Supporting inclusive care and education for young children with special needs and their families; an international perspective.

Jean Paul is learning to use the controls of his new wheelchair with the assistance of the special education resource teacher in his inclusive child care center. He tentatively lurches forward, looking frightened and concerned.

Three friends run past him down the hall. One child, Simone, wears an orthotic on her leg. The teacher encourages them all to turn and call to Jean Paul, "Come." When Jean Paul reaches his friends in his wheelchair, they all cheer and Simone gives him a big hug. Jean Paul has a big smile on his face. (field note, Canada)

Katherine is lying on a flatboard swing and is being swung gently and spoken to by the inclusion teacher in the kindergarten room of the child care center. Two other girls come to see what she is doing and begin to rub her toes. (field note, Australia)

Jean Paul and Katherine are being included in the activities of their early childhood programs with their typically developing peers. Since the United Nations Convention on the Rights of the Child in 1990 declared that all children, including those with special needs, have the right to be provided with a basic education and enjoy full participation in their communities, inclusive events such as these are being observed more often in child care and kindergarten programs around the world. The inclusion of young children with special needs into community child care centers, preschools, and kindergartens has been encouraged internationally as a positive means of enhancing the child's care and early development (Division for Early Childhood [DEC], 2000; Evans, 1998).

While countries have responded favorably with public policies that promote inclusion for young children, questions still remain: What international comparisons can be made among the structures and practices implemented to support the inclusion of young children with special needs and their families, pursuant to the United Nations declaration on the Rights of the Child? What do early childhood practitioners consider to be barriers to full inclusion for young children with special needs? What supports can overcome these obstacles? This article will provide us with a snapshot of barriers and supports for inclusion, based on the author's site visits at inclusive early childhood programs in western and central Canada, the southeastern United States, and eastern and southern Australia. Although continuing barriers to successful inclusion were found in each country, an ecological approach with supports at the individual, organizational, and societal levels holds promise for overcoming the obstacles to inclusion.

While definitions of full inclusion for young children vary, this article takes an ecological view of inclusion as advanced by the Council for Exceptional Children, Division for Early Childhood in 1993 (and then updated in 2000) and endorsed by the National Association for the Education of Young Children (NAEYC) in 1998. The DEC (2000) position states,

Inclusion, as a value, supports the right of all children, regardless of abilities, to participate actively in natural settings within their communities. Natural settings are those in which the child would spend time had he or she not had a disability. These settings include, but are not limited to, home, preschool, nursery schools, Head Start programs, kindergartens, neighborhood school classrooms, child care, places of worship, recreational (such as community playgrounds and community events) and other settings that all children and families enjoy.

An ecological model of inclusion requires that a complete analysis of inclusion must take place at the microsystem level of children, families, and classrooms; the mesosystem level of collaborations and relationships, such as those between parents and professionals; the exosystem level of organizational structures, policies, and external resources; and the macrosystem level of cultural beliefs, assumptions, and values (Odom & Diamond, 1998; Peck, 1993).

In increasingly multicultural societies, any definition of full inclusion also assumes that children and families with diverse developmental needs, from diverse cultural-linguistic backgrounds and diverse social experiences, are accepted and accommodated with sensitivity and respect in high-quality early childhood programs (Early Childhood Resource Teacher Network of Ontario, 1997). In addition, a blended approach, such as that described by Irwin, Lero, and Brophy (2000), assumes that the collaboration of parents, early childhood educators, resource teachers/consultants, center directors, and professionals from community health, medical, and social agencies is actively sought and used to provide effective programs for children with special needs and their families.

Public Policy in Support of Inclusion

Lieber et al. (2000) have noted that "one of the more recent educational innovations that have been inspired by changes in public policy is inclusion" (p. 84). Two key U.S. laws, the Education of the Handicapped Act Amendments of 1986 (P.L. 99-457) and the Individuals With Disabilities Education Act (IDEA) of 1990 (P.L. 101-476), re-authorized in 1997 (P.L. 105-17), influenced inclusion in early childhood programs internationally. In the United States, IDEA provides for free and appropriate public education services to preschool children (ages 3-5) with disabilities and encourages their placement in classes with typically developing children in natural environments (Gargiulo & Kilgo, 2000). The Americans With Disabilities Act (ADA) further supports inclusion by determining that young children with disabilities cannot be denied enrollment in regular child care settings because of their disabilities. The weight of these federal mandates, however, is often offset by state and local policies. The availability of care and education services for typically developing preschool children varies from state to state and has a direct impact on the potential for inclusion. Inclusion becomes particularly problematic in states that have insufficient preschool programs for typically developing children.

In Canada, the Charter of Rights and Freedoms, passed in 1982, upholds the right of every child, including those with a disability, to receive educational services without discrimination. However, Canada does not have federal legislation that governs education (Dworet & Bennett, 2002) or provides for universally accessible child care (Irwin et al., 2000). Current inclusive initiatives in early childhood care and education programs are supported by province or territory legislation and policies, and often community goodwill, rather than federal mandate. Services in support of inclusion in early childhood programs therefore vary from province/territory to province/territory. For example, in British Columbia, a policy of supported child care provides funding for early childhood resource consultative services to all children with extra support needs who attend child care programs. In Ontario, in-house resource teachers and itinerant resource consultants support young children with special needs from birth to 6 years.

In contrast, Australian federal policies provide subsidies for "long day" care services for children, with some priority for admission given to children with disabilities (ages birth to age 5). The Special Needs Subsidy Scheme (SNSS) provides additional funding to facilitate inclusion. In addition, the federally funded Supplementary Services Program (SUPS) provides the services of early childhood resource consultants to support child care personnel in including children with diagnosed disabilities, children from diverse cultural and linguistic backgrounds, and Aboriginal, Torres Strait Islander, and South Sea Islander children. Whereas child care services are under the governance of the commonwealth, preschool/kindergarten services for 4- to 5-year-olds fall under the mandate of each state's department of education or community services. The Commonwealth Disability Discrimination Act of 1992 has increased support for the inclusion of children with disabilities in these state-run preschool classrooms. Therefore, the availability of services for children in child care settings and preschool/ kindergartens provides venues for inclusive programs.

International Views of Inclusion

Systemic implementation of inclusion is a complex process that goes beyond legislated action. All participants need time to understand the pedagogical nature of the change (Fullan, 1991), change agents must be knowledgeable about the innovation and the process of change (Frankel & McKay, 1997), and participants need positive attitudes and should value inclusion (Irwin et al., 2000). Peck, Furman, and Helmstetter (1993) warn that efforts to bring about inclusion must take into consideration not only pedagogical, procedural, and attitudinal factors, but also the evolving sociopolitical realities and relationships that will have an impact on individuals and environments as inclusive practices are implemented.

Three factors influence the inclusion of children with special needs in early childhood settings in Australia, Canada, and the United States. These factors relate to: 1) government funding, 2) staff training and attitudes, and 3) resource supports and consultative services. A review of these themes offers us insight into the challenges and facilitators that professionals experience as they implement the policies and practices of inclusion.

Government Funding. Participants noted that the first barrier to inclusion in each country was often inequitable funding at the federal, state/provincial, and local levels. Participants believed that the varied funding mechanisms available to support inclusion were difficult to navigate and access. One child care administrator from the United States spoke about juggling five funding sources under the same roof: federal Head Start, federal Early Head Start, state child development services, county child development grants, and local school board pre-kindergarten intervention services. Each funding agency has different requirements for teacher qualifications, teacher-child ratios, ages of children eligible, curriculum provided, and percentages of children with special needs to be included in the classroom (interview, child care director, U.S.A.).

Canadian participants described a situation in one province in which the general licensing of community child care programs is under the auspices of one ministry, while the funding for additional supports for children with special needs in community child care centers is carried out by a second ministry, and yet a third ministry provides "inclusion contracts" and funding for extra staff in designated child care centers. The complexity of this shifting scene was noted as a barrier to inclusion, since "the smaller local child care center doesn't know who to go to for what" (interview, key informant, Canada). The confusion that this system poses for child care operators was further revealed by an administrator who noted the need to "amalgamate the management of two funds for inclusion so that a child can go to any community center" (interview, child care director, Canada).

In Australia, local funding sources impose their own requirements for receiving federal funding. One report found "that there were significant differences in the allocation of SUPS assistance among priority groups, geographical areas and child care service types" (The Wallis Consulting Group, 1994, p. ii). In one jurisdiction, young children were required to be placed in a specialized service for a few hours each week in order to receive consultancy support in an inclusive child care or preschool (interview, key informant, Australia).

In addition, the identification, assessment, and labeling of the child is a critical component to receiving funding for services in all three countries and can be a barrier to full inclusion. A child's eligibility to receive supplementary services is typically based on assessment results and degree of disability. Program administrators interviewed by the author noted that requirements for eligibility change depending on the funding source. There was consensus that this framework frequently resulted in gaps in supports for the child and family as they waited on long lists for assessments from specialized agencies and hospitals in the community. During this interim stage, administrators described the practitioners as feeling alone and frustrated. Although they attempt to make modifications to the curriculum for one child with special needs, they feel they are neglecting the other children in the class. Directors noted that practitioners also find it difficult to support and communicate with the families during this interim period.

The dichotomy between services provided by local boards of education and those provided in community child care centers was found to be another barrier to inclusion. Administrators revealed that parents were more likely to show a preference for either a self-contained, school-based program or an inclusive community-based program, depending on the funding available and the services provided. An administrator in the United States noted that school-based, self-contained programs for children with special needs are more prevalent since they provide therapies and transportation. Another key informant in the United States stated that a child with disabilities in child care programs was considered an "accidental" occurrence, although provisions to support the child in such centers are evolving. By contrast, in Canada, provincial/ territorial efforts to support inclusion in child care programs are more prevalent. Most provinces provide funding for some resource support, which may include on-site consultation to teachers, resource teachers, and/or inclusion facilitators in child care centers.

Funding issues also were found to have an effect on staff salaries and, thus, staff stability. Varying funding sources created salary differentials among staff doing a similar job. This imbalance was identified as another barrier to inclusion. For example, staff salaries that are funded by Head Start are higher than the salaries of staff employed by the community group child care program, even though they share space and are administered by the same organization. In this same municipality, school board-operated programs pay their staff at a still higher rate. One administrator of a child care center in the United States noted that "there is a $20,000 differential between the county school board pre-kindergarten teacher's salary and the maximum I can pay my staff." In Canada, it was noted that unionized child care centers pay staff higher salaries than non-unionized child care centers. In addition, although staff stability was cited by center administrators in all three countries as a critical factor for successful inclusion, they also noted that when they cannot provide competitive salaries due to limited funds, their staff turnover rates are high. In a unique joint child care and preschool center in Australia, which receives funding from both the Commonwealth and its state department of education, these differences in salary and benefits were glaringly apparent. Child care practitioners not only received lower salaries but only had 6 weeks of holiday leave, while state-paid teachers earned close to $20,000 more and had 10 to 11 weeks of holiday (interview, child care director, Australia).

Staff Training and Attitudes. The educational requirements for early childhood educators vary, depending upon the provincial/territorial/state jurisdiction in which they work and the type of early childhood program in which they operate: early intervention, group child care center, preschool, or school system programs. All participants identified the lack of training in special needs for early childhood practitioners as a barrier to inclusive practices. Preservice courses in special needs and inclusion are limited or non-existent in some basic early childhood education diploma or associate degree courses. In New South Wales, Australia, for example, all teachers, including early childhood teachers, must complete one unit in special education before they are allowed to teach in Department of Education and Training schools (interview, key informant, Australia). In other jurisdictions, however, early childhood educators who wish to learn more about children with disabilities and their families may have to do so through post-diploma coursework or university degree programs.

The educators with whom the author spoke described a lack of consistency across college curricula in terms of offering courses in special needs. One administrator in Canada stated adamantly that "training institutions were not yet changing the way they were dealing with inclusion ... it is not only a separate course ... it is the language you use and the attitudes you demonstrate in all courses" (interview, child care director, Canada).

According to students who took preservice courses concerning children with special needs, practical experiences that facilitate the linkage of theory and practice were not always available in inclusive early childhood settings. As one key informant in Canada noted, "If you want to promote inclusion, [students] should be required to do placements in inclusive centers" (interview, key informant, Canada). Administrators also noted that early childhood practitioners are not being prepared to support the families of children with special needs. As one director stated, "Every parent is at a different stage and every staff member is at a different stage. It is a dance everyone needs to dance to the same tune" (interview, child care director, U.S.A.).

Early childhood practitioners' limited experiences and knowledge about children with special needs was cited as a further barrier to inclusion. Administrators all viewed teacher attitudes about including a child with special needs as varying with the perceived severity of need. One participant believed that staff expressed "fear, resistance, and an attitude of not going into child care for this" (interview, child care director, Australia). Nevertheless, this director further explained that when staff members have the opportunity to interact directly with children "with G-tube feedings or medication for seizures that needed to be given anally," their fears are alleviated. Other directors explained that their programs are most successful with children with communication disorders or autism spectrum disorders rather than children who require more one-on-one attention because of physical disabilities or disruptive behavioral challenges (interview, preschool director, U.S.A.).

The lack of training for early childhood resource consultants/itinerant special education teachers /SUPS workers has been described as an additional barrier to inclusion in all three countries. Although early childhood resource consultants are trained in adapting and modifying curricula to meet individual children's goals, the consultant's knowledge of ways to promote changes in teacher practices for inclusion may be limited. One itinerant special education teacher expressed frustration that a child care owner/director saw her as a threat, rather than a support, when she made suggestions for instructing a child with a disability (interview, itinerant special education teacher, U.S.A.). The itinerant special education teacher struggled to find ways to cope with the resistant director while still meeting the child's IEP goals. Consultants in each country noted similar challenges.

Resource consultants, who have preservice coursework in special education, may receive only minimal training from their supervisors when taking on the role of consultant (interview, key informant, Canada). This shortfall is reflected in their consultative style. Administrators report that while many consultants facilitate team participation for staff and families in developing and implementing the child's individual program plan, others continued to view their expert role as directive when working with children, families, and staff. The Wallis Report in Australia highlighted the need to revise the SUPS worker guidelines to promote a trainer/facilitator role for SUPS workers, rather than one of direct service (The Wallis Consulting Group, 1994).

Resource Supports and Consultative Services. All program administrators emphasized the importance of resources that offer support to staff when children with special needs were included in the program. As one child care director noted,

Most important is the support that staff get.... They need the emotional support from a teacher who has gone through it (e.g., child with tantrums) in her classroom, how do you deal with it now ... validation needed from their own peer that they are doing a great job. (interview, child care director, U.S.A.)

Supports offered to staff varied in each jurisdiction. In Canada and Australia, the early childhood resource consultant model has become a primary approach to supporting children with special needs in community-based early childhood programs. However, as one key informant noted, even "the consultative models differ across the province from a hands-on direct approach with a child to building the capacity of the provider" (interview, key informant, Canada). A few provinces in Canada still support in-house resource teachers who assume responsibility for the children with special needs in the center. In the United States, itinerant special education teachers are beginning to move out of self-contained pre-kindergarten classrooms to support child care providers working with children with special needs in community child care settings.

For children with complex challenges, temporary staff members may be employed to facilitate inclusion, improve teacher-child ratios, and offer the child and staff additional supports. However, funding is not usually available for hiring inclusion facilitators unless they are paid for by parents (interview, preschool director, U.S.A.). When extra staff members are available, one center administrator noted, these inclusion facilitators are not necessarily trained in special needs and, therefore, are not in a position to upgrade the skills of the regular staff as they interact with the child (interview, child care director, Canada).

Inservice initiatives, workshops, and conference presentations that allow early childhood practitioners to learn about inclusion and adaptive strategies for supporting children with special needs are offered in all three countries. One program in the United States offers child care practitioners training for inclusion and also provides a special instruction consultant to assist with assessing and program planning (interview, key informant, U.S.A.). Teachers are offered resources and suggestions for working with the child until formal assessments can be completed and other specialists become involved with the child and family. Many of the jurisdictions have specialists, such as speech-language pathologists, behavior specialists, and physiotherapists, who come into the center to offer onsite workshops so that all teachers learn specialized, general, and child-specific instructional strategies (interview, child care director, Canada).

Specialized resources for the child, such as speech-language pathologists, physiotherapists, and occupational therapists, are frequently provided by community agencies. Interagency collaborations were described as critical to successful inclusive placements (interview, key informant, U.S.A.).

Discussion

The experiences of early childhood professionals in Canada, the United States, and Australia indeed mirror individual, organizational, and sociopolitical realities as service providers in each country seek to provide inclusive programs for young children with disabilities.

Public policy in Canada, the United States, and Australia allows for the inclusion of young children with disabilities in community-based child care and preschool settings. But while public policy can inform and act as an impetus for change, it also can be a barrier to creative solutions of implementation. This is partially due to varying funding mechanisms at the federal, provincial/territorial/state, and local levels, which impose their own requirements for access to services.

The quality of the early childhood program is considered an essential determinant in the success of inclusive services. General factors of program quality, such as unfavorable class size, poor teacher-child ratios, low licensing requirements, and stability of staff, have been cited as barriers to inclusion (Buysse, Wesley, & Keyes, 1998; Doherty-Derkowski, 1995). Funding that pays early childhood educators differentially according to the program in which they work directly affects quality. In all three countries, early childhood educators are paid at different rates, depending on the funding source, even though they provide similar services to preschool children with special needs. Such practices adversely affect the stability of teacher pools.

Inclusion requires that teachers, parents, and children be prepared for innovation (Peck, Hayden, Wandshneider, Peterson, & Richarz, 1989). These preparations include not only making environmental modifications to ensure programs are physically accessible by children with disabilities, but also enhancing all participants' knowledge about children with special needs and appropriate instructional strategies, and developing positive attitudes towards inclusion (Dinnebeil, McInerney, Fox, & Juchartz-Pendry, 1998; Irwin et al., 2000).

Preservice teacher education programs in these three countries are just beginning to introduce coursework related to children with special needs and inclusion, but these courses are not yet universal or consistent in their content. Without knowledge of specific special needs and appropriate accommodations, practitioners interviewed by the author expressed a reluctance to include children with severe disabilities. Professionals in each country described training for all practitioners involved in the inclusion of children with disabilities as critical to support child development and learning in community programs. Practitioners, however, are still more likely to obtain knowledge about children with special needs and inclusion from inservice workshops and on-the-job experience than from formal coursework at the university level.

The level of support from resource consultants/ itinerant special education teachers/SUPS in Canada, the United States, and Australia has emerged as a positive approach to building the capacity of practitioners. On-site consultation, which is respectful of teacher time, acknowledges teacher values and abilities, and works within the sociopolitical context of a program, is emerging as a successful approach to staff development, promoting change in teacher practices for inclusion (Frankel, 1997). Research has demonstrated that on-site consultation also can support the overall quality of child care centers and inclusion (Palsha & Wesley, 1998; Wesley, 1994).

Participants in all three countries considered the interpersonal relationships between the early childhood consultant and early childhood practitioners as an important factor in the consultant's success in promoting changes for inclusion. While consultation is currently a preferred approach to staff development and supporting inclusion in each country, resource consultants do not receive specific training in this role. In addition, practitioners and administrators have perceived the limited amount of time to collaborate on, communicate about, and supervise special services for children with disabilities and their families as a barrier to inclusion (Buysse et al., 1998). Many resource consultants have a minimal level of qualifications, with university degrees not essential. This investigation also found no perceived consistency in the style and approaches used by resource consultants when interacting with children, families, and teachers.

The Ecology of Inclusion

As research continues to highlight the critical nature of the early years for healthy child development and learning, the need for early care and education for all children is imperative. This endeavor involves identifying children with disabilities and providing early learning programs for them in accordance with the UN Convention on the Rights of the Child. In an ecological framework of inclusion, development and learning for the child with special needs must be viewed within the families and communities that are natural environments for all children. This objective means including children with special needs in community early childhood programs. In these settings, children and families from culturally, linguistically, and socially diverse backgrounds are treated with sensitivity and respect by educators and specialists knowledgeable about their special needs and their special gifts.

While international mandate has proved insufficient to ensure that the changes required for successful inclusion will occur, progress is being made in all three countries. The intent of early childhood professionals is not to block, undermine, or repudiate legislative mandates for inclusion. Rather, early childhood professionals understand the realities for providing inclusive services to all children with special needs within existing organizational and socio-political frameworks, and they work towards improving conditions to allow such inclusive services to flourish.

Inclusion is a complex process that involves coordinated participation at all levels of the ecological system. When conditions are not suitable in a community early childhood program, because of concerns related to funding, staffing, or quality, barriers arise to inclusive practices. On the other hand, positive attitudes, collaborative relationships, creative problem-solving approaches, and consultative supports to early childhood educators can ensure that services delivered to children with disabilities in inclusive settings will advance each child's healthy growth and development. In the long term, universal funding and resource consultation for early childhood care and education have shown promise in promoting the quality of all early childhood programs and making them appropriate environments for inclusion. Resource consultants/itinerant special education teachers/SUPS can play a critical role in building the capacity of early childhood practitioners to successfully include children like Emma.

Emma was enrolled by her parents into her neighborhood child care center when she was 2-1/2. The teachers quickly became aware of significant deficits in her speech and language and social interaction skills. The teachers were frustrated as she wandered around the room all day looking lost, and when she threw disruptive temper tantrums when they attempted to engage her in activities.

With Emma's parents' permission, the center sought the assistance of an early childhood resource consultant from their local early intervention agency. The consultant completed a developmental assessment of Emma and placed her name on the wait list for government-funded speech and language services and developmental assessments in their municipal hospital. In the interim, the resource consultant visited the center weekly to support the teachers in developing and implementing an individual education plan that incorporated language goals and a behavioral support plan for Emma. During the visits, the consultant modeled and coached the staff on appropriate instructional strategies while Emma was in small groups with typically developing peer models. In addition, the resource consultant made herself available to the teachers for support at any time through telephone contact. Teachers attended inservice workshops on autism sponsored by the Autism Society as well as communication workshops on the Hanen approach, to learn about supporting Emma's language development. Emma's mother also expressed to the resource consultant the need to work through her own depression, and so a social worker from the local mental health center became actively involved with the family.

The child care supervisor was able to locate government funding to hire an inclusion facilitator for the first three months to improve teacher-child ratios. Later, when all services were in place and the diagnosis of autism was received, the interdisciplinary team met, including Emma's parents, a resource consultant, teachers, a speech and language pathologist, and a social worker. They were all pleased that Emma was beginning to communicate with a communication board and a few words. The teachers expressed pleasure that they had gained knowledge about children with disabilities, which would help them with other children in the center. (interview, child care director, Canada)

Continued collaboration and consultation at all levels of the ecological system, including families, teachers, social service agencies, and policymakers, is essential to allow for creative and successful solutions for early childhood inclusion. Only then can we ensure that young children with special needs will grow and develop in their own natural communities.

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Elaine B. Frankel is Professor, School of Early Childhood Education, Ryerson University, Toronto, Canada.