Including Students With Severe and Multiple Disabilities in Typical Classrooms: Practical Strategies for Teachers.

Students with sensory, cognitive, and physical disabilities pose unique challenges for educators. This book advocates the full placement of students with severe disabilities in general classrooms. Downing and invited contributors have written a guide that emphasizes "the compatibility of strategies for teaching students with and without disabilities." Their major goals are to "describe how to perform accurate, functional assessments; develop detailed, effective IEPs [Individualized Educational Plans]; stress the importance of teaching skills with everyday applications; offer alternatives to visual and auditory communication modes; provide ways to enhance socialization; and explain how to involve all members of the school community." The authors present specific instructional strategies for preschool, elementary, and secondary students with disabilities. It is intended for administrators, teachers, and parents, but might be most useful for persons unfamiliar with the history and general philosophy of inclusive education.

This book is well-organized, but somewhat redundant. The authors follow a logical progression from preschool through high school. They present limited practical strategies for teachers without sufficient detail or depth of coverage. They summarize a variety of activities and approaches, but the discussions are cursory and replete with "ed-speak." The reports of success are descriptive, and the "case studies" generally omit students' medical and educational histories and evaluations. Downing presents no evidence that the outcomes were scientifically studied. The tables arc neither detailed nor particularly informative. The photographs fail to illustrate important points in the text. However, the book does provide numerous, up-to-date references at the end of each chapter. The appendixes list articles, books, and monographs on teaching resources, augmentative communication, and other technical subjects of potential interest to physical therapists.

The authors did not define or clarify important terms. Although educators generally agree that "all children can learn," how can we define education, academic activity, or full inclusion for children with severe and profound disabilities? The authors basically advocate social learning and ignore, to some extent, the daunting problems of medical fragility and severe cognitive disability. They suggest that students should be provided with highly individualized and dynamic schedules that can be adapted as their skills and goals change, but their methods are essentially the same regardless of the child's age. Downing et al take a great leap of faith. They assume that teachers, classroom assistants, and parents will form teams and assume responsibility for developing, implementing, and evaluating the radically modified lesson plans necessary to include students in the least restrictive environment. Curriculum and program evaluations are difficult to implement. The authors' good faith and positive motivation are admirable, but a more realistic approach would be to weigh the concept of "least restrictive environment" against legal, financial, and logistical considerations.

The subject of this book is relevant to both general and school physical therapy practice. Regrettably, Downing et al consider physical therapists to be "related support staff." The book mentions only the therapists' role in positioning students for activity using a ball or bolster.

Downing et al have made a worthwhile contribution to the ongoing dialogue on how to best serve students with profound multiple disabilities in typical classrooms. Downing fulfills her objectives in the context of her parochial perception of full inclusion as the ultimate educational solution. The book, however, ignores the unique perspective and contribution of physical therapy and its central role in exceptional education. I do not recommend the purchase of this publication.