Learning for life, friendships and relationships from the perspective of children and young people with intellectual disabilities: findings from a UK wide qualitative study.

BACKGROUND: Relationships and sexuality education (RSE) programmes are widely taught in schools, however for children and young people with intellectual disabilities, these programmes appear to be limited regarding information on relationships, informed choices and decision making. The purpose of this study was to seek the views and understanding of children and young people with intellectual disabilities, and those involved in their care and education, to identify best practice and approaches to the delivery on relationships and sexuality education. METHODS: This study used a qualitative design with 37 pupils from five special schools from across the United Kingdom (UK) participating. In-depth semi-structured interviews were held online, or in person. All interviews were recorded and transcribed verbatim. Transcripts were anonymised, assigned a pseudonym and subjected to inductive thematic analysis. FINDINGS: Four themes emerged from the data: (i) enthusiasm and inquisitiveness to acquire knowledge; (ii) dynamics of positive friendships; (iii) experiences and understanding of supportive relationships and sexuality; and (iv) valuing the exchange of knowledge and information. The findings highlight that children and young people with intellectual disabilities want education, support and information on matters relating to their relationships and sexuality. CONCLUSIONS: This is the largest study to date providing a voice to children and young people with intellectual disabilities regarding their relationships and sexuality. While special schools provide relationships and sexuality education, there is a requirement for a programme and resources specific to the needs of pupils with intellectual disabilities to be developed and evaluated. Such education should continue beyond school and be embedded in adult services.

Challenging behaviour and its risk factors in children and young people in a special school setting: A four wave longitudinal study.

BACKGROUND: Longitudinal research is needed to strengthen evidence for risk factors for challenging behaviour in children with intellectual disabilities and to understand patterns of change over time. METHODS: Data on challenging behaviour were collected for 225 students in one school over four annual time points and a range of potential risk correlates. Data were analysed using Generalised Estimating Equations. RESULTS: Prevalence of challenging behaviour, aggression and self-injury did not vary significantly over time. Stereotyped behaviours increased over the 4-year period. Challenging behaviour was associated with lower levels of adaptive skills and autism. Stereotyped behaviour increased with age. Self-injurious behaviour was less likely to be shown in children with profound intellectual disabilities over time. CONCLUSIONS: These findings are consistent with previous research in terms of potential risk factors identified. Implications for schools include proactive interventions for children with intellectual disabilities at high risk; especially those with autism and poorer adaptive skills.

Associations Between Perceived Social Support, Perceived Competence, and Physical Activity in Hong Kong Children With Disabilities During the COVID-19 Pandemic.

This study aimed to examine the associations between perceived social support, perceived competence, and physical activity in children with physical and intellectual disabilities during the COVID-19 pandemic. During the third wave of the pandemic in Hong Kong (i.e., July through December 2020), 291 participants age 6-17 years from 27 special schools were included. After controlling for demographic variables, the total variance explained by perceived social support and perceived competence was 24%, F(2, 240) = 12.42, p < .001, with perceived competence having a stronger association with physical activity (ß = 0.29, p < .001) than perceived social support (ß = 0.07, p = .22). This study highlights two key facilitators for shaping physical activity involvement among children with disabilities during the COVID-19 pandemic.

Results and SWOT Analysis of the 2022 Hong Kong Report Card on Physical Activity for Children and Adolescents With Special Educational Needs.

BACKGROUND: Following the 2019 Hong Kong Para Report Card, the 2022 Hong Kong Para Report Card aimed to provide an updated and evidence-based assessment for nine indicators related to physical activity in children and adolescents with special educational needs and to assess the results using a SWOT (strengths, weaknesses, opportunities, and threats) analysis. METHODS: Using a systematic process, the best available data on nine indicators were searched from the past 10 years and were assessed by a research work group. Letter grades were assigned and considered by stakeholders and auditors. RESULTS: Four indicators were assigned a letter grade (overall physical activity: F [mixed device-measured and self-reported data]; sedentary behaviors: D [device-measured data]; active transportation: D-; government strategies & investment: C+). SWOT analysis highlighted opportunities for facilitating children and adolescents with special educational needs to achieve health recommendations. CONCLUSION: There were deteriorating trends in physical activity and sedentary behaviors. Effective, multilevel, and cross-sector interventions are recommended to promote active behavior in children and adolescents with special educational needs.

The nature and extent of healthcare provision for people with intellectual disabilities in Ghana: A qualitative study.

Ghana has designated special schools with the mandate of training and equipping persons with intellectual disabilities with social functioning and vocational skills needed to promote their social inclusion. This study investigates the nature and extent of healthcare provision for persons with intellectual disabilities in their respective special schools. This research adopted a qualitative, but participatory approach to collect data from respective stakeholders. The findings reveal that some of these special schools do not have professional health workers, and most healthcare providers have challenges diagnosing and prescribing medication for this population due to the health workers' limited understanding of their healthcare needs, coupled with communication barriers. The researchers have suggested setting up of a special health department with personnel who have received training on intellectual disabilities. This department must undertake training for the housemothers in special schools, parents in the communities, and teachers in special schools.

The Efficacy of Virtual Positive Behavior Support in a Special School for Students with ASD.

In response to the demand for adopting a social justice system to manage students' challenging behaviors, many countries are implementing positive behavior support (PBS) programs at the school level. However, the use of PBS in Saudi Arabian schools is still a goal rather than reality. It is strongly evident that school-wide PBS can be applicable to different educational contexts. Therefore, the purpose of this study was to evaluate the efficacy of a virtual school-wide positive behavior support program for students with autism spectrum disorder (ASD) in Saudi Arabia. Teaching and reinforcement procedures were implemented to help the students replace interfering classroom behaviors with alternative, appropriate behaviors. Observations were conducted to collect data on the students' classroom behaviors. The results of the study showed that there was an immediate and major improvement in the students' behaviors upon the introduction of the program. The results support the conclusion that school-wide positive behavior support can be successfully applied to different educational settings and suggest several implications for special and general education schools.

Effects of classroom-based active breaks on cognition, sitting and on-task behaviour in children with intellectual disability: a pilot study.

BACKGROUND: Classroom-based active breaks can help typically developing children reduce sitting, increase physical activity and improve cognitive functions and on-task behaviour. Yet, this strategy has not been tested in children with intellectual disability (ID) - a population who are insufficiently active. This study aimed to investigate the effects of a 5-week active breaks intervention on cognitive functions and on-task behaviour in schoolchildren with ID. METHODS: Twenty-four children, aged between 8 and 12 years (37.5% girls), were recruited. Children's cognitive functions (response inhibition, lapses of attention, interference and working memory) were measured at baseline and end of trial using computer-based tests. Sitting, standing and movement patterns were assessed with inclinometers, and on-task behaviour was directly observed in the classroom before and after active breaks, at baseline, mid-trial and end of trial. Linear mixed models were used to investigate the intervention effects on cognitive functions and sedentary patterns; generalised linear mixed models were used to analyse on-task behaviour data. RESULTS: A significant time × group interaction was found for working memory favouring the intervention (B = 11.56, 95% confidence interval [1.92, 21.21]). No significant effects were found in relation to the other measures of children's cognition or on-task behaviour. Stepping time and bouts of sitting were positively affected. CONCLUSIONS: Classroom-based active breaks can increase physical activity and reduce sedentary behaviour in children with ID and might also benefit their working memory. Further research is required to clarify the effects on cognition and to investigate whether this strategy has other benefits in this population.

Review and action plan for oral health improvement in Sheffield special schools.

A description of the process of a review of oral health improvement in special schools in Sheffield and the implementation of an action plan for these activities. Public health competencies encompassed: assessing the evidence on oral health and dental interventions, programmes and services; strategic leadership and collaborative working for health; oral health improvement.

Factors Contributing to Sexual Violence at Selected Schools for Learners with Mild Intellectual Disability in South Africa.

BACKGROUND: This paper reports part of the findings of a study which exposed sexual violence in schools for learners with mild intellectual disability in South Africa. Special attention was paid on factors contributing to such a problem. METHODS: Data were collected using focus groups and individual interviews with 16 learners with mild intellectual disability at two special schools in South Africa. This was followed by individual interviews with the school nurse and social worker, and an analysis of schools' books of incidents. RESULTS: Factors contributing to sexual violence at schools for learners with mild intellectual disability included: (i) peer pressure, (ii) concealment of reported incidents of sexual violence, (iii) unsupervised areas linked to schools and (iv) arranged relationships. CONCLUSION: The following suggestions are put forth: (i) awareness programmes, (ii) sensitization of teachers about the consequences and prevention of sexual violence, (iii) boundaries within which the arranged relationship occurs, (iv) intensification of sexuality education and (v) supervision around the school premises.

Teachers' perceptions of implementation of aided AAC to support expressive communication in South African special schools: a pilot investigation.

Although the provision of assistive technology for students with disabilities has been mandated in South African education policy documents, limited data are available on the implementation of aided augmentative and alternative communication (AAC) in classrooms. This pilot investigation used a concurrent mixed-methods survey design to determine the extent to which aided AAC was implemented to foster students' expressive communication in preschool to Grade 3 classrooms in special schools from six urban school districts in the Gauteng (the smallest, most affluent and most densely populated of the nine South African provinces), and also obtained teachers' perceptions of this process. A total of 26 teachers who taught students who used aided AAC for expression participated. Although there is evidence of provision and also implementation of aided AAC in classrooms, various limitations still exist. Teachers identified an array of factors that influenced the implementation of aided AAC, including those related to themselves, the classroom context, the characteristics of aided AAC, students using AAC, and other stakeholders. These factors are discussed in the light of international literature as well as the local context, and are used as a basis to suggest a research agenda for AAC in the South African education system.

[Comparative study of stress and psychological well-being in parents of children with and without special education needs during the COVID-19 pandemic].

The COVID-19 pandemic, which rapidly spread worldwide in early 2020, has affected the daily lives of parents and their children in various ways. This study assessed the overall mental health status and stress experienced by parents during the COVID-19 pandemic and the differences between parents of children with special educational needs and parents of typically developing children. Additionally, we explored potential demographic factors that may influence these experiences. In this cross-sectional study, data were collected through questionnaires completed by a sample of 205 parents (103 of children with typical development attending regular mainstream schools and 102 of children with special educational needs attending special education schools) from February to April 2021. Participants completed the Perceived Stress Scale (PSS-10), the short form of the Profile of Mood States (POMS-S), and a demographic questionnaire. Our findings confirmed that parents of children attending special education schools reported higher levels of anxiety, reduced coping abilities, and poorer overall emotional well-being during the pandemic compared to parents of children attending regular schools. The type of educational setting that children attended was identified through multivariate analyses as the only factor consistently influencing all psychometric outcomes. Factors influencing anxiety levels included gender, older age, and family status, while family status and unemployment negatively impacted coping abilities. Taken together, the pandemic appears to have had a greater impact on the mental health of parents of children with special education needs compared to parents of children attending regular schools, highlighting the need for increased psychosocial support within this population group.

Establishing Priorities for Improving Data Collection and Measurement of Mental Health and Well-Being of Adolescents With Special Educational Needs Within Nonmainstream Schools: Protocol for a Delphi Study.

BACKGROUND: There are more than 1.5 million children and young people in England with special educational needs (SEN), with over 160,000 young people in the United Kingdom attending a special school or alternative provision (AP) setting. Young people with SEN have been found to be at risk for poorer mental health and well-being than non-SEN peers. However, there is a range of both school-related and research challenges associated with identifying difficulties in a timely manner. OBJECTIVE: This Delphi study aims to determine a list of stakeholder priorities for improving school-based measurement of mental health and well-being among young people with SEN, at an aggregated level, within secondary special school or AP settings. A secondary objective is to inform the implementation of school-based well-being surveys, improve engagement in special schools or AP settings, and improve survey response rates among children and young people with SEN. METHODS: A mixed methods Delphi study will be conducted, including a scoping review and preliminary focus groups with school staff members and researchers to establish key issues. This will be followed by a 2-round Delphi survey to determine a list of stakeholder priorities for improving the measurement of mental health and well-being at an aggregate level within special schools and AP settings. A final stakeholder workshop will be held to discuss the findings. A list of recommendations will be drafted as a report for special schools and AP settings. RESULTS: The study has received ethical approval from the University College London Research Ethics Committee. The stage 1 scoping review has commenced. Recruitment for focus groups will begin in Autumn 2024. The first round of the Delphi survey will commence in early 2025, and the second round of the Delphi survey in the spring of 2025. The final workshop will commence in mid-2025 with final results expected in late 2025. CONCLUSIONS: There is a need for clear recommendations for special schools and AP settings on priorities for improving the measurement of mental health and well-being problems among young people with SEN. There is also a need for recommendations to researchers implementing school-based well-being surveys, including the #BeeWell program, to enable them to improve their engagement in special schools and AP settings and ensure surveys are accessible. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/58610.

"I Thought It Was Better to Be Safe Than Sorry": Factors Influencing Parental Decisions on HPV and Other Adolescent Vaccinations for Students with Intellectual Disability and/or Autism in New South Wales, Australia.

The uptake of human papilloma virus (HPV) and other adolescent vaccinations in special schools for young people with disability is significantly lower than in mainstream settings. This study explored the factors believed to influence parental decision making regarding vaccine uptake for students with intellectual disability and/or on the autism spectrum attending special schools in New South Wales, Australia, from the perspective of all stakeholders involved in the program. Focus groups and interviews were conducted with 40 participants, including parents, school staff, and immunisation providers. The thematic analysis identified two themes: (1) appreciating diverse parental attitudes towards vaccination and (2) educating parents and managing vaccination questions and concerns. While most parents were described as pro-vaccination, others were anti-vaccination or vaccination-hesitant, articulating a marked protectiveness regarding their child's health. Reasons for vaccine hesitancy included beliefs that vaccines cause autism, concerns that the vaccination may be traumatic for the child, vaccination fatigue following COVID-19, and assumptions that children with disability will not be sexually active. Special school staff regarded the vaccination information pack as inadequate for families, and nurses described limited educational impact resulting from minimal direct communication with parents. More effective communication strategies are needed to address vaccine hesitancy among parents with children with disability.

Are they ready? Moderators of the correlation between work affect and job satisfaction felt by teachers of inclusive and special schools.

BACKGROUND: The study aimed to determine to what extent emotions experienced at work are predictors of the level of teachers' job satisfaction. The moderating role of the type of school - inclusive and special - for this correlation was also analysed. PARTICIPANTS AND PROCEDURE: The study involved 214 teachers at three levels of inclusive and special schools (primary, middle and high) attended by pupils with special educational needs. The respondents represented various age groups. The study used the Work Affect Scale and the Satisfaction with Job Scale. RESULTS: The results clearly suggest that the emotions teachers experience at work are a strong predictor of their job satisfaction - positive emotions imply high job satisfaction whereas negative emotions imply low job satisfaction. This regularity exists in both the responding teacher groups. It was determined that the type of an institution does not significantly affect the above predictive attribute of organizational work affect. CONCLUSIONS: Positive work-related emotions and average and high job satisfaction felt by ca. 2/3 of the responding inclusive and special school teachers suggest that both these groups are fully ready for high-quality education for all.

The Associations Between Accelerometer-Measured Physical Activity Levels and Mental Health in Children and Adolescents with Intellectual Disabilities During the COVID-19 Pandemic.

To examine the associations between physical activity (PA) levels and mental health in children and adolescents with intellectual disabilities (IDs) during the COVID-19 pandemic, 117 participants aged between 6 and 17 years with IDs from 10 Hong Kong special schools were included. There were positive dose-response associations between PA (i.e., light PA, moderate PA, and vigorous PA) and mental health, and participants with higher levels of moderate-to-vigorous PA (MVPA) and self-concept (SC) had better social quality of life (QoL) than those with lower levels of MVPA and SC. Moreover, personal and environmental factors such as age, body mass index, school, sex, ID level, and parental education level influenced the PA levels and QoL in children and adolescents with IDs.

Effect of yoga on the social responsiveness and problem behaviors of children with ASD in special schools: A randomized controlled trial.

CONTEXT: Autism spectrum disorder (ASD) is the most common neurodevelopmental disorder and is increasingly reported among school-age children in India. Many children with ASD attend special schools which extend support for learning basic functional and academic skills. Problem behaviors and lack of social responsiveness are frequently associated with children with ASD in a school environment. Many evidence-based studies have explored various interventions in mitigating the lack of social responsiveness and problem behaviors in children. Few studies have examined the impact of yoga on social responsiveness and problem behaviors in special schools. OBJECTIVE: The objective of the study was to highlight the effect of school-based yoga on the social responsiveness and problem behaviors of children with ASD in special schools. Forty-three children with ASD from four special schools participated in the study. DESIGN: A randomized controlled trial (RCT) design was employed for the study. Children with ASD (n = 43) from four special schools were assessed by their teachers for social responsiveness and problem behaviors with the Social Responsiveness Scale-2 (SRS-2) and Aberrant Behavior Checklist-2 (ABC-2) at the baseline and after the yoga intervention. INTERVENTION: Structured yoga of 45 min for 12 weeks was conducted across four special schools with simple yoga practices conducive to children with ASD. RESULTS: Significant changes were observed post-intervention in the mean scores of the social communication aspect in social responsiveness (p = .021), irritability (p = .041), and social withdrawal (p = .047) aspects of problem behaviors.

Effect of yoga on children with autism spectrum disorder in special schools.

Introduction: Yoga as a holistic mind-body intervention is increasingly evaluated for the management of various autism symptoms in children with autism spectrum disorder (ASD). Methodology: Forty-three children with ASD from 4 special schools were randomized into two groups, yoga group: 23 children and control group: 20 children. The yoga group received 12 weeks of yoga intervention in special schools. Results: Significant improvement in the yoga group was noted in the overall autism severity (P < 0.001) as reported by the parents in comparison to the control group. Conclusion: The findings of the study show that yoga can have a positive impact on the symptomatology of autism.

The Correlation between Organizational (School) Climate and Teacher Job Satisfaction-The Type of Educational Institution Moderating Role.

The quality of work and task implementation in educational institutions to a large extent depends on the personnel of those institutions. This is particularly true in the case of teaching pupils with special educational needs. The climate of education and learning and job satisfaction depend on teachers themselves. The purpose of this study was to verify the extent to which the type of educational institution (a mainstream or special school) moderates the correlation between teachers' subjective evaluation of the organizational climate, their job satisfaction, and work-related emotions. The study involved 214 teachers representing all levels of school education in Poland, i.e., primary, middle, and high schools attended by pupils with special educational needs. Half of the teachers worked in mainstream schools and the other half-in special schools. The study used: The Organizational Climate Questionnaire by Litwin and Stringer; The Satisfaction with Job Scale; and The Work Affect Scale. The results clearly suggest that the teachers' perception of the organizational climate is a strong predictor of their job satisfaction and work-related emotions. A positive climate is associated with high satisfaction and good emotions (enthusiasm and comfort) while a negative climate co-occurs with low satisfaction and bad emotions (anxiety and depression). The organizational type of institution (mainstream or special school) does not significantly affect the above predictive attribute of the organizational climate.

Short report: Correlates of behaviours that challenge in children with intellectual disability in special education settings.

BACKGROUND: Understanding the correlates of behaviours that challenge (CB) can help in both identifying children with intellectual disabilities (ID) at risk of developing CB and designing support programmes and interventions. AIMS: This study explores the correlates of CB exhibited by children with ID in special educational settings in the UK. METHODS AND PROCEDURES: Data on behaviours that challenge were provided by educators of 71 children with ID. Additional measures of adaptive and pro-social behaviours, maternal anxiety, depression, and stress, and demographic variables were included in the cross-sectional binary logistic regression analyses. OUTCOMES AND RESULTS: Results showed that pro-social behaviours of children with ID were associated negatively with overall CB (OR=0.72, 95% CI [0.62, 0.84], p < 0.001), stereotyped (OR=0.81, 95% CI [0.70, 0.94], p = 0.005), self-injurious (OR=0.80, 95% CI [0.70, 0.90], p < 0.001), and aggressive/destructive behaviours (OR=0.79, 95% CI [0.69, 0.90], p < 0.001). Stereotyped behaviours were associated with lower adaptive skills (OR=0.95, 95% CI [0.91, 0.99], p = 0.026) and male gender (OR=9.20, 95% CI [1.07, 79.44], p = 0.044). Aggressive/Destructive behaviours were associated with maternal stress (OR=0.82, 95% CI [0.70, 0.97], p = 0.022), and increased maternal anxiety (OR=1.21, 95% CI [1.00, 1.47], p = 0.050) was a marginally significant predictor of self-injurious behaviours. CONCLUSIONS AND IMPLICATIONS: The findings of this study emphasise the potential role of pro-social and adaptive behaviours, gender of children with ID, and maternal stress, as factors associated with CB in special education settings. Therefore, the present study contributes to extending the literature on correlates of CB for children with ID in special education settings while adopting an evidence-informed methodology for defining and measuring CB that facilitates replicability and allows for comparisons across findings of studies that explore CB thus increasing a more coherent evidence-base regarding assessment of CB.

Psychosocial Wellbeing of Nigerian Teachers in Special Education Schools.

While there is evidence that impaired psychosocial wellbeing can compromise the effective performance of work-related roles, little is known about the wellbeing of teachers working with children with developmental disabilities. We interviewed 68 special education schoolteachers (response rate = 70.8%) in a Nigerian state with 12-item General Health Questionnaire and an adapted Zarit Burden Interview. About four in every ten teachers had psychological distress, representing many-fold the rates reported in the general population, and significant burden was prevalent in 51.5%. Perceived burden correlated significantly with psychological distress, anxiety/depression and social dysfunction (rs = .3). While increased burden predicted psychological distress, longer teaching experience was protective against distress. These findings underscore the need for psychosocial support for special education schoolteachers to enhance their wellbeing and roles.