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When determining the best educational placement for a child following brain injury, the concept of "inclusion" is often discussed. Inclusion is the practice of educating students with disabilities in "regular" education classrooms, classes which they would attend if they did not have a disability. Special instruction is delivered by a special education teacher within the classroom. This article will attempt to clarify the issues surrounding inclusion, define terminology associated with inclusion, and help the reader to understand several placement options related to inclusion.
Although the words mainstreaming, integration and inclusion are often used synonymously, their technical meanings differ. By clarifying the differences between these terms, educators and parents can better determine the goal of the educational program.
Mainstreaming indicates that the child:
· is at grade level
Generally, mainstreaming is used with students whose brain injuries are minimal and who are at grade level using the standard curriculum. It is imperative to note that students with brain injuries who are mainstreamed may always need adaptations in order for them to benefit to the fullest extent from the curriculum. These adaptations may include extended time to complete a test, a quiet room in which to take a test, or shortened assignments.
In comparison, integration infers that the student:
· is not a grade level
Typically, integration is utilized for students with moderate to severe cognitive impairment or students at their initial phase of re-entry into the educational system. The student may use the same curriculum as the nondisabled students, but the purpose for the student attending the lesson may be to expand the student's vocabulary, social skills, and awareness. A student who is integrated attends a special education class for part of the day and a regular education class for part of the day. The student's home base is generally the special education classroom. Some students who are integrated attend their home school in regular education classes for the morning and then are bussed to their special education classroom for the afternoon where they receive a functional curriculum.
A student who is an inclusion student would be:
· not a grade level
A student who is included has a regular education class as a home base. However, inclusion does not mean that a student must spend the entire school day in a regular education classroom. Inclusionary placement should include educating a student with a brain injury anywhere through the school building. The delivery of the IEP should occur wherever is most appropriate. Thus the student may attend the regular classroom for the first hour of the day. Then the student may go to the school kitchen to prepare a snack as part of a functional curriculum. The student may then need quiet instruction in a private room. The practice of having a child with a significant brain injury remain in a regular education classroom throughout the entire day just so the child is "fully included" can have devastating effects on the student. Placement should be a flexible notion, based on the student's minute-to-minute educational needs.
There are two purposes for inclusion. It is imperative that an educational team determine the purpose for a student's inclusion activities before planning a program. The purpose can change for each subject or throughout school re-entry. The purpose of SOCIAL inclusion is to improve the student's behavior and language while offering appropriate role models. A student who is integrated for social reasons may be using the standard curriculum, but the educational goal is different. Social inclusion may be used for a student with a brain injury who cannot grasp all the concepts of a science curriculum but who may benefit from cooperative learning, vocabulary, and peers modeling appropriate behavior. A student utilizing social inclusion is not expected to complete assignments and understand all the concepts presented. Instead, this student's goals may be to improve language and behavior while attending science class.
INSTRUCTIONAL inclusion is designed to meet the student's academic IEP goals in regular education. This may be accomplished by using the standard curriculum with modifications or by using a parallel curriculum, a specially designed curriculum for the student with a brain injury. Often a student's IEP goals can be dovetailed with the standard curriculum being taught. It is important to consider the relevance and appropriateness of instructional inclusion if the student's IEP goals are very different from the educational goals of the standard curriculum. If the student with a brain injury is utilizing a curriculum which is many years below grade level, delivering this instruction in the regular classroom may not be the best placement. If the entire building is being used to educate the student, then this instruction may best be delivered in a quiet room down the hall. A combination of educational options may work best.
These options may include:
· modified curriculum- determining the most important part of the curriculum and focusing instruction for the student with a brain injury on those components.
· shared teaching- having the regular education teacher and the special education teacher plan a lesson together and teach the lesson in the same classroom with the special education teacher making the necessary modifications for the student with a brain injury.
· push-in/pull-out service- the special education teacher delivers the specialized instruction within the regular classroom for certain lessons while "pulling the student out" of the classroom for other, more difficult points of instruction. This is a flexible system, based on the curriculum for the day and the student's educational needs.
· direct instruction- structuring the learning environment so as to leave no part of learning to inference. Direct instruction is academically focused using carefully sequenced and structured materials and methods which lead to mastery learning with continuous monitoring of progress.
· study skill instruction- teaching the student with a brain injury the skills necessary for successful learning. Although many of these skills were intact previous to injury, these skills may now require direct instruction and review.
· remediation of basic skills- review and relearning of the basic skills of reading, math, and language. Students with brain injuries often have some academic skills which remain at grade level while other skills are far below grade level. Instruction in these weak academic areas may need to be delivered by a special education teacher in a highly structured manner.
The most important issue to remember when considering inclusion, integration, or mainstreaming is that the placement must be based on the individual needs of the student. This educational practice, as any educational practice, is not for all students. Many students returning the to the educational system following brain injury benefit most from a self-contained classroom which is highly structured, both academically and behaviorally. This placement may be short-term to assess educational needs. Other students do best with a combined placement utilizing the ideas for integration or mainstreaming. Other students have adjusted well to full inclusion placements.
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