Fenotipos clínicos en el diagnóstico sicopedagógico de las necesidades educativas especiales

El desarrollo científico tecnológico caracterizado, entre otros por los avances en el campo de las ciencias biomédicas, trascienden a la educación, especialmente se denotan los nexos entre la genética médica y la educación especial. En la provincia de Camagüey se desarrolla una investigación entre los servicios de Genética y el Centro de Diagnóstico y Orientación de la educación especial. A partir del análisis de la interrelación entre ambas ciencias se proyectan en la práctica de la atención de educandos con necesidades educativas especiales enfoques multi, inter y transdisciplinarios con el fin de contribuir al perfeccionamiento del diagnóstico sicopedagógico. El estudio se desarrolla con la colaboración de la Benemérita Universidad Autónoma de Puebla.

Scientific and technological development, characterized among cons by advances in the field of biomedical sciences, transcend education, especially the links between medical genetics and special education. In the province of Camagüey, research is being carried out between the Genetics services and the Diagnosis and Guidance Center for special education. Based on the analysis of the interrelation between both sciences, multi, inter and transdisciplinary approaches are projected into the practice of caring for students with special educational needs, in order to contribute to the improvement of psychopedagogical diagnosis. The study is developed with the collaboration of the Benemérita Universidad Autónoma de Puebla.

Prognostic factors for employment outcomes in patients with a history of childhood-onset drug-resistant epilepsy.

Objective: The employment outcomes of childhood-onset drug-resistant epilepsy (DRE) has not been studied enough. The aim of this retrospective cohort study is to investigate the employment outcomes of childhood-onset DRE in June 2022 and identify the risk factors associated with non-employment. Materials and methods: The sample consisted of 65 participants ≥18 years of age with a history of childhood-onset DRE. Fifty participants (77%) were salaried employees and 15 participants (23%) were non-employed. Clinical and psychosocial information were evaluated for calculating the relative risk (RR) of non-employment. Results: Regarding medical factors, lower IQ [RR, 0.645; 95% confidence interval (CI), 0.443-0.938; p = 0.022] was positively associated with employment. In contrast, age at follow-up (RR, 1.046; 95% CI, 1.009-1.085; p = 0.014); number of ASMs at follow-up (RR, 1.517; 95% CI, 1.081-2.129; p = 0.016); use of medications such as phenobarbital (RR, 3.111; 95% CI, 1.383-6.997; p = 0.006), levetiracetam (RR, 2.471; 95% CI, 1.056-5.782; p = 0.037), and topiramate (RR, 3.576; 95% CI, 1.644-7.780; p = 0.001) were negatively associated with employment. Regarding psychosocial factor, initial workplace at employment support facilities (RR, 0.241; 95% CI, 0.113-0.513; p < 0.001) was positively associated with employment. In contrast, complication of psychiatric disorder symptoms (RR, 6.833; 95% CI, 2.141-21.810; p = 0.001) was negatively associated with employment. Regarding educational factor, graduating schools of special needs education (RR, 0.148; 95% CI, 0.061-0.360; p < 0.001) was positively associated with employment. Conclusions: Specific medical, psychosocial, and educational factors may influence the employment outcomes of childhood-onset DRE. Paying attention to ASMs' side effects, adequately preventing the complications of psychiatric disorder symptoms, and providing an environment suitable for each patient condition would promote a fine working status for people with childhood-onset DRE.

Vocal Behavior Acquisition with a Toy Operating by Sound Detection.

We investigated a speech training support system targeting students in special needs education classes who are engaged in training to acquire a binary relationship where their vocalizations elicit reactions from others. Previously, there was a challenge in maintaining interest and achieving learning effectiveness when teachers intervened to encourage vocalizations using teaching aids such as picture books. To address this, we designed and integrated an electronic circuit with a movable toy that captures the interest of the supported students. The circuit includes a switch that turns on and activates a secondary circuit only when vocalizations are detected. In this paper, we report on the training using the developed speech support system and validate its functionality.

A Follow-Up Study on the Influence of Personal, Family, and School Factors on Learning Outcomes of Students with Disabilities in Senior High School.

The purposes of this study were to describe the learning outcomes of students with disabilities in senior high school, to establish a model to explain the effects of personal, family, and school experience factors on the learning outcomes of students with disabilities, and to determine the relationship between post-school and in-school outcomes. There were 496 participants selected in the 2011 and 2012 academic year from the database of Special Needs Education Longitudinal Study. The survey data obtained from questionnaires for teachers, parents, and students were used to conduct secondary analysis. Descriptive statistics such as frequencies and percentages, a PLS structural equation model, and multiple regression were used in this study. The results of this study were as follows: (1) Students with disabilities had the best learning performances in school, and most parents were satisfied with their students' education in school; however, employment performance was the weakest upon leaving school. (2) School experience factors had the greatest influence on the school learning outcomes model, followed by student factors and family factors. (3) In-school outcomes effectively predicted postsecondary education, employment, social adaptation, and satisfaction after leaving school. In conclusion, the results of this study found that personal, family, and school factors have a significant impact on the learning outcomes of students with disabilities, and in-school outcomes can effectively predict postsecondary education, social adaptation, and satisfaction after leaving school.

Covid-19, competencias digitales docentes y educación especial en México / COVID-19, Educational Digital Competences and Special Education in Mexico

Los retos que enfrentó el profesorado durante el confinamiento causado por la covid-19 se acrecentaron para quienes atienden a estudiantes con necesidades educativas especiales o barreras para el aprendizaje, a causa de la escasez de herramientas tecnológicas especializadas y el incipiente desarrollo de competencias digitales. El objetivo de este artículo es analizar las condiciones en las que este profesorado que labora en educación básica y media superior en México trabajó durante el período abril 2020-diciembre 2021. Se realizó una investigación atributiva estructural de alcance explicativo que empleó la encuesta como técnica de recuperación de información. Participaron 140 docentes cuyas respuestas fueron analizadas estadísticamente y cartografíadas utilizando el Sistema de Información Geográfica y el programa ArcGIS, con la finalidad de destacar diferencias y carencias regionales. Los resultados se centran en dos ejes del Marco Común de Competencia Digital Docente (Creación de contenidos y Seguridad), y evidencian la persistencia de brechas socioeducativas, siendo docentes de zonas urbanas quienes expresan haber desarrollado estas competencias, destacando quienes tienen menos años de servicio, mayores grados académicos y buscan estabilidad laboral, lo que lleva a concluir en la necesidad de fortalecer procesos formativos diferenciados que respondan a las necesidades específicas de los contextos educativos. (AU)

The challenges faced by teachers during the confinement caused by Covid-19 were more severe for those who look after students with special needs or learning barriers, particularly in a context marked by the scarcity of specialized technological tools and an incipient development of digital skills among both teachers and students. The paper analyzes the conditions in which teachers who work in basic and upper secondary education in Mexico carried out their jobs from April 2020 - December 2021. The analysis is based upon a structural attributive research of explanatory scope that retrieved information through a survey. 140 teachers participated in the process; their responses were statistically analyzed and mapped out using the Geographic Information System and the ArcGIS program, in order to highlight regional differences and shortcomings. The results presented focus on two axes of the Common Framework for Digital Teaching Competence (Content Creation and Security) and show the persistence of socio-educational gaps. Those who express that to have developed these competences are teachers from urban areas, particularly those who have less years of service, higher academic degrees, and are in the seek of job stability. This leads to the conclusion that there is a need to strengthen differentiated training processes that respond to the specific needs of educational contexts. (AU)

Technology for supporting emotion regulation of individuals with developmental disabilities: A scoping review.

BACKGROUND: Emotional competencies are skills necessary to adequately understand, express, and regulate emotional phenomena. Among the emotional competencies is emotion regulation. Not having adequate development of this emotional competence is related to psychological problems such as depression. One of the characteristics of individuals with developmental disabilities is the presence of difficulties with emotion regulation. These difficulties can affect an individual's autonomy, social competence, and the development of independent life. AIMS: This paper presents a scoping review to identify the technology designed and developed to support the emotion regulation of individuals with developmental disabilities. METHODS AND PROCEDURES: We combined the guidelines for a systematic literature review in computer science and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology. The process resulted in twelve stages through which we conducted this scoping review. First, a search query was defined and executed in computer science's five most representative search engines. We used different inclusion, exclusion, and quality criteria for selecting the works included in this review. OUTCOMES AND RESULTS: Thirty-nine papers aimed at supporting the emotional competencies of individuals with developmental disabilities were included, of which nine support emotion regulation. As a result, different areas of opportunity in developing technology to support the emotion regulation of individuals with developmental disabilities are discussed. CONCLUSIONS AND IMPLICATIONS: Technology supporting emotion regulation in individuals with developmental disabilities is a growing but little-explored field. For the literature supporting emotion regulation, we detected opportunities for study. Some of them aimed at investigating whether we could use technologies developed for other emotional competencies to support emotion regulation and how the characteristics of this technology can support individuals with developmental disabilities.

The Lower the Physical Function, the Higher the Quality of Life in Japanese Adolescents with Cerebral Palsy.

AIMS: To investigate the factors that contribute to subjective quality of life (QOL) in adolescents with cerebral palsy (CP). METHODS: We evaluated the subjective QOL in 51 adolescents with CP through interviews using the Japanese version of KIDSCREEN-27 (J-KIDSCREEN-27) and compared the scores with those of 60 typically developing adolescents. Correlations of subjective QOL with age, sex, the levels of functions (gross motor, manipulation, and communication), intelligence, the level of activity of daily living (ADL), and the type of educational support were examined. Thereafter, we investigated the predictors of the subjective QOL by multiple regression analysis. RESULTS: The total QOL scores and individual J-KIDSCREEN-27 domains were not significantly different from those of typically developing adolescents. Sex, manipulation and communication functions, and intelligence had no relationship with subjective QOL. Gross motor function and ADL level negatively correlated with satisfaction with the school environment. Multiple regression analysis revealed that higher age predicts lower psychological well-being, lower gross motor function predicts higher satisfaction with the school environment, and attending schools or classes for special needs predicts higher physical well-being. CONCLUSIONS: Seeking adequate support for mildly affected adolescents attending regular classes will be the key to further improving subjective QOL in adolescents with CP.

Opinions, training and requirements regarding ICT of educators in Florence and Granada for students with functional diversity.

Information and communication technology (ICT) is a means of learning for people with functional diversity (FD), in the context of both formal and non-formal education. These digital options favor their inclusion, participation and motivation, so having competent professionals in the field of educational technology is crucial for the full development of this population. Within this framework, the opinion, training and requirements regarding ICT of 809 educators in Florence (Italy) and Granada (Spain) were analyzed, following a quantitative study, with a non-experimental, descriptive, cross-sectional and comparative design. Descriptive statistics (mean, standard deviation and mode) and frequencies were used. After checking the normality of the data (Kolmogórov-Smirnov test), inferential analyses were performed, applying Student's t- test and one-factor ANOVA, calculating the effect size (Cohen's d and eta squared). Statistically significant differences were found according to city of origin, gender, and years of experience with students with FD. The results point to the need for different educators to have sufficient technological training, as despite being aware of the functionalities of ICT and having a favorable opinion of them, resources and knowledge about their use fall short of what is desirable.

Inclusive education for children with disabilities in a refugee camp.

Children in refugee camps, and particularly those with disabilities, face unique challenges in accessing education and are at high risk of being marginalised. Best practices suggest that main-streaming is the optimal strategy for serving students with disabilities. This study examines the extent to which mainstreaming in a refugee camp helps to promote children's prosocial behaviours, taking into account their emotional and behavioural problems. In Kakuma Refugee Camp, Kenya, researchers collected data from the parents of children currently enrolled in special needs education centres (n=65) and from those formerly enrolled at these facilities who transitioned to mainstream classrooms (n=81). Children in mainstream schools functioned better in terms of prosocial behaviours, but this relationship disappeared when factoring in children's emotional and behavioural difficulties. In the context of a refugee camp, mainstreaming alone is not likely to help children's psychosocial and educational functioning, which requires dedicated supports, appropriate facilities and infrastructure, and a dual focus on disability-specific and disability-inclusive initiatives.

Supporting a Tsonga learner living with Bardet-Biedl syndrome, a rare complex disability.

Background: Bardet-Biedl syndrome (BBS) is a rare, systemic, hereditary disorder characterised by obesity, polydactyly, visual and auditory impairment, and cognitive disability. Providing quality education in appropriate schools for children who present with such complex chronic conditions is challenging. Objectives: This study explored the dimensions of psycho-educational support needs for a child with BBS in South Africa to contribute to the improvement of early detection and holistic interventions. Method: A descriptive in-depth qualitative case study of Gezani, an adolescent Tsonga boy diagnosed with BBS, was undertaken. Semi-structured interviews were conducted with his parents and teachers to ascertain the boy's psycho-educational support needs. Medical reports provided information on the complexities and prognosis of the syndrome. Observations in the classroom corroborated the learner's symptoms and behaviours. Results: Thematic content analysis revealed the key areas of support needs. Gezani's cognitive disability required a modified, slow-paced curriculum. His visual impairment required mobility orientation training and learning Braille. His emotional needs were supported with psychotherapy to maintain a sense of well-being. Medical monitoring was recommended with interventions for walking and managing his diet and weight. Speech therapy supported his communication skills. Conclusion: Learners with multiple disabilities require carefully planned, individualised psycho-educational support programmes addressing their unique needs and delays with targeted remedial interventions in appropriate special needs schools. Contribution: This study informs educators about BBS and provides multi-faceted, holistic support. The Department of Basic Education could bring special schools and national policies in tighter alignment for learners presenting with complex disabilities.

Inclusive education in a refugee camp for children with disabilities: How are school setting and children's behavioral functioning related?

Many refugee children face challenges accessing education, but refugee children with disabilities are especially vulnerable to exclusion from school environments as well as social settings. Mainstreaming is considered a best practice but may not always be feasible given the limited resources available in refugee camps. The purpose of this study is to examine the extent to which school setting (i.e., special needs vs. mainstream classrooms) is associated with changes in children's prosocial behaviors (i.e., social skills and ability to get along well with peers) and behavioral difficulties, accounting for disability status. In Kakuma Refugee Camp in Kenya, researchers collected two waves of data (approximately 2.5 years apart) for students enrolled in special needs schools (n = 78) and students who had transitioned from special needs schools into mainstream classrooms (n = 51). Children's average prosocial scores decreased between wave 1 and wave 2, but scores from children in special needs schools decreased at a lower rate indicating potential protective factors in these settings. While children's average total difficulties decreased over time, children's difficulties in special needs schools decreased at a faster rate, also indicating potential protective factors. Neither severity of disability nor gender significantly predicted change in prosocial or difficulties scores. In the context of a refugee camp, mainstreaming alone may not fully address the needs of children with disabilities. Specific factors seen in special education settings, such as individualized services, accessible accommodations, and infrastructure supports, must be considered as a means of creating inclusive educational environments.

Loneliness in online students with disabilities: qualitative investigation for experience, understanding and solutions.

Online learning has given access to education for diverse populations including students with disabilities. In our university, the ratio of students with disabilities is substantially higher in the online programmes than face-to-face. Online learning provides high accessibility though it can result in a lonely experience. Accordingly, this study aimed to appraise the first-hand experience and understanding of loneliness in online students with disabilities (OSWD), and to discuss possible solutions. Thematic analysis on semi-structured interviews attended by nine OSWD identified: 'Self-paced study can reduce stigma but cause loneliness (Theme 1)', 'Loneliness and social difficulties relate to misunderstanding of disability (Theme 2)', and 'Activities, events and staff for informal socialisation are needed (Theme 3)'. As the demand for online learning is further expanded due to the current global pandemic, our findings will be helpful for online learning institutions worldwide to establish effective strategies to reduce loneliness in OSWD. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s41239-021-00301-x.

Using a community-based system dynamics approach for understanding inclusion and wellbeing: a case study of special needs education in an eastern African refugee camp.

BACKGROUND: Children with disabilities face unique challenges in humanitarian aid settings and education may provide protective measures against abuse and exploitation. There are growing calls for inclusive education of children with disabilities in formal education, but little guidance exists on how to enhance inclusion in complex and resource-constrained contexts of humanitarian settings. CASE PRESENTATION: This study used a community-based system dynamics approach to understand key stakeholders' perspectives of the drivers and effects of inclusion and wellbeing for children with disabilities, and to elicit recommendations to enhance educational inclusion in a refugee camp in Eastern Africa. Community-based system dynamics sessions, designed based on group model building scripts and facilitated by a team of four people, took place with organization staff, community leaders, and parents and caregivers of children with disabilities. The process produced a causal loop diagram depicting the stakeholders' perspectives of how multiple components interact in a system to drive inclusion and wellbeing of children with disabilities over time. CONCLUSIONS: Findings indicate participants have a broad conceptualization of inclusion, highlighting the value of community interaction and importance of meeting basic needs, and also demonstrate that including children in mainstream educational settings in a complex humanitarian context requires a more nuanced approach given the lack of existing resources to support Western models of educational inclusion fully.

Collecting to understand: the art of children and the medical-pedagogical approach in twentieth-century Portugal.

In this essay I look at the art of children as a tool in the medical-pedagogical approach, as proposed by the founder of child psychiatry in Portugal, Vítor Fontes (1893-1979). First, the topic of the art of children is introduced, and the second part focuses on the model of medical pedagogy as it was practised in Portugal. The third and fourth parts present Fontes's own investigations on the drawings of children with intellectual disabilities under observation at the Instituto Médico-Pedagógico António Aurélio da Costa Ferreira (IAACF) in Lisbon. In the conclusion it is argued that Fontes contributed to the development of child psychiatry in Portugal by showing that children's art can mirror their cognitive and emotional development.

Adolescentes com necessidades especiais de saúde: desafios da inclusão escolar no discurso de familiares/cuidadores / Adolescents with special health care needs: challenges of school inclusion according to family members/caregivers' viewpoint / Adolescentes con necesidades especiales de salud: desafíos de la inclusión escolar en el discurso de la familia/cuidadores

Objetivo: conhecer os desafios da inclusão escolar de adolescentes com necessidades especiais de saúde a partir do discurso dos familiares/cuidadores. Método: Pesquisa qualitativa, realizada no ambulatório pediátrico de especialidades, que atende adolescentes com necessidades especiais de saúde. Realizou-se a análise de prontuários, entrevista semiestruturada com 35 familiares/cuidadores de adolescentes. As entrevistas foram submetidas a dupla transcrição e à análise de discurso Pecheutiana. Resultados: os familiares/cuidadores trouxeram em seus discursos os desafios enfrentados para a integração e inclusão escolar, os profissionais e as pessoas que contribuem no processo de inserção social do adolescente, as habilidades e potencialidades da CRIANES. Conclusão: a educação inclusiva deve ser articulada de forma interdisciplinar, engajada por todas as esferas de gestão, política, trabalho, famílias e usuários. A inclusão deve ser debatida pela enfermagem, em busca da promoção da saúde e de espaço social para o adolescente

Objective: The study's main purpose has been to understand the challenges of school inclusion of adolescents with special health care needs according to family members/caregivers' viewpoint. Methods: It is a qualitative research that was performed at an ambulatory pediatric specialty care, which assists adolescents with special health care needs. There were carried out analysis of medical records and semi-structured interviews with 35 family members/caregivers of adolescents. The interviews were subjected to double transcription and the Michel Pêcheux's Discourse Analysis. Results: Family members/caregivers brought in their speeches the challenges faced for school integration and inclusion, professionals and people who contribute to the adolescent's social insertion process, as well as the skills and potential of Children and Youth with Special Health Care Needs (CYSHCN). Conclusion: Inclusive education must be articulated in an interdisciplinary manner, engaged by all spheres of management, politics, work, families and its users. Inclusion should be discussed by nursing while looking forward to implementing health promotion and social space for the adolescent community

Objetivo: Conocer los desafíos de la inclusión escolar de adolescentes con necesidades especiales de salud desde el discurso de los familiares/ cuidadores. Método: investigación cualitativa, realizada en la clínica de especialidad pediátrica, que asiste a adolescentes con necesidades especiales de salud. Se realizó el análisis de los registros médicos, una entrevista semiestructurada con 35 familiares/cuidadores de adolescentes. Las entrevistas fueron sometidas a doble transcripción y análisis del discurso pechetiano. Resultados: los familiares/cuidadores presentaron en sus discursos los desafíos que enfrenta la integración e inclusión escolar, los profesionales y las personas que contribuyen al proceso de inserción social del adolescente, las habilidades y el potencial de CRIANES. Conclusión: la educación inclusiva debe articularse de manera interdisciplinaria, involucrada por todas las esferas de la gestión, la política, el trabajo, las familias y los usuarios. La inclusión debe ser discutida por la enfermería, en busca de la promoción de la salud y el espacio social para el adolescente

Understanding of and misunderstandings regarding epilepsy: A survey of teachers in schools for special needs education in Japan.

The present study surveyed the understanding of epilepsy and attitudes toward epilepsy among teachers in Japanese schools for special needs education. An adapted version of a self-reported questionnaire, consisting of 27 questions, was sent to 3474 teachers at all schools for special needs education in Saitama Prefecture. The response rate to the questionnaire was 62%, corresponding to 2109 valid responses. The responses to three basic questions were as follows: 99% had heard about "epilepsy", 90% had seen epileptic seizures, and 63% had an acquaintance who had epilepsy. Numerous questionnaire items gave low correct answer rates for knowledge- and attitude-related questions. Correct responses to knowledge questions and a positive attitude toward epilepsy were associated with whether individuals had acquaintance with epilepsy, experience seeing a seizure, and read or heard about epilepsy. There was skepticism and uncertainty about whether people with epilepsy should be allowed to drive, likely due to vague fears of the risks of driving with epilepsy. According to our results, knowledge about epilepsy does not necessarily lead to a positive attitude. However, respondents who had acquaintances with epilepsy were most likely to demonstrate a positive attitude. Thus, familiarity is an essential factor in the likelihood of having a positive attitude toward epilepsy. Therefore, it is essential for teachers to understand how to manage and respond to epilepsy. There were a variety of concerns related to people with epilepsy driving. This finding highlights the importance of disseminating correct information on the risks of driving with epilepsy.

Violence prevention in special education schools - an integrated practice?

Research has shown that employees in special education settings are at high risk for work-related threats and violence. Previous research has not yet been able to identify the essential components of training programs that offer protection from work-related threats and violence. Therefore, the aim of this study was to explore how employees in special education schools deal with prevention of work-related threats and violence. Group interviews were conducted with 14 employees working at 5 special education schools. Results show that employees use a wide range of prevention strategies drawing on specific violence prevention techniques as well as professional pedagogical approaches. We propose that the prevention of threats and violence in special education schools can be understood as an integrated pedagogical practice operating on three interrelated levels.

Education and related support from medical specialists for Japanese patients with major skeletal dysplasias.

BACKGROUND: Skeletal dysplasias manifest various clinical symptoms. Age at onset, severity, and progression of symptoms differ even among individuals with the same diagnosis. Though necessary support in education is presumed to differ among patients with different disorders, few articles report on education in patients with skeletal dysplasias. OBJECTIVE: To clarify what types of schools children with major skeletal dysplasias attend, what kind of support they needed at schools, and how the advice on such support was conveyed from medical specialists to schools. METHODS: Questionnaire study on patients with achondroplasia or hypochondroplasia (A/HCH), and osteogenesis imperfecta (OI). RESULTS: In A/HCH childhood locomotion ability was high and most patients had received general education, irrespective of their generation. Children with OI showed a lower level of locomotion ability; only about half of them had received general education. In selecting schools, the patients received advice from pediatricians, physiatrists, and orthopedic surgeons. The degree of necessity and content of support at the schools differed between A/HCH and OI. Remodeling of the lavatory, washbasin, and chair and support during swimming lessons were common in A/HCH patients. Support in school for OI patients was more frequent and included propelling wheelchairs, assisting in the use of the bathroom, and remodeling the lavatory. Most children were restricted from participating in physical education classes. CONCLUSIONS: Locomotion ability and the necessary support at school differed between A/HCH and OI. Support and advice from medical specialists who recognize disability of patients with skeletal dysplasias may improve patients' participation and education in schools.

Struggling for recognition and inclusion-parents' and pupils' experiences of special support measures in school.

During the last decade an increasing use of differentiated support measures for pupils with special educational needs, indicative of a discrepancy between educational policies and practices, has been witnessed in Sweden. Another trend has been the increased use of medical diagnoses in school. The aim of this study was to explore the main concern of support given to pupils with special educational needs and how pupils and parents experience and handle this. Interviews were conducted with eight pupils in Grades 7-9-and their parents-at two compulsory schools in a city in northern Sweden. A grounded theory approach was used for analyzing the interview data. A conceptual model was generated illuminating the main concern of special support measures for pupils and parents. The core category of the model, struggling for recognition and inclusion, was related to two categories, which further described how this process was experienced and handled by the participants. These categories were labeled negotiating expertise knowledge within a fragmented support structure and coping with stigma, ambivalence, and special support measures. The developed conceptual model provides a deeper understanding of an ongoing process of struggle for recognition and inclusion in school as described by the pupils and parents.