Inclusive education in Europe
A systematic literature review about the benefits
of inclusive education for primary school aged
children with intellectual disabilities
Ann-Marie Sander
One year master thesis 15 credits Supervisor
Interventions in Childhood Eva Björck
Examinator
SCHOOL OF EDUCATION AND COMMUNICATION (HLK) Jönköping University
Master Thesis 15 credits Interventions in Childhood Spring Semester 2021
ABSTRACT
Author: Ann-Marie Sander Inclusive education in Europe
A systematic literature review about the benefits of inclusive education for primary school aged children with intellectual disabilities
Pages: 33
Inclusive education is one major goal nowadays in the whole world. Looking into policy inclusive education is highly valued and quality and equity shall be ensured that every child can benefit to develop his or her full potential. Looking into Europe there is still a gap between policy and practice, especially when it comes to children with intellectual disabilities. This population is considered as vulnerable faced by increased separation and exclusion. A systematic literature review was conducted aimed to understand the benefits of inclusive education for primary school aged children with intellectual disabilities in European countries. 15 articles published between 2010 and 2021 were analysed using narrative analysis. The findings showed overall good progress of this population within academic achievement, the sense of belonging, participation, socio-emotional and cogni-tive development, and behavioural outcomes. However, poor outcomes were reported as well. To better understand these benefits, they were discussed using the concept of partic-ipation by Maxwell and Granlund, the need to belong according to the theory of human motivation by Maslow and Vygotsky’s socio-cultural theory. It became obvious that no-where a system is fully inclusive and that there is still a long way to go. Nevertheless, benefits can be seen already which shows a step towards meeting the best interest of the child by making progress towards a full inclusive education system.
Keywords: Inclusive education, Europe, children with intellectual disabilities, primary school, benefits, participation, sense of belonging.
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Table of Content
1 Introduction ... 1 1.1 Background ... 2 1.1.1 Inclusive education ... 2 1.1.2 Intellectual disability ... 6 1.2 Theoretical Background ... 7 1.2.1 Participation ... 8 1.2.2 Sense of belonging ... 81.2.3 Vygotsky’s socio-cultural theory ... 9
1.3 Rationale ... 9
1.4 Aim and research question ... 10
2 Method ... 11
2.1 Systematic literature review ... 11
2.2 Search strategy ... 11 2.3 Selection criteria ... 12 2.4 Selection process ... 12 2.4.1 Title/Abstract screening ... 12 2.4.2 Full-text screening ... 14 2.5 Data analysis ... 16 2.5.1 Quality assessment ... 16 2.5.2 Data extraction ... 16 2.5.3 Data analysis ... 17 2.6 Ethical considerations ... 17 3 Results ... 19
3.1 Overview about the included studies ... 19
3.2 Implementation of inclusive education ... 19
3.3 Benefits of inclusive education for children with intellectual disabilities .... 21
3.3.1 Academic achievement ... 21
3.3.2 Sense of belonging ... 22
3.3.3 Participation ... 23
3.3.4 Socio-emotional and cognitive development ... 23
3.3.5 Behavioural outcome ... 24
4.1 Reflection on findings ... 24
4.1.1 Participation ... 25
4.1.2 Sense of belonging ... 28
4.1.3 Vygotsky’s socio-cultural theory ... 29
4.2 Methodological issues and limitations ... 30
4.2.1 Methodological issues ... 30
4.2.2 Limitations ... 31
4.3 Future research and implications for practice ... 32
5 Conclusion ... 33
References ... 34
Appendices ... 42
Appendix A: PEO search model ... 42
Appendix B: Search strings ... 43
Appendix C: JBI critical appraisal checklist for qualitative research ... 45
Appendix D: JBI critical appraisal checklist for quasi-experimental studies ... 46
Appendix E: JBI critical appraisal checklist for analytical cross sectional studies . 47 Appendix F: Quality assessment – Overview of the included articles ... 48
Appendix G: Extraction protocol – categories ... 51
Appendix H: Implementation of inclusive education ... 53
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1 Introduction
“In all actions concerning children with disabilities, the best interests of
the child shall be a primary consideration.” (United Nations [UN], 2006, Art. 7.2)
But what is really the best interest of the child according to the UN Convention on the Rights of Persons with Disabilities (UN CRPD)? One could argue in favour of or against inclusive education, a main goal to achieve within education nowadays in many countries which is faced by a lot of changes and challenges. It depends also on who will be asked, the child, the parents, or different stakeholders. According to the Committee on the Rights of Persons with Disabili-ties (2016) this concept “is aimed at ensuring the full and effective enjoyment by the child of all human rights and the child’s holistic development” (p. 13), including the realization of full inclusive education. However, when looking at its implementation “a gap between ideals and realities” (Haug, 2017, p. 210), between policy and practice within the European countries can be captured.
Discussing the best interest of the child, learning and development become a main issue centred around inclusion as an ethical and moral imperative and a reality marked by an ableist ideology and a meritocratic system (Buchner et al., 2020). However, the European Agency for Special Needs and Inclusive Education (2017) stressed in their project “Raising the Achieve-ment of All Learners in Inclusive Education” (RA) “that it is possible to have both equity and excellence within national systems” (p. 10).
Children with intellectual disabilities (ID) are faced by increased vulnerability and be-long to the group of the most excluded children (European Intellectual Disability Research Network, 2003; World Health Organisation [WHO], 2010; Buchner et al., 2020) and will be therefore addressed in this systematic literature review. A reflection is that the focus on a spe-cific group of children can be seen as labelling which is not conform with inclusion (Buchner et al., 2020). However, when looking at the current situation in the European countries the issue of categorization is not a main point. This could be addressed in a next step. Thus, it is im-portant to mention that the focus on this population is without an intention of discrimination.
Bringing all this together, this systematic literature review aims to understand the ben-efits of inclusive education for primary school aged children with intellectual disabilities in European countries.
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1.1 Background
1.1.1 Inclusive education 1.1.1.1 Definition
Inclusive education is “a key aim of education policies around the world” (Buchner et al., 2020, p. 1). Today inclusion has become the core of the United Nations organisations’ agenda of “Education for all” (EFA) from 1990 which “means ensuring that all children have access to basic education of good quality” (United Nations Educational, Scientific and Cultural Organi-zation [UNESCO], 2005, p. 10). The roots of inclusive education go back to 1948 when edu-cation became a human right within the Universal Declaration of Human Rights (UN, 2015), followed by steps towards non-discrimination within education by the Convention Against Discrimination in Education (UNESCO, 1960) and the Convention on the Rights of the Child (UN, 1989) among others. A significant international step was made by the Salamanca State-ment and Framework for Action on Special Needs Education (UNESCO, 1994). With the UN CRPD in 2006 the right to inclusive education was emphasized again. However, the UN CRPD was not detailed about the definition of inclusive education and did not pronounce that only one school for all without a co-existence of special schools is the aim. This led to the general comment no. 4 on article 24 of the UN CRPD in 2016 by the Committee on the Rights of Persons with Disabilities (UNESCO, 2020). There inclusive education is defined as the fol-lowing:
Inclusion involves a process of systemic reform embodying changes and modifications in content, teaching methods, approaches, structures and strategies in education to over-come barriers with a vision serving to provide all students of the relevant age range with an equitable and participatory learning experience and environment that best cor-responds to their requirements and preferences. Placing students with disabilities within mainstream classes without accompanying structural changes to, for example, organi-sation, curriculum and teaching and learning strategies, does not constitute inclusion. Furthermore, integration does not automatically guarantee the transition from segrega-tion to inclusion. (Committee on the Rights of Persons with Disabilities, 2016, p. 4)
At this point it has to be mentioned that integration, the process before inclusion, addressed mainly the placement of children with special needs in mainstream schools with an existing two group theory in many countries. However, the goal of inclusive education is one
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heterogenous group of learners (Hehir et al., 2016; Wocken, 2012). Inclusive education means to address the diverse needs of all students in one regular school, and no one is separated or excluded (UNESCO, 1994; UN, 2006) by shifting “from seeing the child as a problem to seeing the education system as the problem” (UNESCO, 2005, p. 27). Next to placing all children in mainstream classes, quality education has to be ensured benefitting all students and further society (UNESCO, 2005; UNESCO, 1994; UN, 2006). Inclusive education became an ethical and moral ideal and is therefore difficult to reach. Haug (2017) described inclusion as “a mas-terpiece of rhetoric, easy to accept and difficult to be against or even criticize” (p. 207).
1.1.1.2 Benefits of inclusive education
Focusing on policy, meeting quality and equity and addressing the diversity within an inclusive education system achieves a benefit for every learner. Children will not only make progress academically but also regarding their whole development for example socio-emotional or cog-nitive (UNESCO, 2005; UNESCO, 2020). Full participation of everyone is the aim, in terms of attendance and involvement, socially and academically. Social acceptance is a benefit too, helping the children to develop a sense of belonging (European Agency for Special Needs and Inclusive Education, 2017). According to the Salamanca Statement are “regular schools with this inclusive orientation […] the most effective means of combating discriminatory attitudes, creating welcoming communities, building an inclusive society and achieving education for all; moreover, they provide an effective education to the majority of children and improve the efficiency and ultimately the cost-effectiveness of the entire education system” (UNESCO, 1994, p. ix). Therefore, the benefit lies not only within the child but is directed to the whole society.
The child’s personality will be strengthened and grows, and participation will increase by giving the child a voice and by acknowledging every child’s individuality and looking at the child’s strengths (European Agency for Special Needs and Inclusive Education, 2017; UNESCO, 2005). Democratization shall be ensured that children can advocate for themselves and shape their education (Haug, 2010).
Inclusive education can protect the child against different risk factors and facilitates coping abilities, the child’s inclusion in society, and dealing with different factors faced in adult life (Ebersold et al., 2011). Thus, there is a benefit in the short and long term.
Making the step from the policy expectations regarding benefits to research generally about children, one can see that inclusive education will be a benefit to every child regardless of the child has special educational needs (SEN) or not (Hehir, 2016; European Agency for
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Special Needs and Inclusive Education, 2014; Ruijs & Peetsma, 2009). The review by Ruijs and Peetsma (2009) investigated the effects of inclusive education on children with mild to moderate SEN and children without SEN regarding an academical and socio-emotional out-come. Results showed a higher academic achievement in inclusive settings or no differences to separated settings in most of the studies. However, poor outcomes were reported as well, though less. Regarding the socio-emotional outcome the findings were oppositional with pos-itive but also poor outcomes of socio-emotional functioning. According to Broomhead (2018) and Koster et al. (2010) children with SEN and disabilities are faced by less acceptance, fewer mutual friendships, and fewer interactions with their typically developing classmates. Prince and Hadwin (2013) presented also very mixed findings regarding academical achievement, social participation, and affective outcomes.
Although poor outcomes were presented by studies, a positive effect of inclusive edu-cation practices is still present. Poor outcomes can drive to make improvements towards full inclusion within education. Therefore, in this present systematic literature review findings ad-dressing poor outcomes will be reported as well.
Furthermore, it has to be kept in mind when examining the current effect of inclusive education how it is implemented in each case. Looking at European countries one has to be aware that full inclusion is not really met anywhere (Ramberg & Watkins, 2020). And also, it is important to think of that children with SEN showing a higher functioning are more common to be educated in mainstream classrooms than children with a lower functioning (Buchner et al., 2020; Ebersold et al., 2011).
1.1.1.3 Inclusive education in European countries
Europe consists of 50 countries. Out of these 27 countries belong to the European Union (EU), which all have already signed and ratified the UN CRPD (Schengen Visa Info, 2020; European Commission, n.d.).
The international guidelines regarding inclusive education found their way into Euro-pean policies as well as national policies of the individual EuroEuro-pean countries, however ex-pressed very differently (Ramberg & Watkins, 2020). The Salamanca Statement in 1994 was a main step producing awareness among European countries regarding the high meaning of inclusive education for all children (Haug, 2017). Within the EU the European Commission for example adopted the European Disability Action Plan 2004-2010 (Commission of the Eu-ropean Communities, 2003) and the EuEu-ropean Disability Strategy 2010-2020 (EuEu-ropean Com-mission, 2010) to facilitate inclusive education especially for people with disabilities. Also, the
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Council of Europe, a human rights organisation, adopted the Disability Action Plan 2006-2015 (Council of Europe, 2006) and the Strategy on the Rights of Persons with Disabilities 2017-2023 (Council of Europe, 2017). The European Social Charter, a treaty by the Council of Eu-rope to address social and economic rights, was as well an important step (Council of EuEu-rope, n.d.). Moreover, the European Agency for Special Needs and Inclusive Education aims to im-prove the implementation of inclusive education.
However, because of different historical pathways and traditions (WHO, 2010), differ-ences between the “educational systems, available resources and understandings of inclusive education, implementation strategies differ considerably between national states” (Buchner et al., 2020, p. 1). The conditions in each country when it comes to traditions, resources or societal attitudes can restrict making progress towards full inclusive education (European Agency for Development in Special Needs Education, 2012). Nevertheless, there can be seen progress, although in many countries very slow (Ebersold et al., 2011; Buchner et al., 2020). Haug (2017) reported a gap between policy and practice addressing all European countries. Not only this can be seen in looking at the still existing multitrack approaches but also in a change in termi-nology of integration to inclusion without changing the system and thinking (Ebersold et al., 2011; European Agency for Development in Special Needs Education, 2012). A lot of coun-tries have a two-track approach, regular and special schools at the same time, whilst others already have a one-track approach (e.g., Norway and Italy) although often not fully inclusive as there are still resource rooms or special inclusive rooms, or the special classes are just relo-cated into the mainstream schools. In other countries special schools started to function as re-source centres for mainstream schools to become inclusive (Ebersold et al., 2011). Adopting multitrack approaches in connecting special and inclusive education is reality without imple-menting anywhere full inclusion yet (Buchner et al., 2020; Ramberg & Watkins, 2020).
Furthermore, it was reported that “the extent of special education has increased in many countries, as well as the labelling, diagnosing and even segregation of students with disabilities” (Haug, 2017, p. 210). The countries still investigate significant in special schools (Ebersold et al., 2011). When it comes to children with severe or profound disabilities as well as cognitive impairments they were often found in special classes or special schools. However, children with learning difficulties have a higher chance to attend mainstream classes because they easier ‘fit’ into the existing system (Ebersold et al., 2011; Buchner et al., 2020). A focus is still on the placement of the pupils and considers not the improvement of mainstream schools towards an inclusive system. A big barrier at this point can be the strong focus on knowledge, leaving behind the social aims (Weiss et al., 2018; Göransson et al., 2020). In line with this, inclusive
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education is sometimes just defined according to the benefits as “the best place for learning” (Haug, 2017, p. 209), there will still be an option for special schools then, a connection to the decision about placement, which is not in line with the ideal concept of inclusive education.
1.1.2 Intellectual disability 1.1.2.1 Definition
Intellectual disability (ID) is a neurodevelopmental disorder and a “heterogenous condition with multiple causes” (American Psychiatric Association [APA], 2013, p. 38).
Most European countries apply the International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) of the World Health Organisation (WHO) (WHO, 2010). There it is referred to mild, moderate, severe, and profound mental retardation, characterized by limitations within intellectual functioning, considering the intelligence quo-tient (IQ), and social adaptation originating in the developmental period (WHO, 2019). A comorbidity with other motor and sensory impairments is possible. As well there is an associ-ation with genetic syndromes like Down syndrome (DS), Rett syndrome or San Phillippo syn-drome (APA, 2013). Because ID can occur with different synsyn-dromes they will be addressed in this review as well.
With the development of the biopsychosocial approach to disability “as a universal hu-man experience situated within a broad continuum of huhu-man functioning” (WHO, 2010, p. 3) by the WHO’s International Classification of Functioning, Disability and Health (ICF) the term mental retardation is not used anymore but intellectual or learning disability (WHO, 2010). Many European countries and international organisations adopted the term ID whereas the United Kingdom (UK) is using the term learning disability by meaning the same population (Emerson & Heslop, 2010).
In relation to inclusion, it is questionable to use the medical explanation of ID as it is deficit oriented and does not address all aspects of functioning. Moreover, it does not conform with the new approach of disability and no one should be labelled. But the current trend within Europe makes it necessary to state a concrete definition.
1.1.2.2 Children with intellectual disabilities and inclusive education in European coun-tries
Children with ID belong to a vulnerable population. These children did not benefit much from the progress towards inclusive education within the European countries and are much more
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excluded and separated from mainstream schools than children with other types of impairment (Buchner et al., 2020; European Intellectual Disability Research Network, 2003; WHO, 2010). When looking at persons with ID the history is important to consider. Special sensitivity is required as they were victims of the Nazi Regime. Furthermore, children with ID were clas-sified as non-educable in different countries and thus did not attend any form of school. Insti-tutionalization was and is also not untypical. As well it happened that they were not educated because it was too difficult or would be too expensive (European Intellectual Disability Re-search Network, 2003; Buchner et al., 2020; Inclusion Europe, 2015; WHO, 2010).
This changed in the 1960s when the “special education systems opened up for this pop-ulation” (Buchner et al., 2020, p. 3). In the 1970s (e.g., Norway and Italy) and 1980s many Western European states (e.g., Austria, Germany, and Greece) started to educate pupils with disabilities in mainstream education. In 1989 with the fall of the Iron Curtain many Eastern European countries (e.g., Poland and Czech Republic) followed this trend (Buchner et al., 2020). But “deinstitutionalization has progressed less quickly in the countries of central and eastern Europe and the Baltic countries” (WHO, 2010, p. 9).
Within the multitrack approaches of the European countries one can find special schools specifically for ID (e.g., in Austria, Cyprus, Germany, the Netherlands, Poland, Swe-den and the UK) (Ebersold et al., 2011). However, when it comes to children with severe ID or complex needs, in many countries they receive no education “as they are being placed in daycare centers or residential institutions that provide no education” (Inclusion Europe, 2015, p. 5) like in the Netherlands, France, or Bulgaria. In some countries (e.g., Czech Republic, Germany, and the Republic of Ireland) children with ID still attend segregated settings to a large extent but progress is recorded. Italy is seen as a pioneer with a very high inclusion rate (Buchner et al., 2020).
Questions arise when looking at all the trends within inclusive education: Is it really “a result of a transfer of students from special to mainstream settings […] or an increase of clas-sifications of students in mainstream settings” (Buchner et al., 2020, p. 10)? And is it just about placement like it was the practice with integration or is the shift to inclusion not only a rhetoric one?
1.2 Theoretical Background
The three following theories were chosen to later discuss the findings of this review to get a deep understanding of the processes within inclusive education regarding the benefits. A dis-cussion may further facilitate benefits when outcomes are lacking. Participation and the sense
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of belonging are two essential frameworks within inclusive education and state important out-comes for children attending mainstream schools. Vygotsky’s socio-cultural theory was further chosen to better understand learning, a third main outcome.
1.2.1 Participation
Inclusion is often discussed within the frame of participation which “is defined as a person’s ‘involvement in a life situation’ and represents the societal perspective of functioning” (WHO, 2007, p. xvi) looking into the International Classification of Functioning, Disability and Health for Children and Youth (ICF-CY). Concepts highlight two aspects influencing the child’s func-tioning: “frequency of attending and intensity of involvement” (Maxwell, 2012, p. 21). The child has to attend a situation as other children and also to be engaged in it to fully benefit and thrive. At the school level participation will take place in social but also in academic activities helping the child to become more independent, have a better academical outcome and be so-cially integrated (Maxwell & Granlund, 2011). Participation is impacted by different personal and environmental factors, which are interrelated (Garbarino & Ganzel, 2000; Gal, 2015). A model was developed outlining five environmental dimensions (availability, accessibility,
af-fordability, accommodability and acceptability) shaping participation (Maxwell & Granlund,
2011). This is based on the 4-A Framework by Tomaševski (2001) which “requires that inclu-sive education contexts must exhibit four essential markers, namely availability, accessibility, acceptability and adaptability” (Ramaahlo, 2018, p. 351). The fifth A, affordability, was added by Maxwell and Granlund (2011).
1.2.2 Sense of belonging
Next to participation is the sense of belonging another overriding aspect within inclusion. Prince and Hadwin (2013) showed in their review that a sense of belonging within “school is related to positive academic, psychological, behavioural and social outcomes” (p. 238).
The sense of belonging belongs to the five basic needs (the physiological needs, the safety needs, the belongingness and love needs, the esteem needs, the need for self-actualiza-tion) of all human beings within Maslow’s theory of human motivation (Maslow, 1954). The sense of belonging “refers to a social desire to be connected with other human beings and to feel accepted by a group” (Prince & Hadwin, 2013, p. 241). The five needs build “a hierarchy of relative prepotency” (Maslow, 1954, p. 38) addressing an order where the first need has to be at least partially satisfied to be able to fulfil the next need on the hierarchy. However, this order is not to a full degree fix but is open for individual exceptions. Therefore, personal
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progress could be limited when the need to belong is not satisfied. Then this unsatisfied need dominates, and the next higher needs are not the main objective at this point. If this need will be thwarted psychopathological symptoms can be a result (Maslow, 1954).
1.2.3 Vygotsky’s socio-cultural theory
According to Vygotsky’s socio-cultural theory “learning and development are interrelated from the child’s very first day of life” (Vygotsky, 1978, p. 84). Without a learning process not directed to the zone of proximal development progress in development cannot be achieved. The
zone of proximal development is “the distance between the actual developmental level as de-termined by independent problem solving and the level of potential development as dede-termined through problem solving under adult guidance or in collaboration with more capable peers”
(Vygotsky, 1978, p. 86, emphasis in original). Development can only progress when the arising internal developmental processes through learning within a socially active environment will be internalized. Then the child will make the step from the actual to the potential developmental
level and latter will become the new actual developmental level.
Intersubjectivity as well as scaffolding, learning through adjusted assistance by more
capable peers, teachers, or parents, within social interaction facilitate the progress of cognitive development focusing always on the zone of proximal development to help the child to develop his or her full potential (Daniels, 2008; Berk, 2009; Gindis, 1999). When it comes to children with disabilities, Vygotsky is talking about compensatory strategies, compensating the impair-ment, and helping them to make progress in development as the other children. In line with this he argues for a learning environment which is highly differentiated and helps the child with a disability to successfully thrive, emphasizing the collaborative learning within mainstream classrooms (Gindis, 1999; Berk, 2009).
However, evaluating Vygotsky’s theory he barely took the biological processes within child development into account and “placed less emphasis on children’s capacity to shape their own development” (Berk, 2009, p. 26). Focusing only on the social aspects leaving behind other important influences makes the perspective on child development and learning very one sided.
1.3 Rationale
Understanding how the children with ID benefit from inclusive education is a step to get a picture about the current situation, looking at the implementation of inclusive education. Fur-ther it can be seen how benefits can be facilitated when discussing them with the concepts of
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participation and a sense of belonging and Vygotsky’s socio-cultural theory regarding learning and development. It is important to address all aspects regarding inclusive education, also the benefit to get a full inclusive education system without segregated discourses. Although maybe the main discussion should not be centred around whether children achieve better in inclusive schools than in segregated ones to justify the implementation of inclusive education, as inclu-sive education has become an ethical and moral imperative. But it seems necessary to start a debate when looking at the current situation in Europe, with large gaps between policy and practice, and a goal to create quality inclusive education systems which benefit all children.
When it comes to children with ID there is an obvious gap within inclusive education research which is not helpful in making progress towards the inclusion of these children (Buch-ner et al., 2020). There is a need of “greater attention, in terms of both research and school practices” (Weiss et al., 2018, p. 839), especially from the very start when children enter the school system after going to the kindergarten and preschool, where inclusion is much more practiced than in school. Facilitating inclusion from the start of attending schools can promote inclusive education on all educational levels and help children to develop their full potential.
Looking at the benefits not only academic achievement will be investigated as it should not be the core of an inclusive school system but is nevertheless important for achieving im-portant skills for coping in everyday life like reading, writing, counting, or getting to know the clock. Therefore, all other possible benefits will be explored as well, covering among other things social participation and child development in many facets.
As no European country really shows a full inclusive education system, the actual ex-isting implementations of inclusive education will be investigated. In this study, different con-cepts of inclusive education are allowed presupposed that the child attends the mainstream classroom for most of the time. Individualized and separated learning situations can occur but only if they are not dominating during the school day. This is not like it should be, but it builds a starting point, looking at the actual situation and showing that it is worth investing in inclusive education like it is stated in policy.
1.4 Aim and research question
This systematic literature review will focus on children with intellectual disabilities as this population is faced by a high risk of exclusion from the regular school system. The aim is to understand the benefits of inclusive education for primary school aged children with intellec-tual disabilities in European countries. The following research question was formed to guide the research:
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• How do primary school aged children with intellectual disabilities benefit from inclu-sive education in European countries?
2 Method
2.1 Systematic literature review
A systematic literature review was conducted to address the above stated aim and to answer the research question. Such a review is defined either by referring to the used methodology or the actual resulting research article. Information from various peer reviewed scientific papers was gathered, synthesized, and appraised to answer the stated research question in a systematic way to obtain objectivity, transparency, and replicability as well as the minimization of biases and errors (Jesson et al., 2011).
2.2 Search strategy
The literature search is based on the PEO (Population, Exposure, Outcome) search model (See Appendix A) (City, University of London, 2021). Primary school aged children with an ID in European countries are the population (P), inclusive education in Europe is the exposure (E) and the different benefits from inclusive education are the outcome (O).
The search was conducted within the following three databases: ERIC, PsycINFO and Web of Science. The first two were selected as they cover literature in the field of education. Web of Science was added to get a more comprehensive search looking into all subjects and see what is out there. Depending on the databases certain thesaurus terms and free-text terms were combined based on the PEO to get an optimal search result. As the database Web of Science covers no thesaurus terms there were used only free-text terms. In each database all search terms in total were almost identical. There were made a few necessary adaptations to get an optimal result. The free-text terms were searched in ERIC in the title and abstract, in PsycINFO in the title, abstract and identifier (keyword) and in Web of Science in title, abstract, author keywords, and keywords plus. Boolean operators, truncations and phrase searching was used to get an optimal search string for each database. The individual search words were sorted according to the topics: intellectual disability, primary school, inclusive education, and benefit. Only in PsycINFO the terms for primary school were excluded as they were limiting the search too much and would cross out important articles. The terms of each topic were connected by the Boolean operator “OR” and all these in turn were connected by “AND” building the final search strings. The search string used in PsycINFO was optimized by adding the location
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United States with the Boolean operator “NOT” to already exclude the articles about the United States. An overview about the different search strings can be found in Appendix B.
To get a more precise result limitations were set on published between 01.01.2010 and 13.02.2021 for all databases and peer reviewed for ERIC and PsycINFO, but not for Web of Science as all articles published there are already peer reviewed. Further there was set a limi-tation on the age group school age (6-12 years) in PsycINFO. All searches were conducted in February 2021 at the same day.
2.3 Selection criteria
Based on the aim and research question of this study and the formulated PEO inclusion and exclusion criteria (see Table 1) were set. With these the selection process was conducted.
2.4 Selection process
The selection process was facilitated by the web application Rayyan which was developed for undertaking this kind of studies (Ouzzani et al., 2016). Conducting the searches within the three databases a total of 342 articles was obtained. These were exported from the databases and imported into Rayyan. There the different articles were categorized and labelled to ensure a systematic selection process. After removing the duplicates, the remaining articles were screened at the title and abstract level according to the inclusion and exclusion criteria. After-wards the still included articles were screened on the full-text level as well according to the different criteria. This process resulted in the finally included articles for this systematic liter-ature review and is shown in Figure 1.
2.4.1 Title/Abstract screening
After excluding 29 duplicates from the total amount of results (n=342), 313 articles were screened on title and abstract level according to the stated inclusion and exclusion criteria. Finally, 249 articles could be excluded.
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Table 1
Inclusion and exclusion criteria
Note. ID=intellectual disability; TD=typically developing
Inclusion criteria Exclusion criteria Peer reviewed articles, theses Not peer reviewed
Published 2010 to 2021 Reviews, book chapters, reports
English and German language Any other language than English or German Quantitative, qualitative, and mixed
method studies
Experimental studies
Population Primary school (grade 1 to 4 or 6/7) and age 5/6 to max. 12/13 years, depending on the school system of the European country the study is about
Studies about preschool or higher educational levels than primary school
Articles addressing intellectual disability/ intellectual development disorder (mild, moderate, severe, and profound, according to ICD-10), mental retardation (term used until 2010/2011 for intellectual disability)
Studies about developmental disabilities Studies not addressing ID directly, only in
general about children with disabilities or
special education needs or special needs Studies about borderline intellectually
functioning Genetic syndromes associated with ID,
participants show an ID, and it is addressed as a main aspect: Rett Syndrome, Fragile X Syndrome, Prader Willi Syndrome, Fetal Alcohol Syndrome, Phenylketonuria, Williams Syndrome, Down’s Syndrome, San Phillippo Syndrome
Articles about genetic syndromes without a present ID
Learning disability when it comes to articles from the United Kingdom
Studies about learning disabilities from all other countries than the United Kingdom Exposure Inclusive education in European
countries
Studies of non-European countries Different concepts of inclusive
education are allowed, meaning that next to attending the mainstream classroom separate learning conditions can still be present
Studies only about special schools or special
classes Studies about TD peers attending not the
same classroom as the children with ID Studies examining the actual
implementation of inclusive education
Studies evaluating
interventions/instructions/strategies/methods Studies about inclusion within society or
recreational activities Outcome Studies reporting benefits/outcomes of
inclusive education for the children with an intellectual disability, meaning academical achievement, learning, cognitive development, socio-emotional development, belongingness,
participation
Studies about benefits of inclusive education
for TD peers Studies about outcomes regarding
interventions/instructions/strategies/ methods although supporting inclusive education
Publication/ study design
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Figure 1
Flow chart of inclusion and exclusion process
2.4.2 Full-text screening
64 articles were left for the full-text screening using again the stated inclusion and exclusion criteria. One duplicate and two articles which were not accessible could be excluded from the beginning. 46 articles were excluded after going through the texts precisely. This selection
ERIC PsycINFO Web of Science 135 91 116 342 Excluded duplicates: 29 Included for title/abstract screening: 313 Excluded after title/abstract
screening: 249
Exclusion reasons:
Studies of non-European countries: 71 Languages other than English or German: 4
Wrong publication type/study design: 14
Wrong population (educational level, age, type of disability): 61
Wrong exposure (not directed to inclusive education,
interventions/training programs): 91 Wrong outcome (not related to the benefits of inclusive education for the children with ID): 8
Included for full-text screening: 64
Excluded after full-text screening: 46
Exclusion reasons:
Studies of non-European countries: 7 Languages other than English or German: 3 Wrong publication type /study design: 3 Wrong population according to age and IQ: 6 Intellectual disability is not clearly differentiated: 9 The educational levels are not clearly differentiated: 2
Special school context: 1 Intervention: 3
The different educational forms children attending are not differentiated in the results: 1
Unclarity about the implementation of inclusive education: 2
TD children visiting not the same class as the children with ID at the inclusive school: 1
Wrong outcome or inaccuracy about the outcome: 8
Included for the systematic review: 15 Not accessible: 2 Excluded duplicates: 1
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process resulted in a total of 15 articles (Table 2) included to investigate the benefits of inclu-sive education for children with ID in Europe.
Table 2
Overview of the included articles
Author(s) Year Title Country
Schnepel et al. 2020 The mathematical progress of students with an intellectual disability in inclusive classrooms: results of a longitudinal study
Switzerland Garrote 2017 The relationship between social participation and social skills of
pupils with an intellectual disability: A study in inclusive classrooms
Switzerland
Sermier Dessemontet et al.
2012 Effects of inclusion on the academic achievement and adaptive behaviour of children with intellectual disabilities
Switzerland
Smogorzewska et al.
2019 Theory of mind development in school environment: A case of children with mild intellectual disability learning in inclusive and special education classrooms
Poland
Szumski & Karwowski
2012 School achievement of children with intellectual disability: The role of socioeconomic status, placement, and parents’ engagement
Poland Szumski &
Firkowska-Mankiewicz
2010 Is Polish special education effective? Academic and socio-emotional effects of schooling in special, integrated and regular Schools
Poland
Szumski & Karwowski
2015 Emotional and social integration and the big-fish-little-pond effect among students with and without disabilities
Poland de Graaf & van
Hove
2015 Learning to read in regular and special schools: a follow-up study of students with Down syndrome
Netherlands de Graaf et al. 2013 More academics in regular schools? The effect of regular versus
special school placement on academic skills in Dutch primary school students with Down syndrome
Netherlands
Nikolić et al. 2020 Not there yet: Lessons learned on the journey to inclusion in the Republic of Serbia
Serbia
Potter 2015 ‘I didn't used to have much friends’: Exploring the friendship concepts and capabilities of a boy with autism and severe learning disabilities
United Kingdom (UK) Snipstad 2019 Democracy or fellowship and participation with peers: What
constitutes one's choice to self-segregate?
Norway Dolva et al. 2011 Facilitating peer interaction - Support to children with Down
syndrome in mainstream schools
Norway Yildiz 2015 Teacher and student behaviors in inclusive classrooms Turkey Avcıoğlu 2017 Classroom teachers' behaviors and peers' acceptance of students in
inclusive classrooms
Turkish Republic of Northern Cyprus
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2.5 Data analysis
2.5.1 Quality assessment
The finally selected articles were quality assessed to judge whether they should be included or excluded in/from the systematic review and to give an overview about the quality of the in-cluded studies. Low quality articles should be exin-cluded. The critical appraisal tools from the Joanna Briggs Institute (JBI) were used for it. These JBI tools underwent critical peer review and got approval from the JBI Scientific Committee. According to the different study designs the following checklists were filled out: checklist for qualitative research (Lockwood et al., 2015) (n=4), checklist for analytical cross sectional studies (Moola et al., 2020) (n=7), and checklist for experimental studies (Tufanaru et al., 2020) (n=4). The checklist for quasi-experimental studies was adapted for one study because of a pre-quasi-experimental design investi-gating only one group and no appropriate checklist for this design could be noticed. Therefore, four questions (2, 3, 4, and 7) were excluded assessing its quality. An overview about the dif-ferent checklists can be seen in Appendices C, D and E. Each item of the checklists was an-swered with “Yes” receiving 2 points, with “Unclear” receiving 1 point, or with “No” receiving 0 points. Then an overall quality score was calculated in per cent to be able to compare the different studies’ quality (0-50% = low quality; 50-75% = medium quality; 75-100% = high quality). The conducted quality assessment resulted in nine studies having medium quality (Garrote, 2017; Smogorzewska et al., 2019; Szumski & Karwowski, 2012; Szumski & Firkow-ska-Mankiewicz, 2010; Szumski & Karwowski, 2015; de Graaf & van Hove, 2015; Nikolić et al., 2020; Snipstad, 2019; Yildiz, 2015) and six studies having a high quality (Schnepel et al., 2020; Sermier Dessemontet et al., 2012; de Graaf et al., 2013; Potter, 2015; Dolva et al., 2011; Avcıoğlu, 2017). Therefore, no study had to be excluded due to low quality. In Appendix F, the results are viewed in tabulation.
2.5.2 Data extraction
After the quality assessment the data of all included studies was extracted. A data extraction form with different categories addressing the main points was developed and filled out for each selected article. This form contains information about the study details, the type of study de-sign, the participants, the method and analysis, the implementation of inclusive education, rel-evant results regarding the aim and research question of this review, the discussion and con-clusion and the quality level as well. The different categories can be seen in Appendix G.
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2.5.3 Data analysis
Conducting narrative analysis (Centre for Reviews and Dissemination, 2009), the results from the different studies were aggregated to one result using the comprehensive data extraction form. First a descriptive summary was constructed which will be presented in text and tabula-tion. The implementations of inclusive education were reviewed as well as these build the basis for the retrieved findings. The results regarding the research question of this review were sorted along five aspects: academic achievement, sense of belonging, participation, socio-emotional and cognitive development, and behavioural outcome. As different studies investigated more than just the benefits of inclusive education it has to be mentioned that the results which are not relevant for this review will not be reported neither discussed. The findings of the different studies were analysed according to similarities and differences.
2.6 Ethical considerations
Although data is not collected directly from participants ethics had to be considered. In the whole process the impact of the own subjectivity shaping the research process, the data assess-ment, findings, and synthesis was reflected (Suri, 2020). The whole search process was con-ducted in a structured and standardized way and only peer-reviewed articles were retrieved to ensure overall good-quality and minimize bias. Low quality articles according to the conducted quality assessment should be excluded.
As children with ID are faced by increased vulnerability sensitivity is essential when examining research studies as well as when it comes to the data synthesis and the writing up of this review (Oliver, 2010). Looking into the studies, 10 addressed ethical considerations (Schnepel et al., 2020;Sermier Dessemontet et al., 2012; Smogorzewska et al., 2019; Szumski & Karwowski, 2012; Szumski & Karwowski, 2015; Nikolić et al., 2020; Potter, 2015;Dolva et al., 2011; Yildiz, 2015; Avcıoğlu, 2017). However, five studies (Garrote, 2017; Szumski & Firkowska-Mankiewicz, 2010; de Graaf & van Hove, 2015; de Graaf et al., 2013; Snipstad, 2019) did not report them which is highly questionable when collecting data directly from this vulnerable population. Nevertheless, all articles showed a medium to high quality ensuring a well elaborated research process and did not raise an issue of unsensitivity or discrimination.
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Table 3
Overview about the included studies
Note. ID=intellectual disability; MID=mild intellectual disability; TD=typically developed; DS=Down syndrome; IEP=individual educational plan; IQ=intelligence quotient; a=quantitative, b=qualitative, c=longitudinal, d=cross-sectional, e=comparative; f=child with disability, g=parents, h=teacher/profes-sionals, i=TD peers, j=researcher; *comparison of children with ID and TD peers in inclusive class-rooms **comparison of children in different educational settings
No. Author(s) Year
Country Target group Age (in
years)
Sample size
a b c d e f g h i j
1 Schnepel et al., 2020
Switzerland X X Children with ID
(DS (n=6)), IQ: M=62.03 (SD=8.63)
M=8.32 (SD=0.68)
38 X X
2 Garrote, 2017 Switzerland X X X* children with ID, IQ:
M=62.1 (SD=9.8) & TD peers M=97.92 month (SD=10.51) 692 X X X 3 Sermier Dessemontet et al., 2012
Switzerland X X X** children with ID, IQ:
M=62.1 (SD=9.8)
7.0-8.8 68 X X X
4 Smogorzewska et
al., 2019
Poland X X X** children with MID,
IQ (N=106): M=63.23 (SD=5.34), IQ range: 47-70 6.1 - 12.4 1rst wave: N=166; 3rd wave: N=133 X X X 5 Szumski & Karwowski, 2012
Poland X X X** children with MID 10-13 605 X X
6 Szumski & Firkowska-Mankiewicz, 2010
Poland X X X** children with MID (grade 1-3) 254 X
7 Szumski & Karwowski, 2015
Poland X X X** children with MID 9-13 605 X X
8 De Graaf & van Hove, 2015
Netherlands X X X** Children with DS,
IQ: M=49.3 (SD=9.6)
5-8.9 55 X
9 De Graaf et al., 2013
Netherlands X X X** children with DS, IQ:
M= 48/in regular education 51.7 (SD=7.8) and in special education 42.9 (SD=9.9) 5-13 121 X 10 Nikolić et al., 2020
Serbia X X X** students with MID,
IQ: 55-69
11-12 249 X
11 Potter, 2015 UK X X Child with autism
and severe learning disabilities
10 1 X X X
12 Snipstad, 2019 Norway X X student with ID 12 1 X X
13 Dolva et al., 2011 Norway X X children with DS &
teachers and teachers’ assistants Children with DS: 10 children with DS (N=6), teachers (N=6), teachers' assistants (N=6) X X
14 Yildiz, 2015 Turkey X X students with MID &
general education teacher Students: 8-13 54 teachers; 54 students with MID X 15 Avcıoğlu, 2017 Turkish Republic of Northern Cyprus
X X students with ID &
TD peers & classroom teachers --- teachers: 16; students with ID: 16; TD students: 355 X X X X Data reported by Study design
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3 Results
3.1 Overview about the included studies
The 15 included studies (Table 3) captured the following European countries: Switzerland (n=3), Poland (n=4), the Netherlands (n=2), Serbia (n=1), UK (n=1), Turkey (n=1), Turkish Republic of Northern Cyprus (n=1) and Norway (n=2). Three countries (Poland, the Nether-lands and Cyprus) belong to the EU. It has to be added that when the study about the UK was conducted this country was as well an EU member, however not anymore. All countries have signed and ratified the UN CRPD, except Switzerland which acceded to the Convention in 2014.
Most of the studies adopted a quantitative study design (n=11) as well as a cross sec-tional design (n=11). Two of the qualitative studies were case studies investigating the situation of one student each. Nine studies conducted a comparison. One study compared children with ID and their TD peers in inclusive classrooms whereas the other studies compared children with ID from non-segregated settings and segregated settings.
Concerning the population most studies recruited children with mild and moderate ID and DS mainly with an average IQ indicating mild and moderate ID. Only one study from the UK addressed a severe learning disability with a comorbidity of autism.
Viewing all articles, the age range of 5 to 13 years was captured. Three studies investi-gated nearly the whole age span, whereas two studies focused on children below 9 years of age and six studies on children above 9 years of age. Two studies showed a mean age of around 8 years and another two did not report the children’s age. However, one of the latter ones reported an investigation towards the end of grade three.
3.2 Implementation of inclusive education
All studies investigated the situation of children with ID, including DS, in inclusive settings. There were recognized differences but also similarities within its implementation between the different countries. Garrote (2017) and Sermier Dessemontet et al. (2012) reported both for Switzerland that the children with ID attend the general classroom full-time and are supported by a special education teacher for a certain number of hours per week. Schnepel et al. (2020) reported support from a special education teacher for mathematics as well. In this study though, it was said that the children with ID learn together with the other children but also separately. In line with Switzerland, children with DS attending regular schools in the Netherlands receive additional support as well, promoted by a personal educational budget which can be invested
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in educational assistance for a few hours per week for teaching inside or outside the mainstream classroom (de Graaf & van Hove, 2015; de Graaf et al., 2013). De Graaf and van Hove (2015) reported separate instruction and partially participation in literacy activities. Individual educa-tional plans (IEP) are used for pupils with DS (de Graaf et al., 2013).
The studies about Poland (Szumski & Karwowski, 2012; Szumski & Firkowska-Mankiewicz, 2010; Szumski & Karwowski, 2015) showed an educational system structured into special schools, regular schools without special educational aid and integrative schools. Regular schools capture around one to two children with disabilities per class and the latter three to five. The latter also presents a smaller class size and a teacher team consisting of one general and one special education teacher. All students were taught regarding one curriculum. Children with ID have an extra IEP and were supported by therapies and further training next to regular school activities. Smogorzewska et al. (2019) reported the same but using instead of integrative schools the term inclusive classrooms. However, Szumski and Karwowski (2015) are more in line with the Netherlands as they are talking about segregated learning situations in integrated and regular schools. Nevertheless, it has to be reflected that the other studies about Poland did not say something about whether they were really full-time members of the general classroom or not.
Both studies about Norway (Snipstad, 2019; Dolva et al., 2011) also reported an edu-cation with the other classmates in the mainstream classroom but also separated in another room. Academic activities were commonly taught outside. They referred to a special education teacher supporting the child with ID or DS academically but also socially. Snipstad (2019) reported that the child with ID had alternative more practical subjects and that the general teacher approached the child seldom. In addition, Dolva et al. (2011) talked about an IEP.
For Serbia it was presented that the regular curriculum applies for all, like in Poland. Children with disabilities have an IEP, done by an inclusion team found to be in every school, and have extra therapies. However, Nikolić et al. (2020) reported that “instruction […] is not individualized and specialist support is itinerant” (p. 457), and that there is a lack in teacher training when it comes to children with SEN.
The studies about the UK, Turkey and the Turkish Republic of Northern Cyprus did not report in detail about the inclusive setting. All participants attended an inclusive classroom where they learned together with their typically developed (TD) peers. Potter (2015) also talked about a classroom assistant and Avcıoğlu (2017) about the use of an IEP.
An overview about the different implementations of inclusive education can be found in Appendix H.
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3.3 Benefits of inclusive education for children with intellectual disabilities
The benefits of inclusive education for children with ID viewed in tabulation can be found in Appendix I.
3.3.1 Academic achievement
Eight studies were addressing the academic achievement of children with ID in inclusive set-tings. All adopted a quantitative design.
Schnepel et al. (2020) found that children’s with ID mathematical achievement in-creased within a year. Sermier Dessemontet et al. (2012) registered significant mathematical and literacy progress of children with ID. De Graaf and van Hove (2015) investigated chil-dren’s with DS reading skills and found that the achievement in reading skills is positively impacted by a higher amount of years in regular education.
Focusing on the comparison to special schools some studies (Sermier Dessemontet et al., 2012; Szumski & Firkowska-Mankiewic, 2010) registered no differences according to placement in mathematical skills. Szumski and Firkowska-Mankiewic (2010) registered no significant differences in language results for children with mild intellectual disabilities (MID) as well. However, Sermier Dessemontet et al. (2012) showed that there was a bit more progress in the children’s literacy skills in general education classrooms than in special schools. Szumski and Karwowski (2012) found that the achievement of children with MID in reading and math-ematics was the highest in integrative classes, then in regular classes and lowest in special schools. In addition, two other studies showed that the academic achievement was higher in students attending non-segregated schools, looking at children with MID and children with DS (Szumski & Karwowski, 2015; de Graaf et al., 2013). De Graaf et al. (2013) divided the age group of 5 to 13 years into two groups and found significant differences in reading, writing and mathematic skills for the age group 9 years or older and only a significant difference in reading for children below the age of 9. According to their study these differences arose because of a higher amount of years spend in regular education and a higher “amount of teaching time in academics” (de Graaf et al., 2013, p. 31).
Contrary to these findings the study of Nikolić et al. (2020) resulted in a significant difference in mathematical skills but in favour for pupils with MID in special schools achieving higher scores than pupils with MID in regular schools.
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3.3.2 Sense of belonging
A total of seven studies addressed the sense of belonging within school. Among these are all qualitative studies (n=4).
Garrote (2017) investigated the social participation of pupils with ID in inclusive class-rooms and found that nearly half of the pupils were rejected (n=14) or isolated (n=5) and the other half was accepted (n=23) and popular (n=1). However, not accepted and accepted pupils did not significantly differ in their number of friendships. Of all pupils with ID 63% “had at least one reciprocal friend” (Garrote, 2017, p. 6). Avcıoğlu (2017) presented difficulties about the acceptance of pupils with ID by their TD peers because of challenging behaviours which resulted in segregation sometimes. Nevertheless, the pupils were overall good accepted by their TD peers which love to help and protect the pupils with ID. Discussing the preferences of the TD peers sitting together came before playing and studying together.
Potter (2015), Snipstad (2019) and Dolva et al. (2011) showed all a development of positive peer interactions and friendships and a good social integration. Potter (2015) studying a child with a severe learning disability and autism in the UK emphasized a significant progress and establishing friendships which remain constant over time. Dolva et al. (2011) however adds that different activity interests challenge social interaction, investigating children with DS. Moreover, Snipstad (2019) described a case of an increased wish of self-segregation.
Two studies (Szumski & Firkowska-Mankiewic, 2010; Szumski & Karwowski, 2015) compared different placements. Szumski and Firkowska-Mankiewic (2010) found that pupils with MID in special classes showed a much better emotional (“emotional attitude toward school” (p. 253)) and social integration (“satisfaction with peer relations in the classroom” (p. 253)). There were no significant differences between integrated or regular schools. But the pupils with MID in integrated schools were worst emotionally integrated. In addition, this study presented that school achievement was related to psychosocial functioning within regular schools showing that a higher achievement was associated with a better integration. This effect was lowest in integrated classes. Szumski and Karwowski (2015) also found a better emotional integration in special schools as well as a better academic self-concept (ASC), but no differ-ences when it comes to social integration. School type and academic achievement were both negative predictors of ASC, but it was positively predicted by emotional and social integration having a big influence on the Big-Fish-Little-Pond Effect (BFLPE). The BFLPE, describing “that students’ ASC is positively associated with their school achievement, but negatively in-fluenced by their peers’ achievement” (Szumski & Karwowski, 2015, p. 63), was weaker when pupils showed a good emotional and social integration.
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3.3.3 Participation
Both case studies (Potter, 2015; Snipstad, 2019) dealt with participation. The participant from the study by Potter (2015) showed strong social engagement within peer-interactions which increased over time since the beginning of attending the mainstream school. Within the study of Snipstad (2019) the peers demonstrated engagement in interactions with the girl with ID and asked her to attend the activities. However, she expressed the wish of self-segregation and withdrew from the activities with her peers often which the school tried to favour considering the democracy concept.
Furthermore, the study of Yildiz (2015) investigated the academic engagement and re-vealed that the children with MID were 58.58% of the lesson engaged in academic activities. The placement within the classroom showed a significant impact with a higher academic en-gagement when placed in the front but no impact of adapting instructions was revealed. How-ever, pupils with MID were sitting only in 57.87% of all observed sessions in the front rows.
Smogorzewska et al. (2019) and Szumski and Firkowska-Mankiewic (2010) assessed the study motivation of the children with MID. Szumski & Firkowska-Mankiewic (2010) con-ducting a comparison found that pupils with MID attending integrated schools had the lowest study motivation and pupils in special classes were much better motivated to learn. In addition, Smogorzewska et al. (2019) reported a decrease of study motivation over time.
3.3.4 Socio-emotional and cognitive development
One study (Smogorzewska et al., 2019) investigated the socio-cognitive development of chil-dren with mild and moderate ID. They conducted a longitudinal study to investigate the Theory of Mind (ToM) development “defined as the understanding that people possess and display different mental states, desires, beliefs, emotions and intentions” (Smogorzewska et al., 2019, p. 1242). They found a positive ToM development over time and a significant faster develop-ment in inclusive classrooms compared to special classrooms.
In addition, Potter (2015) showed in the case study that the boy with autism and a severe learning disability in the UK made significant progress in his socio-emotional development over time. Potter (2015) presented progress of using social skills within interactions, for exam-ple in gaining and obtaining friendships, and developing communication skills within peer in-teractions.
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3.3.5 Behavioural outcome
The study of Sermier Dessemontet et al. (2012) revealed that the adaptive behaviour of pupils with ID improved significant according to the teachers and parents, but there were no signifi-cant differences compared to pupils with ID in special schools.
Yildiz (2015) showed that pupils with MID spend 34.11% of the lesson with off-task behaviour, which becomes more less when instructions are adjusted, and 7.31% with problem behaviour, which becomes better when placing the students in the front desks. The rest of the lesson time they were engaged in academic activities. However, he showed that instructional programs were adjusted only in 14.81% of the examined lessons and placement in the back rows of pupils with MID was observed in 42.13% of the lessons.
4 Discussion
4.1 Reflection on findings
The aim of this systematic literature review was to understand the benefits of inclusive educa-tion for primary school aged children with intellectual disabilities in European countries. The findings will be discussed according to the three theories presented in the theoretical back-ground. This can facilitate a progress towards an overall improved benefit and a full inclusive education system.
The findings of this study regarding academic achievement are in line with other re-search such as the reviews by Ruijs and Peetsma (2009) and Prince and Hadwin (2013) inves-tigating children with SEN. Conducting this present study an overall positive outcome within academic achievement regarding mathematical and literacy skills was recognized also with making significant progress over time. As well there were found almost no differences com-pared to attending special schools. However, this implies no negative result but rather shows that children with ID can thrive in inclusive settings as well.
Regarding social acceptance and peer relationships this review revealed mixed findings in line with other research undertaken by Ruijs and Peetsma (2009), Prince and Hadwin (2013), Broomhead (2018) and Koster et al. (2010). Investigating the included studies there was shown a strong social engagement as well as a positive socio-emotional and ToM development over time, but also self-segregation. Furthermore, the studies found that there are some difficulties with emotional and social integration, academic self-concept, and study motivation.
Progress regarding behavioural outcomes and a high and moderate intensity of involve-ment, academical and social, were also reported.
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Overall, there was a good benefit for children with mild and moderate ID or DS pre-sented. One study investigating the social situation of a child with a severe learning disability and autism within the UK revealed a high positive benefit for the child as well. Although latter findings are less representable as there is only one case discussed, they show that it is possible for this population to benefit from inclusive education.
4.1.1 Participation
In practice, there is often a focus on placement leaving open options for special and segregated settings with a danger of pushing quality education and its benefits into the background. This, however, is not in line with inclusive education (Haug, 2017). Different options on a continuum are still reality connected to discussing a good benefit and trying to act in the best interests of the child. Segregation and exclusion are remaining in many countries. Full inclusion is not met anywhere (Buchner et al., 2020; Ramberg & Watkins, 2020). Looking at the implementations of inclusion described in the different studies, this can be reported for this investigated popu-lation as well, although there was done a lot internationally as well on the European level to facilitate the progress towards full inclusive education. Studies addressed either an attempt of inclusive education or just an imprecise description which makes it difficult to judge whether it is full inclusion or not. Overall, full attendance of the mainstream classroom is only partially achieved. This leads to the first two environmental dimensions availability and accessibility (Maxwell & Granlund, 2011).
These dimensions are only partially obtained as the schools often adopt additional sep-arated learning situations. Furthermore, Yildiz (2015) described that a high number of students with MID were placed in the back rows which hinders the child’s academic achievement and increases problem behaviour. As well he found that the instructional program was adapted very rarely which had a negative impact on off-task behaviour, addressing a not well met
accom-modability. These practices present a barrier to be able to fully participate which in turn limits
positive outcomes (Maxwell & Granlund, 2011). Sitting in the front desks and adjusting the instructions would result in lower problem and off-tasks behaviours which would have a posi-tive impact on their social acceptance. Avcıoğlu (2017) found that TD peers easier accept pu-pils with ID who show less problem behaviour. Addressing these issues, this could lead more likely into a higher engagement socially and academically when attending the mainstream classroom.
Szumski and Karwowski (2012) investigated different placements and showed that pu-pils with MID in integrative classrooms had the best academic achievement compared to pupu-pils
