should ensure a positive self-image for the child. Students with physical disabilities are aware of the fact that they are physically different from others and there are things they cannot do. Therefore, they may fall prey to other students’ jokes, insults, exclusion from games and groups. Students with physical disabilities want to be involved as much as possible and to make it in group activities; therefore, as teachers, you need to encourage it. It is important to focus on what the child can do and not on what he or she cannot do.

Some strategies you may use to help them:

Children with physical disabilities want to be like the others and to be seen as ‘normal.’ Focus mainly on what they can do most of the time.

Discover and highlight their strengths. They need to feel successful.

Establish high, but realistic expectations.

Don’t allow other children to harass or insult them.

Compliment them about their looks from time to time.

Make adjustments and accommodations every time you can, to allow their full participation in school.

Don’t pity them, because they do not need your pity.

The information below will help you understand better the needs of a student with physical disabilities.

Students who have disabilities in the upper part of the body should have notebooks or registering tapes, in order to take notes in the classroom.

In case of exams, these students will need extra time. It is better for such testing to take place in a quiet environment and for auxiliary tools to be used.

Students with disabilities in the upper part of the body have dificulty raising their hand in the classroom. Discuss with students and ind ways to realise their desire to contribute to class discussions.

The wheelchair is part of a person’s personal space. Nobody should touch it. Part of the classroom will have to be adjusted for wheelchairs.

Be careful if the student chooses to not sit in his wheelchair but prefers to sit on a bench.

Try to consider their possibilities when you plan activities outside the daily routine.

Plan accordingly in the case of ield trips and other extra-curricular activities that require special transportation.

Not all physical disabilities are constant and unchangeable. Some of them may have relapses and may need to lie in bed or in a hospital. In most cases, students with physical disabilities can make it in spite of shortcomings. However, sometimes they need more time.

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When the child is absent, take the opportunity to teach the rest of the class about physical disability; this will encourage understanding and acceptance in the class.

Spend frequent personalised time with the child, so he or she is aware you are there any time he or she needs you.

Bibliography

• Best, S.J., Heller, K.W. and Bigge, J.L., (2010). Teaching Individuals with Physical or Multiple Disabilities (6th edition), Upper Saddle River, New Jersey: Pearson-Merrill-Prentice Hall.

• Bennett S., (2008) Special Education in Ontario Schools (6th edition) Highland Press (Chapter 13).

• Save the Children, (2010) Një shkollë për të gjithë, përvojë pune me fëmijët me aftësi të kuizuar në shkollat e zakonshme, Tiranë.

• Smith, D.D. and Tyler, N.C., (2010). Introduction to Special Education: Making a Difference (7th Edition), Upper Saddle River, New Jersey: Pearson-Allyn and Bacon.

• Vagas, C.M. and Prelock, P.A., (2004) Caring for Children with Neurodevelopmental Disabilities and their Families, Mahwah, New Jersey: Erlbaum.


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10INDIVIDUAL EDUCATION PLAN (IEP)

Adjustment

In general, all research in the area has proven that the common curriculum gives more results than special curricula for the education of students with disabilities, because when processed and adjusted, it becomes lexible and easy to use, depending on the needs. ‘When it is handled as a special curricular variant, it loses its inclusive mission’ (Friend, M., 2007).

Furthermore, successful Albanian and world experiences in using the same curricula have proven that students with disabilities have better academic achievements in normal schools than in specialised schools or institutions (Ndrio, M., 2012).

The school curriculum or program may be used in two ways:

modiied

adapted

It would be a major damage if modiication or adaptation were to be seen as a minimisation of the curricula.

Adjustments and modiications are conducted:

For students for whom the school commission decides to draft an IEP

The IEP is a document that establishes, plans, organises and monitors the teaching and learning process, adjusting the common curricula to individual needs. It also informs the teacher, student and parents about the goals, progress and methods required to achieve them.

The IEP is a practical work document that can be used by the entire faculty, by all teachers of all subjects and programs and that allows and welcomes realistic, achievable changes related to the student’s daily life and future.

The IEP allows, encourages and monitors progress and success, focusing on the student’s strengths, abilities and talents. (Bennett, S., Dworet, D., & Weber, K., 2008).

The objectives of the IEP should be individual and personalised. They should:

respect the identity, dignity and individuality of the student, the child’s rights for quality education and encourage independence

consider teaching elements that are based on what students are able to do or not do, with help or assistance provided by the teacher or assistant teacher

be drafted with clear, understandable language (easy for the student as well) and, above all, convey compassionate, motivating, welcoming and caring messages.

Students who need a differentiated approach, adjustment and explanation may need a PEP

In spite of its form, adjustment should be considered an ongoing and not inal process and, above all, as the joint work of the school commission consisting of all agents that are part of this process, such as the teachers of all subjects, directory members, social workers, doctor, parents and psychologist.

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Teaching through differentiated instruction as an inclusive strategy and PEP

Teaching through differentiated education offers every student the opportunity to develop special skills and improve him or herself in his or her strengths or where he or she displays the best results. (Halton District School Board. (2011).

Personalised objectives are developed by the teacher in differentiated education, based on the needs, preparation and interests of each student. For these objectives to be realised, they have to be accompanied with methodologies and strategies used in the classroom for the students with disabilities who have not been identiied or deemed to have an IEP.

Some researchers, such as Evelyn Freedman and others, illustrate this concept with the comparison to an orchestra where the teacher is the conductor. Suppose that you need to conduct (teach) the orchestra (your class) made up of, for instance, 30 instrument players (students), the same song (the program and its standards) but in different ways. Furthermore, it is very important not to forget that you are the conductor and you will be setting the tone in this orchestra (class).

Researchers of different ields have been attracted for a long time to the study of human intelligence. Of these, we’ll summarise the three most important and essential conclusions, to understand and apply inclusive strategies.

Intelligence is not single. It varies, it is different and appears in many forms and types. We think, learn and create in different ways (Garden, 1997).

Intelligence is changeable and not ixed. In other words, if students are offered the right teaching ways, intelligence grows.

Neurons, the brain cells, grow and develop when set to motion and are atrophied when not used (Tomlinson, 2011).

Through social psychology, in 1991, Gardner categorised eight types of intelligence while Sternberg summarised them into three kinds in 1985: 1)analytical, 2)practical and 3)creative.

M. Montessori believes that children should be encouraged to work in a personal way and at their own speed, without the need for the teacher to encourage competition and increase the pressure of grades or exams. They should be encouraged to pursue their interests and preferences when it comes to reading and writing. This kind of freedom allows and motivates children with disabilities to lourish and advance. (Montessori, M., 1866)

Children fail, not because they are incapable, but because adults have not guaranteed the right conditions for them to achieve success.

Montessori. M, 1866


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As you can observe in the chart, there are four pillars upon which differentiation relies, through adjustment and modiication.

1. Content differentiation: This method allows students to choose a topic of interest to them.

2. Process and environment differentiation: Some students may respond through drawings instead of words, while others may work in the school library.

3. Product differentiation: Some students may produce a poster drawing and others may create a play.

4. Evaluation differentiation: This differentiation goes in parallel with the other differentiations.

Also, Glasser’s learning choice theory that is based on the four psychological needs that encourage motivation and efforts: (Glasser, W., 1997) can be consider when we design an IEP.

1. Need to belong

2. Need for power

3. Need for freedom and independence

4. Need for pleasure.

Thus, allowing students to choose to work in groups, in pairs or individually, practically addresses their need to belong. When the teacher offers the choice between copying from the board or the book or word formulation, in other words, he/she has addressed their need for freedom of action. While giving them the opportunity for creativity, you have given them pleasure. The more we address the students’ needs, the more we motivate them.

Based on interviews with students in Tiranë, Durrës and Korçë, we found that students lack choices and they see this as a friendly and welcoming approach by the teacher. ‘I would have learned the poem more easily and eagerly if I had chosen the book to recite,’ a second grade student in Kënetas, Durrës,

content process

evaluation product

Differentiation

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says; instead his teacher was rightfully bothered by the fact that most would choose short poems that would lack the right content. A teacher from Vlorë gave us the solution for this: ‘I have divided the books into three categories in different coloured boxes; the red box has animal books; the yellow box has fairy tales; and the blue has Pokémon books…’

Elements of differentiation

Learning modalities

‘The learning modality is the sensory channel through which every student collects and processes information. All modalities are equally important but, with time, one or two modalities appear more than others in every student.’ (Bennett, S., Dworet, D., & Weber, K. (2008).

Inclusive alternatives and methods for differentiated instruction

Interactive learning integrates and includes students with disabilities in working groups with other students in the class. Collaborative learning stands out for its cooperative and assisting spirit, eliminating to the maximum the spirit of competition and race. This kind of teaching has potential and offers equal opportunities and chances for participation, problem solution and decision making for every student member of the group. Many teachers believe and afirm that this kind of learning equally helps the behaviours of both kinds of students, with and without disabilities and the understanding and acceptance of one another, based on respect and care.

Learning in pairs is another form of collaborative learning, whereby a student agrees, voluntarily, or oriented by the teacher, to collaborate and interact with a disabled student. There are numerous successful experiences of disabled students becoming more aware, or perceiving and ‘assimilating’ more, when the task requirements or instructions have been explained by classmates rather than by the teacher.

Student inclusion, visual

• Use bright colored markers

• Draw attention with posters and photographs

• Show movies and documentaries

• Use graphic igures, tables

• Stress details in illustrations

• Use gesture and body language.

Student inclusion, auditory

• Read out loud

• Use audio systems, audio players, radio

• Use music as a teaching tool

• Change voice tones in speaking

• Encourage pair discussions

• Use headsets.

Student inclusion, tactile/ kinesthetic

• Use role play

• Use play-dough

• Use water colours

• Include sports exercises in class

• Allow walking inside and in the school yard

• Encourage the use of cubes and other building games.


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However, experience has shown that there are numerous cases when collaborative learning in mixed pairs or groups does not always function successfully for all students with disabilities. In these cases, the role of the teacher is to observe and monitor attentively the process, progress and group dynamics to then relect on the right changes and adjustments to be made in the future.

Partially collaborative learning, as another variant of interactive learning, offers new room for cooperation. For instance, when the student with disabilities has serious dificulties or impediments, partial participation is recommended as an opportunity for beneit. In this case, the helping teacher intervenes actively by assisting the disabled student for the most part of the assigned task. In cooperation with the teacher, the assisting teacher orients or changes the ‘rules of the game’ or the way the activity has been organised. In this way, the student with disabilities has been given the opportunity to participate in and beneit from social interaction and collaboration with other students.

Advice for teachers by teachers

The following advice about adjustments that help students with disabilities achieve differentiated objectives was collected by different teachers from Albania, Canada and Italy.

Admit that your teaching method is not necessarily the same learning method for all of your students.

In the classroom, give messages that differentiated work is normal and equally helps all students. Foresee and plan tasks that contain elements of success.

Offer different options: working in pairs, in groups or individually. Choosing your own preference is itself a challenging practice for students with disabilities that helps and offers an opportunity to learn to select an option. In order to motivate, foresee alternatives or two or three possibilities as solutions, considering the student’s preferences.

Give brief instructions, possibly in one sentence, simple and clear to understand, underlined if in written form. Do not use dialect phrases such as ‘create working groups among you.’ Avoid words with double meanings, the use of quotation marks, or unknown words.

Acknowledge when there is a need to ask other class students to demonstrate what to do.

Demonstrate yourself, when necessary, or ask other class students make a demonstration.

Reduce and minimise long and complicated tasks, or those that require concentration and focus for a long time.

Plan and ensure the repetition of preliminary knowledge together with selected students.

Follow, monitor and stimulate tasks with the technique ‘This irst and then…’

Create a comfortable environment to work in, micro-environments inside or outside the classroom that could eliminate distractions.

Build a routine and be consistent, repeating the same request every day.

Give them the right to choose other work in the class, such as helping one another, watering lowers, or wiping the blackboard. Do class work in a corner or special corner that is visible to all.

Do not use loud or aggressive tones.

Give frequent personalised, positive and encouraging verbal or written notes; enjoy every success

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and accomplishment, no matter how small it may seem. For instance, ‘Wow, that’s pretty. I like that you used the red colour appropriately, although I know violet is your favorite colour. Good job, but don’t forget to write your name in capital letters.’ Knowing how dificult it is for the teacher to give constant feedback to a class of 30 students, give them the opportunity to check their own work by providing them with a copy with the correct answers.

Instead of ‘I’m proud of you’ to the student or ‘He’s very good in math’ to the parent, use the phrase ‘Be proud of yourself ’ or ‘He has very good achievements in math.’

Do not forget to allow time to think after every question, time for breaks, free time, or time for listening to music, allowing them to pick their favourite songs, if these are appropriate in school. The brain needs breaks.

Do not be afraid to ‘challenge’ and give students with disabilities the opportunity to feel challenged after carefully considering their level of readiness.


• Bennett, S., Dworet, D., & Weber, K. (2008). Special Education in Ontario Schools, sixth edition.

• Earles, T. Carlson (1998). Instructional Strategies to Facilitate Successful Learning Outcomes for Students with Autism. Redwood Books, London.

• Friend, M. (2007). Special Education; Contemporary perspectives for school professionals, third edition).

• Gardner, H. (2009). Five Minds for the Future. Harvard Business School Press.

• Glasser, W. (1997). Choice Theory.

• Halton District School Board (2011). Differentiated Instructions Checklist. Halton District School Board, Burlington, Ontario.

• Montessori. M. (1964). The Montessori Method. Schocken NY, 1964.

• Ndrio, M. (2012). The Right to Inclusive Education for Children with Disabilities - Analysis of the History of Educational Development of Children with Disabilities in Albania during 1945–2011.

• Save the Children (2010). Nje shkolle per te gjithe. Pervoje pune me femijet me aftesi te kuizuar ne shkollat e zakonshme.

• Tomlinson, C. (2011). The Differentiated Classroom: Responding to the Needs of All Learners. Toronto District School Board, Toronto.


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Each of us leaves a mark in life


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11COMPETENCES, SUCCESSFUL STRATEGIES AND TECHNIQUES

Rudina and art

Logic takes you from A to B; imagination takes you everywhere.

A. Einstein

Art is another way of learning. Education through art and art therapy give students with special needs opportunities and chances to express themselves. Different teachers say that, without the need to speak or explain their condition and emotions, creatively, through elements of visual, musical, photographic art, dancing, sculpture, embroidery, etc., they can express themselves and establish relationships, according to individual needs and preferences. In other words, through art, students with special needs may communicate what they cannot express through words. ‘The very fact that art in itself has the potential to break barriers and obstacles, among students with or without talents, with or without mental and physical disabilities, gives art and art therapy an extremely important role in inclusive classes.’ (Remacka, 2012).

Education through art may be realised everywhere, every time and by anyone… By not daring to put a period to end the deinition, we’re leaving the sentence open and every student may add his/her own deinition of art in inclusive school. ‘Art makes my students use their hands, brain and heart,’ says the head teacher of art classes for children with Down syndrome in Tirana. Likewise, Rudina’s story may be used as the ‘living, authentic deinition’ on the role of art in inclusive education.

Diary pages from the visit to Rudina’s study.

Tirana, May 2013, green afternoon…

It was lightly lit evening and on the way back, M…na and I were walking and talking all the time… The emotions we got from Rudina’s study and her art were so strong that the great Poradeci could have called them ‘beautifully insane’ or ‘insanely beautiful’… Magically, I felt how ‘the beauty, the art, Rudina herself ’ had melted and overcome every difference between us, speechless and so ‘ordinary’ compared to Rudina, diagnosed as ‘incapable,’ and her genial talent. I recalled painters Nasui, who writes: ‘Rudina’s painting is a fascinating appeal for people called normal!’

Go igure where the normal begins and ends?!? Vehip, a very caring father and Lola, the super-dedicated mother, told us, very naturally, of how Rudina was one of the pioneers, among children with disabilities, who dared to enroll in school. ‘She loved school and her friends; she was happy,’ Lola says. As the conversation lew, Rudina played with her chubby ingers, the ones she makes miracles and wonders with, to give us strong existence lessons and messages.

‘Girls took turns on who would sit at the same desk with her,’ Vehip said. Lola went on, ‘Generally, Rudina paints girls’ igures.’ She created about 400 works with different techniques, from oil to graphic, pen and pencil, but what most impressed me from my silent counting of paintings hanging in her study, were the about 600 igures of girls/friends who were imagined and maybe missed and very wanted…

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Two very signiicant examples demonstrate how each teacher Rudina had would have felt if he or she had guided her to practice according to models and colours chosen for her to use.

1. Her irst teacher, who admitted her in the painting group he had started with normal talented children, after three months, told her parent with concern that Rudina would not agree anymore to have models put in front of her. She only wanted to do what she felt like, even if she was willing to accept his advice. The parents fortunately told the painter, ‘Let her be free; our goal is not for her to become a painter, but for her to become part of society!’ And that’s what happened. Her talented instructor, Bashkim Dervishi, the moment Rudina would walk into the classroom, would ask her what she wanted to do and, after receiving a response, encouraged her to work and advised her during the class. This left her free to decide independently about her work and that’s why she blossomed, picking up her painting brush herself and not bothering about the space she would work on. To her, a piece of paper, a newspaper, a magazine page, was and still is, a material that she can use and a working tool.

2. When Rudina’s irst personal exhibition was opened, it was a special artistic event in Tirana and in Albania. Her art teacher from school cried and cursed herself for giving Rudina only an 8 as a inal grade in her class. This happened because Rudina ignored the models that were presented to her, but decided to work, instead, only according to the images that she formed for her artistic subject.

Likewise, we’re convinced of one thing now: the feelings that Rudina’s irst wonderful teacher, Hëna Hashorva, has, are shared by her other teachers and classmates from irst to eighth grade, when they look at Rudina’s painting exhibits.

Known Albanian painters have called her a ‘colleague’ since Rudina was 15 years old. That’s not all, though. These comments of appreciation from Rudina’s beginnings as a painter convince us of this:

Sali Shijaku (painter): ‘She is original because she knows no trends… It’s just a general one; she knows no other levels…’

Kujtim Buza (painter): ‘Now Rudina Proda is a painter; she has come amongst us with all of her magical world, thanks to her talent; she’s so hard-working, has developed self-education skills, with support from friends and experienced artist colleagues; especially her parents have been everything and Rudina herself is a lake of joy, but also of concern.’

Nazmi Hoxha (painter): ‘Through colour, Rudina speaks all languages of the world. In the thick of the night she brings colour; in colour she creates darkness…’

Shpend Bengu (painter): ‘To talented Rudina I wish to continue to see the sun, that sun that she likes, the sun that she resembles, so that its light can enter into those corners where there’s just darkness for others!’

Xhevahir Spahiu (writer): ‘Rudina is a wonder that discovers the inexistent.’

Pjerin Logoreci (publisher) ‘...Rudina, may you have the most unthought of thoughts; may they say the most unsaid words for you!’

Andon Andoni (writer) ‘A pleasant suddenness and a shivering feeling, coming entirely from the uniication of the fact that those paintings, with a developing character and as mysterious as readable, are the fruit of the hand, mind and soul of a girl who is like us, like the rest of the world and is not such, at the same time.’


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The 36th General UNESCO Conference held in May 2014, for the irst time, announced that the third week of every May would be dedicated to celebrating arts in schools and artistic education. ‘Youth should learn how to love art. It will help them know get to know and love one another… It helps form tolerant and active citizens of the world.’ (I. Bokova, 2012)

The century we live in and the life we face are proving every day how connected we are and how much we need one another. Given that school is an institution that evolves and changes every day, building human potential, it is essential that art and its role are considered very important in inclusive Albanian school. In this low of changes, artistic education itself seeks to 1) transform not only education or the curricular framework, but also to 2) emancipate the worldview of Albanian society, by presenting the value of art as a breaker of excluding barriers and stereotypes, 3) be considered a promoter of intellectual development in students with special needs, a promoter of artistic talent in students with disabilities and, furthermore 4) in accelerating inclusive social reforms and tolerant and accepting practices by all.

In ending his manifest ‘Art as experience,’ J. Dewey (Dewey, J, 1934) says that ‘imagination is the main instrument of every achievement.’ It is precisely art and through it, personal imagination (not a copy of the model presented by the teacher) that encourages and sensitises success and the feeling of self-realisation and independence among students with special needs. It is necessary to include art that encourages imagination, not reproduction, no matter how perfect.

Another strategy could be ‘artistic cross-subject integration,’ which seeks to be treated as an initiative with quality, ethical, civic and reforming values, into Albanian education, for all. Education through art should be understood as such for every Albanian child without distinction. Labels such as ‘with or without talent’ seriously and unjustly harm the understanding and value of art and, even more, the dignity of every child. (‘I recall how bad I felt when my art teacher didn’t like my autistic son’s art and criticised him for not having a good “hand,” saying that his works are not worthy of the school stand, because they are just scribbles. My daughter (not autistic) had the same feeling when she was removed from the choir because she did not have a good “ear.”) Parent in Tirana.

Education through art deserves to be considered a mindset, an opportunity, an alternative with transforming and progressive values not only for the ‘outstanding’ and ‘capable’ students in classes and schools, but, equally, for all. Moreover, the arts can transform the Albanian society of the new 21st century as a whole, presenting educational artistic values that match global and national pace and developments of cooperation and inclusion. The example of the great success of the staging of classical tale ‘Cinderella,’ as a joint initiative of the ‘School for deaf and blind students’ and eight-year schools of Tirana, powerfully demonstrated how ‘incapable’ the public was to identify which of the

Prof. Dr. Ljubomir Radovançeriç (Croatia): ‘Rudina is vis-à-vis métier, very disciplined in practice; that’s why she uses coloured pencils, felt-tip pens, paintings of oil on canvass and other techniques of visual arts. It is very dificult to establish which of the previous artists Rudina’s works are like. It is proof that her talent is genial and original.’

Geill-Peter Loche (Helsinki, Finland): ‘Heartfelt thanks for a world that to me is unknown. I wish the artist courage for her work in the future, as a “diplomat” of a closed world!’

Nimfa Jaço: (artist): ‘Entering the world of Rudina’s painting, you are amazed… You stand for a long time and experience the harmony and shine of colors, the sadness in the eyes of her portraits, the naivety of a child, the talent of a genius, the miracle of an unknown world that managed to speak…’

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actors could hear and which could not. The emotions were strong and meaningful for all. (Remacka.L, 2012)

Photography

As another form of art photography is a way of exploring, expression and inspiration. All the pictures on the manual are selected with full rights from the exhibit or children with disabilities, supported by the ‘Photo Voice’ project, World Vision 2012, implemented in Elbasan, with children from the areas of Shushicë and Shirgjan, in order to:

“Give voice and hope to the future of children with disabilities.”

Photography is another form of expression, which offers other forms of inclusion easier than some other arts. In particular, photography enables anyone to share and show his perspective or experience through the presentation of real experiences. The combination of the real moment, captured on camera and the reason for the personal choice, is an endless way of communication. In the case of students with disabilities, photographing and photography may be used as a tool of expression at any time and space.

The experience of the project ‘Children’s voice through photos,’ in June 2012 and the exhibits in three districts of Albania showed the force and impact of photographic art in inclusive processes.

Play

According to the United Nations Convention for the rights of the child, every child is entitled to education, play and free time. (Article 31).

Play is an important part of childhood and growth processes. It is spontaneous, gives pleasure, intentional and without a given purpose. Also, play is a tool for exploring, discovering yourself and others. Through the free communication in free play, without the need for speciic and meaningful ‘rules,’ the teacher may understand and communicate with all students and the students can do so among themselves. For instance, traditional games, such as dollhouses or cars, allow every child of every age to express their interests without the need for spoken language. According to Ellis, (Ellis, M. (1984), play is a voluntary activity that makes every child ask himself, ‘What can I do with this toy/object?’ Some teachers have successfully used game therapy as an educational tool to encourage motor skills, speaking, communication, thinking, physical activity and above all, social activity. Furthermore, some others have used it as a diagnosing and evaluating tool for learning skills and dificulties.

Nature and the power of the school yard (education outside the classroom)

‘Fun games are played outside the walls, in the yard and the ield,’

say students of the special school in Korçë.

The expression of our grandfathers that ‘children learn more by playing outside’ indicates the strong relationship between playing, nature and education. ‘The low of sounds, light, shapes, aromas that the nature offers stimulates the brain and creates experiences, a process of learning that creates order from disorder.’ (www.ode.kinda.se/object.php.)

Let’s consider nature, the environment outside the walls, as an ‘alternative’ and strategy, as an open and complementary class to the traditional class, whereby we may organise thematic and cross-subject lessons. ’Often students play in places where teachers do not “prefer” to see them… but they learn a lot even from this kind of ‘informal’ education and this experience… (Brodin, J. & Lindstrand, P., 2006).

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schoolyard. 1. The self - the student will participate in games where he may know and become aware of himself and his skills. 2. The others - through interaction, conversation with friends, socialisation in groups or pairs occurs. 3. Nature - the natural environment (outside the walls) offers opportunities for adventures and new challenges (Hopkins & Putnam, 1993).

Nevertheless, we should consider the fact that often our schoolyards are not suitable for students with physical disabilities or those in wheelchairs. We should take into consideration that the environment itself may cause social isolation, being excluding, non-welcoming and non-inclusive.

Adjusting the physical environment

Research shows that the adjustment and modiication of the physical environment on the basis of individual needs has a positive impact on the performance of students with disabilities. (Earles, 1998). Proper attention to an effective use of physical space in the classroom or the decoration of walls is in itself a preventive or retroactive strategy that can be adopted since the beginning of the school year. The structured environment of an inclusive classroom gives welcoming messages, communicates rules and visual aid to support and accept all students on the basis of their individual needs.

The placement of desks should respond to the techniques of working in a large group, small groups, or one on one work with the teacher or the assistant teacher. In the case of students with special behaviours, usually it is recommended that the micro-environment, corner or desk be placed

Far from doors and windows for safety and to prevent unpredictable or unwarned escapes; it may be completed with STOP, my turn – your turn, now – then signs and near the teacher’s spot to facilitate observation and control.

Part of the walls near this micro-environment should be empty or as individualised as possible, to avoid distraction and to help establish routine and the creation of repeated skill.

The wall board where the teacher writes should have a special spot that shows and refers to the change of the class environment (work in groups, or in the quiet area, in the library) during the day, depending on the planned agenda.

The place and position of the assistant teacher may vary. First, it is recommended to start with standing next to the student and then move naturally behind the desk and later with the creation of physical distance, depending on the task or the agenda.

Identiication of various speciic ‘areas’ in the classroom, such as a work area, play area, or free time area encourage understanding of expectations by the student and facilitate the teacher’s achievement of differentiated objectives.

Visual support is a useful tool that includes paintings, symbols and signs that help students with disabilities concentrate, understand written language and abstract the low of actions, agenda, time and place.

Natural light helps and soothes more than artiicial ones. Decorate the classroom with photos of the life of students’ families and friends, or natural lowers in pots.

Consider allergies and sensitivity to the environment, foods and smells.

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From dependence to independence

When we asked a second-grade student, in a wheelchair, in Toronto, what he likes the most, he said ‘push buttons,’ and when asked what he hates the most, he said, ‘the fact that others push the buttons for me

when we get into an elevator.’

The path from dependence to independence is long and toilsome. This path is a long process of continued and repeated efforts, by the teacher and the student, to achieve individual and digniied freedom.

The word ‘independence,’ for a student with disabilities, indicates actions and activities without assistance. Independent actions or those partially assisted or supported may represent the long-term or short-term goals of IEP objectives.

Together with the school commission, the teacher follows and contributes:

1. to establish clear objectives and realistic expectations that seek complete or partial ‘independence’ based on the needs of the student with disabilities. Some objectives may be very simple, such as ‘learn to write your name’ or complicated ‘form and write short sentences’

2. to establish and document the initial condition of the student and monitor progress continuously

3. to establish strategies and techniques for teaching the student

4. to decrease help and assistance and increase independence of the student with disabilities

5. to develop the skills needed in the future, such as if a student with disabilities is in irst grade, we should consider the skills he/she will need when he/she is in third grade.

Many teachers use the formula ‘Help me do it myself,’ which mentally helps the teacher or assistant teacher avoid the instinct that comes naturally to help a child with disabilities. Since 1866, Maria Montessori advised us, ‘Never help a student for a task that he/she feels he/she can do him/herself.’ (Montessori. M, 1866).

This is a long process that begins with small steps and these will need to be repeated frequently until they turn into a routine. ‘This is the key that closes the door to dependent and semi-independent actions and opens the door to fully independent actions,’ says a school principal in Tirana.

‘Usually, students with disabilities come in September with a formed habit, full dependence on the teacher. The irst step may be to explain the word “dependence” and the importance of independent actions for all

students and particularly for students with disabilities,’ a irst grade teacher in Bathore says.

Encouragement and support

Encouragement is an auxiliary tool offered to students with disabilities to ensure success during the teaching process. Encouragement can be given before or after class tasks; it foresees success and often goes from visible to invisible encouragement.

1. Encouragement may be physical. For example, when teaching how to write the alphabet, the teacher or assistant teacher may encourage by placing his or her hand on top of the child’s hand. You may also use physical support when the student has dificulties in motor skills or walking.

2. Verbal encouragement, through gestures and demonstrations. One of the most essential skills and competences, that students with disabilities need the most, is the skill to understand written or verbal instructions. ‘The moment students understand instructions, they may act without your assistance. I have sought to give only verbal instructions, sometimes with gestures, drawing the


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attention of everyone and then I have asked that students in pairs to paraphrase my instructions, also considering Arben, an autistic student in my class. I had realised that he better understood instructions for class tasks, when given by his schoolmates than when given by me,’ says Arben’s teacher.

3. Visual encouragement may be given through paintings, illustrations or symbols that turn into a routine that helps the teacher and the student at the same time.

4. Encouragement through positive comments and expressions and the creation of a cooperative environment between students with disabilities and teachers. For instance, using initial exclamation phrases, ‘Oh, how pretty,’ ‘Ah, that’s wonderful,’ after writing the irst letter helps continuity and completion of the whole line.

Stimulus

Most students with disabilities have internal stimuli that help them achieve success. It is very important to use the right stimuli at the right place and time; otherwise the stimuli may cause problems or undesired behaviours. Stimulation is a process that may be free time, socialisation with friends, toys, play, desert, etc., depending on individual desires or preferences.

Choosing stimuli

It is very important to personalise stimuli by knowing and considering the needs and desires of the student with disabilities. It is very effective to offer interesting opportunities in options, such as, ‘Would you like to play with friends in the schoolyard, or play with your favorite toy?’, ‘Will you choose exercise A or B?’, ‘Will you work at the desk with student A or B?’, ‘Will you irst do this or that?’

Giving stimuli

Stimuli should be given immediately after a successful performance. It should be useful and be expressed and accompanied with enthusiasm by the teacher or assistant teacher. It is also very important to keep promises.

Diminishing the use of stimuli

Although stimuli should be consistent and continued after every achieved objective, it should be diminished naturally when, for example, it begins after ive minutes of work, it diminishes into being given after longer intervals (after 10 or 15 minutes).

Replacement of an undesired behaviour with another acceptable alternative

Standardised discipline: The student with disabilities should respect all the same rules and standards established by law, like all the other students. However, it is recommended that for every consequence to students with disabilities, the peculiarity, conditions and causes of every single case should be taken into consideration.

Dividing and parceling complex tasks into small steps

Often, the tasks that the teacher gives in the class appear complex for students with disabilities. The use of this strategy helps especially in cases when explaining or giving a new task, when independence of action has not yet been achieved. Parceling into smaller steps varies depending on the needs and skills; someone may need two or three steps, others may need more.

For instance, tying shoe laces; action 1, forming ‘rabbit ears’ (day one); action 2, tying the knot (day two), action 3, pulling the ‘rabbit ears’ (day three), action 4, repetition, repetition, repetition.

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Name of the student, class Observation date

Observer’s name Time

Description of the behaviour/problem Place

Who is involved

What happens before the

incident

Evaluating undesirable behaviour and documenting it

All behaviours and attitudes have a cause and happen for a reason. Often reasons are easy to understand, but sometimes we face problematic behaviours of students with disabilities ‘without a cause or reason.’ Finding or understanding the WHY is very important for solving the problem both temporarily and in the long run. If we do not take a position towards the behaviour or solve the problem, it will reappear.

Behaviours may be caused by lack of motivation, encouragement or a problematic behaviour:

1. not wanting to do the task assigned by the teacher or leaving a certain situation or place

2. seeking attention from friends or the teacher

3. desire to touch or take food, an object, a toy, etc.

4. triggers that have to do with hearing and smelling, such as hand clapping, noises, alarm sirens, certain smells.

In order to determine the WHY, interpretation and collection of information through the following is helpful:

interviews and conversations with parents or previous teachers and school staff

speciied, documented and measurable observations, such as yelling, aggressive behaviour towards friends or the teacher, crying, name calling, pulling hair, biting nails, blushing in the face, ears or neck.

Observation sheet

What was the student doing

when the incident occurred

What happened immediately

after the incident


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Determined manifestation (behaviour)

The process of determining whether the behaviour manifested by a student with disabilities is or is not an indicator, is called ‘determined manifestation.’ This process is often complicated and dificult. The most valuable advice in this case is the use of positive interventions and support to prevent problems or enhance the proper or desired behaviours.

It is helpful to look at the question that the teacher may ask herself and the parents, ‘Is this request or behaviour a manifestation of disability or not? How should we understand and tolerate this in the name of fairness?’ There are several ways, techniques to manage the ‘consequence’ or positive intervention.

These behaviours or positive intervention (as the case of tolerance for toys) may turn into ‘accepting behaviour’ or ‘supporting behaviour,’ because of the individual needs of the student with disabilities. They are accepted by teachers, parents, other students and school directory, in most cases because they help the learning process or behaviour of the student with disabilities. Research has shown that emphasising ‘rewards’ or positive consequences (as in Arben’s case, allowing the use of his favourite car in the classroom) is more eficient than the use of punishment of an unacceptable behaviour (Bradley, 2001).

Although we said above that every undesirable behaviour is the consequence of an inner or outer cause, it also serves as a goal for the student with disabilities, if it is, for instance, to eliminate or diminish undesirable behaviours. If the teacher tries to eliminate this behaviour and does not provide or replace this behaviour with a new alternative, the student with disabilities will try to ind another undesirable behaviour to achieve his goal.

The technique of replacing undesirable behaviour with another acceptable alternative, or a new skill, allows the teacher to move one step closer to speciic objectives and expectations for the student with disabilities

Example: A teacher in Tirana says: ‘Arben (an autistic student), on his irst day of class, brings with him his favourite toy, a small wooden car that he rolls through his ingers endlessly…This made him happy and calm.’

According to the rules the teacher has established for her class, it is not permissible to bring toys from outside. The question is whether the teacher, for the sake of ‘equality,’ should not allow Arben to bring the toy to class, or for the sake of ‘fairness’ and based on Arben’s needs, she should allow him. Can we determine where tolerance begins or ends?

The same teacher says, ‘…in the beginning, I did not allow it; although I had been told by Arben’s grandmother that he can’t do without it, thinking that I should be equal towards all students. He began to cry and hit the desk with the head, became aggressive and the other students asked me to make an exception for him. I don’t know how I should have behaved in the beginning, but I set a condition that he could bring his toy, only if he illed the notebook page with “A, a.” Understandably, my expectation was not realistic, but I realised that Arben would do everything to achieve his goal. He illed a page with small and big irregular circles and gave it to me in exchange for his toy.’

‘Anytime I burden him a bit, he begins to stress out and tries to bite himself. I need many minutes to calm him down,’ says a teacher from Korça.

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For instance, the Korçë teacher says, ‘…I wanted Alda, a second grade student, to remain seated at her desk and inish her class work. Alda does not like to write at all and she gets annoyed and tears up the work sheet in front of her.’ Instead of this undesirable behaviour, the assistant teacher offered Alda another alternative of an acceptable behaviour. Alda learned that there are other ways for her to display her aggressive behaviour in another acceptable and appropriate manner, which could be ‘pushing the work sheet to the corner of the desk to show that she needs a short break.’

Finishing the task = desired long-term goal

Replacement of aggressive behaviour = alternative, short-term goal

with an acceptable behaviour

Examples of acceptable alternatives could be:

use of signs, gestures, drawings instead of undesirable behaviour

relaxing techniques such as seeking a break instead of shouting, crying or losing control

use of the stimuli technique, such as Beni may be stimulated with one break if he pushes his work sheet to the corner of the desk and two breaks if he completes his work sheet

enjoy very small successes by believing and hoping for bigger ones.

Parents as partners in education

‘It took us time to accept that there were no more hopes or dreams and that, above all, we had to start hoping for things that had not even crossed our minds before. For instance, my dream now is that my

daughter will, one day, ask something directly to me…’

Parent of a girl with serious speaking dificulties, Durrës

Not only do the needs of disabled students differ, but parenting too varies. Every family is different and maybe inside the same family, the parents or brothers and sisters have different needs, styles, cultures, beliefs and ideas. Everyone has the right to think differently about his/her child’s growth, education and development. Concerns begin when problems are generalised and especially when parents are prejudiced or categorised without considering the speciic conditions of every single case.

Never forget that a parent builds dreams and desires and wishes the best for his/her own child, even before that child is born. Think of how painful it is for a parent to see his/her dreams and expectations crushed completely, when he/she discovers that his/her child has dificulties and disabilities. The irst step towards proper cooperation is when the teacher begins to understand the parents’ concern.

Not every child with disabilities enrolls in school identiied as such. Although efforts have been made and are being made in a more organised way to carry out identiication in the very irst years of life and in kindergarten, there are numerous cases of irst, second, or third grade teachers who identify dificulties and disabilities in special students. There are also many cases when disabilities are caused by traumas and accidents that may occur while the children are in their school years.

So, the irst phase in which parents need support is when the situation is diagnosed and assessed by professionals. There are plenty of cases in which parents ind it dificult to accept the fact that their child needs an evaluation.


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Second phase: There are also numerous cases in which, upon evaluation, the parents do not accept the fact that their child has been diagnosed with a disability. ‘Success and failure begins and ends with the parent-teacher cooperation,’ says the principal of the E. Duraku School.

Third phase: The parents feel angry, upset and often guilty about the situation. This is a phase that the teacher should consider part of the acceptance process and she/he should not take the parents’ aggravation and shutdown personally. Avoid self-defence and further aggravation even if the parents have made you feel as if you did not work enough.

Fourth phase: The more dificult cases are when the parents themselves go through very dificult situations, with the feeling of shame, guilt, responsibility, loss and hopelessness increasing to the level of depression.

Fifth phase: The phase of accepting the fact that their child has a disability. Usually, these are the cases when a healthy cooperation and partnership is established between the school and the teacher. The task of the inclusive teacher is to help parents ind a balance between hope and reality.

Not all parents of children with disabilities will necessarily go through the above phases, but as professionals, teachers will often have to cope with and help parents in different situations.

Communication

Numerous research studies show that the way in which the diagnosis of the child with disabilities has been explained to the parents for the irst time has had an impact on their behaviour towards their child and the teacher. Figuratively speaking, a teacher in Tirana summed it up as follows, ‘…the irst meeting with the parents of V… I can say laid the irst brick in founding cooperation with them.’

In inclusive schools, cooperation with parents of students with disabilities should be considered a necessity, not an option.

Practical advice that help teacher-parent communication

Before the meeting with the disabled student’s parents:

Become familiar with and study the case, the ile and the IEP.

Share concerns with the directing staff and other teachers in the school.

Prepare by writing, in advance, the purpose of the conversation, the priorities, the elements you may negotiate and the new solutions, expecting that every participant in the meeting will be cooperative and supportive.

Foresee and prepare the necessary documentation.

During the conversation, be an active and attentive listener.

Do not hesitate to ask in order to avoid misunderstandings.

Take notes.

Do not judge.

Demonstrate calm and positive attitudes and try to understand before giving your opinion.

Offer new solutions and options.

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Avoid distractions or shifts from the focus and purpose of the meeting.

Use the child/student’s accurate name.

Start the conversation compassionately, giving hope (in accordance and proportionate to the need and dificulty diagnosed by the commission) and human messages that show your perspective, care, respect and professional dignity as an educator of their child.

Give and emphasise messages of clear professionalism that show your readiness and the priority you give to parent-teacher cooperation.

Try to be credible, emphasising your morals and professional values, your ethics and the conidentiality of the professional and human relationship you want to establish with the parents. Do not compare or give examples of other children.

Give parents the time and opportunity to express their emotions and opinions about the ways and educational methods used with their child. Create a warm environment and give them time to “open up” to you.

Consider the proper time for the transition from 1) ‘shock state’ to 2) ‘acceptance’ to 3) cooperation.

Make them feel appreciated for all the work they’ve done and the method they’ve chosen and offer new ways, approaches, opportunities and techniques.

Inform them about the latest procedures in the legal framework, in teaching children with disabilities. Also, share information about all the institutions that offer support for children with disabilities.

Give parents the right to choose their way of communicating with you, either verbally, in written form, or by email. Establish, together with the parents, the information that you will share with the child’s classmates about the situation.

Concentrate on the child’s positive aspects and strengths and not only on the obstacles that the parents encounter every day. Cooperate closely in order to establish realistic, possible, short-term and long-term objectives in the IEP and ways to achieve them, considering together the children’s speciic needs. Share approaches and opportunities about accommodation and modiication of the curricula, textbooks, tools and curricular and extra-curricular programs and premises.

If you think that you articulated something in the wrong way, or you mentioned it by mistake, do not hesitate to apologise.

Do not hesitate to ask for help.


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• Bokova, I. (2012). Message on the occasion of International Arts Education Week, UNESCO.

• Brodin, J. & Lindstrand, P. (2006). Inclusion of Children in Outdoor Education. Learning in Motion. Stockholm Institute of Education.

• Earles, T. Carlson. (1998). Instructional Strategies to Facilitate Successful Learning Outcomes for Students with Autism. Redwood Books, London.

• Ellis, M. (1984). Play, Novelty and Stimulus Seeking. Schocken Books, New York.

• Gardner, H. (2009). Five Minds for the Future. Harvard Business School Press.

• Halton District School Board. (2010). Autism Checklist. Halton District School Board, Burlington.

• Hopkins, D. & Putnam, R. (1993). Personal Growth through Adventure. London Press.

• Dewey, J. (1934). Art as Experience. New York.

• Martin, N. (2009). Art as an Early Intervention Tool for Children with Autism. Jessica & Kingsley Publishers, London & Philadelphia.

• Montessori, M. (1866). Absorbent Mind. Holt, New York, 1966.

• Remacka, L. (2012). Arti ne fokus. Bulletini shkencor N 2, Universiteti Planetar, Tirane.

Links

• http://www.ode.kinda.se/object.php

• http://www.unesco.org/new/en/unesco/events/prizes-and-celebrations/celebrations/international-weeks/international-arts-education-week-2012

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12ETHICS OF PROFESSIONAL COMMUNICATION, CONFIDENTIALITY COMPLIANCE AND TREATMENT WITH DIGNITY

Over the last decade, both at global level and in Albania the focus on issues of child abuse has been grown, especially regarding children with disabilities. In this regard, series of measures were taken to complete the legal and institutional framework. International or national behaviour standards and protocols have been adopted to guarantee the implementation of the rights and protection of children.

More speciically, the school, as an institution which accommodates thousands of children each school year has adopted a behaviour protocol for the institution itself and its employees, as regards the way how student should be treated. Compliance with the standards is very important, in order to build and strengthen ways of behaviour and positive, hospital, and inclusive attitude, and have a service of the best and most effective performance.

Due to the speciicity of the issue dealt with in this manual, we would like to irst refer to some international principles and rules which should serve as a guide to your work with disabled children.

Advice for the teachers on the implementation of professional ethics rules1

1. Protect the dignity and show and display respect for the child. In every situation, we should put the interest of the child in the irst place, and that is the reason why we should not label a person according to his speciic situation. The example given by the teacher is very important, since it is transmitted to all the other children in the class.

2. Do not suppose on address of the disabled child. Therefore, e.g. you cannot know whether someone who missed a leg since birth, still suffers this fact or feels challenged time after time. Perhaps, because the child was born with one leg, he does not suffer any trauma anymore because he is skilled to make all daily actions in such conditions. The child should not be treated with mercifulness or as a being a sick person.

3. The use of victimizing terms is discouraging. A child who had an accident during early childhood can be considered as a victim, but it would be insulting to keep treating him as such. That child may have already overcome the trauma of the accident and gained self –conidence. Therefore, putting him in front of a victimizing factor may discourage and demoralize him.

4. Don’t judge! What is normal for you may not be normal for others, due to personal, cultural, and origin differences. People may be categorized as part of the majority, as part of the average, or the minority, but they may not be categorized as normal or abnormal, in a way or another.

5. Accept that all children have basic needs, but also have special needs. All people have their different abilities and disabilities. For example, someone using glasses would not like to be addressed to as someone “with glasses”, “with special needs” or “different abilities”. By addressing someone as a person with “special needs” would deinitely put him in a special category, making him feel discriminated or isolated from the majority. Everyone is special and talented, and has different abilities and disabilities.

1These rules have been developed and adapted refereeing to the European Disability Forum. Adopt a Disability Attitude

as well as International Roadmaps of World Vision Organization regarding disability

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6. In any case, and any time, respect conidentiality. If you, as a teacher of a disabled child have full knowledge of the situation of the child, of the causes and reasons why the child is in such a situation, your should respect conidentially and refrain from sharing with others the personal information or personal story of the child, unless this is requested by the social worker, the psychologist, or doctor of the child, based on an authorization of the parents in cooperation with the Evaluation Committee.

How to identify and respond to cases of abuse of children with disabilities

The distinctive signs of abused children with disabilities do not differ very much from the signs of non-disabled children who are abused too. In your role as teachers, you should be trained to identity whether the disabled child has been or is being abused. The following table summarises some of the distinctive signs of abuse. Let’s have a look at the table and analyse those signs we consider typical for disabled children and that we can identify in children in school, families, or communities.

Signs of abuse in children with disabilities2

Physical signs of abuse

• Scratches, burns, spots from pinches, or hair pulling

• Signs of hands/ingers remained due to a coercion

• Lost teeth

• Eye injuries (black or bruise eyes)

• Ricks of broken bones

• Vaginal, rectal pain or scratches in the area

• Frequent infections of the urinary tract or frequent urination

• Constant redness of throat

• Sudden start of psychosomatic complains (males more often complain about stomach-ache whereas females for head-aches)

• Sudden dificulty to stand or stay seated

Physical signs of neglect

• Dehydration, not a good state of the skin, or its drying or cracking

• Inadequate hygiene or unpleasant look, (very long nails, uncut or unclean hair; unshaved face, parasites, smell of urine of the persons.)

• Malnutrition/ weight loss

• Mess, dirt, or bad smell in the house of the disabled person

• Inappropriate cooking

• Lack of necessary health and dental care

• Lack of right supervision or care

Signs of child’s behaviour

• Changes in the way of expressing affection/love especially when expressed in an unusual or inappropriate way

• Sudden experience of fear, sudden start of having bad dreams, and changes in sleep models

• Sudden regress in infantile behaviour (i.e. shaking in bed, sucking the thumb in the mouth, etc)

• Sudden interest on sexual matters (including excessive masturbation)

• Cruel behaviour towards the animals

• Appearance of a sudden fear of the shower/washing/ toilet, of a person or a place

• Depression, closure in oneself, or mood swings

• Unexplained changes of behaviour

2 Agency for Persons with Disabilities (APD), http: ///apd.mylorida.com/about


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What is our role, after we identify a case of abuse of a child with disability?

QARK Council

Municipality

Office of Social Service

PMF Social

Administrator SCHOOLNGO

MLSAEO

Technical Child Secretariat

State Social Service

Regional Office of

State Social Service

Social

centres

FAMILIES VULNERABLE

CHILDREN COMMUNITIES

Every teacher, likewise any other citizen and professional who identiies a case of abuse, has the legal duty (Law on the Protection of the Rights of the Child, November 2010) to report the Case to the Multidisciplinary Commission of the School, or to the Child Protection Employee (CPE) in his commune /municipality. Another way of referral is to refer to the school psychologist and, subsequently, is the psychologist who will follow the line of reporting and handling of the case.

According to the law of year 2010, the Child Protection Unit is the legal structure, which is a constituent part of the Department of Economic Aid and Social Services in every municipality/ commune, for dealing cases of violation of any right of children, including disabled children.

The professionals are part of the multidisciplinary group handling the case, under the guidance of the CPE, and give their contribution with information on the case in the multidisciplinary table.

Regardless of the structure that will handle the case, either that within the school or outside the school, such as the Child Protection Unit (CPU) in the commune/ municipality, there is a very important principle to be implemented in any case; Never be silent if you identify a case. Report it immediately!

Based on what we mentioned above, we saw how exposed to abuse and weak disabled children are. Even so, due to the mindset in our society, what is considered as damaging or abusing treatment for children in general, sometimes, in case of the disabled children, is accepted. The fact they are made fun of and do not participate in any decision in the family, school, and are often bitted to tell them that they should be silent, etc. is considered accepted by the society where we live in.

In order to achieve protection of disabled children there is a need for more attention and care especially when a speciic community or the society does not recognize the human rights of these children.

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The above scheme is a visual way to explain the child protection mechanisms according to the Law on the Rights of the Child, November 2010.

The school is one of the key actors, as part of the multidisciplinary table, which is convened by the Child Protection Employee (CPE) to discuss about the case of abuse, contribute with practical solutions, and follow the progress of the case further on. As previously mentioned, other than the teacher, the multidisciplinary table is also composed of professionals of various areas, such as the employee of the health care centre, the social administrator, the police oficer of the area, the psychologist of the school and other specialists based on the speciic needs of the case. (Manual of the Child Protection Employee, 2009).

During the identiication and referral of a case of abuse there are some important principles, which should applied, as follows:

• The high interest of the child. All decisions shall be taken, giving priority to the interest of the child.

• Conidentiality. All the information that you might have regarding abused children with disabilities should be keep conidential and used to deine the needs of the child and protect him from harm, exploitation and/or neglect. All measures should be taken to preserve the privacy and identity of the child. The disclosure of information should be limited to parties/ structures for which it is needed and necessary to have knowledge regarding such information. The information should be shared only with specialists of public or private institutions of social care, court, or employees of administrative authorities etc., who have a direct role in the protection of the child.

• Always trust the child and check the facts. Even though the child might have been the one initiating a conlict, even though the child has allowed being victim of an abuse, even though the adult pretends that all can be a fantasy of the child, as professionals, we should only be on the side of and trust the child. The adult is legally responsible for the actions conducted towards the child, and in no way, we can blame the child for the consequences of an abuse, even though he might have been voluntarily involved in the abusing activity. This principle becomes even stronger to be applied in the case of disabled children, who are even more vulnerable and often unaware of the decision and actions undertaken.

Bibliography

• The State of the World’s Children 2013, Children with Disabilities

• Children Rights Convention

• Law “On the Protection of the Rights of the Child” Albania, November 2010

• World Vision Study Report “Assessing factors that contribute to the practical implementation of inclusive education” Albania, March 2012.

• Stalker, K. and McArthur, K. (2010) Child abuse, child protection and disabled children: a review of recent research. Child Abuse Review. ISSN 0952-9136 (In Press) UK, 2010.

• The Risk and Prevention of Maltreatment in Children with Disabilities, Chid Welfare Information Gateway, US, March 2012

• Child Protection Unit Evaluation Study, S.Delaney, 2012 World Vision


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• ADRF, “Monitoring Report on the Implementation of the Action Plan on the National Strategy on People with Disabilities in 2010”, 2011.

• “Travelling together in the road of Disability” L.Wapling & S.Coe Agency for Persons with Disabilities (APD), http://apd.mylorida.com/about/

• Violence Against Children, UNICEF 2006 Study

• Keeping Children Safe Modules, Produced by the Keeping Children Safe Coalition

• Manual of Child Protection Employee, 2009

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Florian KullaFlorian Kulla is a child psychologist,

specialized in counseling and therapy, working with marginalized groups. Florian has

participated in many international and national

articles and studies in the area of inclusive education. He works as an expert in the “Inclusiveness“projects of “Save the

Children” organization.

In 2003 Flori graduated from the University of Tirana in clinic psychology. The PHD he holds is focused on education of children with problems and different development abilities. He has worked for 10 years as a community psychologist for the Municipality of Tirana (Economic Center for Child Development). In that position

his main responsibilities included early intervention on children with special needs, as well as training and counseling of their

parents, teachers, and pre-school teachers. In 2009, Florian

development by “Save the Children” organization, where he still works at to date.

Lidra RemaçkaLidra Remaçka is co-founder of the International Alliance “Sustainability Frontiers”, and has been working as an international consultant in the area of global education and special education since

Board, Ontario, Canada. In 2009, Halton Hills Board nominated her for “Excellence in Teaching”title, awarded to her by the Head of the Government of Ontario. In 2002, she received an award from “Soros” foundation for her study on “Global and Civic Education in Albania” conducted in the context of her “Master Studies” in the University of Toronto. During the years of study and subsequently, (2000-2005), Lidra has been working for the University of Toronto as a

Furthermore, Lidra was selected as the leader consultant for the joint project between the University of Toronto and UNICEF, on “Reform of Quality Education in Countries of Central Asia”.

Lebanon, Afghanistan, Brazil, Iran, Palestine, Saudi Arabia, Kosovo”. Her focus and passion are on education for

all and special education. Lidra is an Albanian and Canadian citizen and lives in Ontario with

her family.

Marina Ndrio Marina Ndrio is a pedagogue in the

Labor and Social Policies Department at the University of Tirana, from which she

graduated in 1996 as a social worker. Her professional interest and priorities are on

educational policies, especially in special education, and community groups. Marina had this experience in her numerous studies in the area of mental development, child development, inclusive

education, and especially implementation of the rights of disabled children.

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