The social relationships of a child with Down Syndrome or other Special Educational Needs (SEN) often constitute the single area of school life about which parents and carers are most concerned (Cuckle and Wilson 2002). Therefore, it is perhaps not surprising that exposure to peers and opportunities for friendships in the local community are frequently the main reasons why parents send their children with SEN to the local primary school (Nakken and Pijl 2002). However, these pupils belong to a vulnerable population of young people with learning disabilities who are more likely than their non-disabled peers to experience peer rejection, depression, anxiety, behavioural and conduct problems, delinquency, school dropout and poor academic adjustment (e.g. Sinson and Wetherick 1981; Weiner 1987; Werner, 1993; Guevremont and Dumas 1994; Laws, Taylor, Bennie and Buckley 1996; Wenz-Gross and Siperstein 1996). Furthermore, the extent to which these young people experience fully inclusive education has been the subject of considerable debate in recent years.
Despite a recent increase in research investigating the social relationships of pupils with Down Syndrome (eg. Murray and Greenberg 2006), studies of the attitudes of non-disabled children towards their peers with Down Syndrome are in their infancy and very little research of this kind has been conducted in Ireland (Gash et al 2000). The primary aim of the present study was to assess the attitudes of non-disabled children in several rural mainstream primary schools toward children with Down Syndrome. A secondary aim of the study was to examine the impact on attitudes (if any) of administering a video designed to promote inclusive attitudes toward children with Down Syndrome.
A convenience sample of 118 children (comprising 54 males and 64 females) was drawn from six rural mainstream primary schools in North Kildare. Participants were recruited from twelve Third and Fourth Classes and were aged between 8 and 11 years (mn=9.35; sd=0-72). Classes which included children with learning disabilities (LD) were excluded from the study due to ethical reasons. The research was conducted during the Social Personal Health Education (SPHE) class in each school. Specific objectives of this module for Third and Fourth Classes involve acknowledging the importance of friendship and the practice and recognition of the value of care and consideration, courtesy and good manners when interacting with others (Government of Ireland 1999). The sample size and age-range of the children were considered appropriate in view of other similar studies in this area conducted elsewhere (Laws, Taylor, Bennie and Buckley 1996; Gash et al 2000; Gash, Romeu and Pina 2004; Roberts and Smith 1999).
Prior to commencement of the study, a letter was sent to the parents/guardians of all potential participants informing them about the study and seeking their consent for their child to be involved on an ‘opt-out’ basis. Participants were first asked to complete a brief Background Questionnaire (BQ) which was devised to elicit details on age, sex, number of children in family and position of the child in family. Information regarding the participants’ experience of a friend or relative with Down Syndrome was also obtained. It was thought that some or all of these kinds of variables might be linked to overall attitudes.
Following this, participants completed an Attitude Questionnaire (AQ) at two points in time and each on a group basis. The AQ was based on a slightly modified version of a questionnaire devised by Gash (1993) to examine attitudes towards children with special needs. For purposes of the current study, the term ‘mental handicap’ was replaced by ‘Down Syndrome’. This 20-item measure comprises 10 items relating to the sociability of non-disabled children toward their counterparts with Down Syndrome (Scale One) and 10 items that assess the views of non-disabled children on the inclusion in schools of children with Down Syndrome (Scale Two). The children answered ‘yes’ or ‘no’ to each statement. A ‘yes’ response was scored as ‘1’; a ‘no’ response was scored as ‘2’, so that higher scores reflect more negative attitudes.
A brief excerpt from a video entitled Including children with Down Syndrome in your school (Down Syndrome Ireland 2004) was shown upon completion of the first AQ. This 10-minute excerpt depicted children with Down Syndrome in an inclusive classroom participating in everyday school activities such as reading, writing, spelling and singing. This video was sent to every school in the Republic of Ireland in 2004 by Down Syndrome Ireland in cooperation with the Department of Education and Science in order to promote the inclusion of children with Down Syndrome in Irish primary schools. The literature accompanying the video provides general information on inclusion strategies and benefits, the learning profile of a child with Down Syndrome (e.g. reading, writing, phonics and numbers) and on the motor skills and behaviour of these children. Once the videotape had concluded, the class were invited to complete the AQ for a second time (also on a group basis). Upon completion, the participants were fully de.briefed and thanked for their co-operation.
The mean AQ scores obtained on each scale at both Time 1 and Time 2 are shown in Table 1, alongside the background data. As shown in the table, the pattern of scores was broadly similar across both time points in relation to all key variables, although scores on Scale Two (attitudes toward inclusion) were consistently higher than those for Scale One at both time points. It can be seen that those who were middle children had the lowest mean score on Scale One (at both time points), while those who were only children obtained the highest mean scores overall. The youngest children in the group (≤ 9 years) also attained marginally higher (i.e. more negative) scores than those aged 10 years and over- Closer inspection revealed the following key findings:
- Sociability versus inclusion: Scores on Scale Two were consistently and statistically higher than those on Scale One, indicating more positive attitudes toward sociability than toward inclusion in general.
- Gender differences: Males and females did not differ significantly in terms of their Scale One and Scale Two scores at baseline (Time One).
- Most sociable group: Females in the over 10 years group were found, statistically, to be the most sociable toward their peers with Down Syndrome. No statistically significant differences were found for the effect of age on attitudes toward inclusion for either males or females.
- Role of familiarity: Those who had a relative or friend with Down Syndrome did not differ significantly from those without such contact in sociability or in attitudes toward inclusion in this study.
- Position in family (i.e. oldest, youngest, middle or only-child): This was not shown to play a role in children’s levels of sociability and attitudes toward inclusion as measured by the AQ.
- Analysis at Time 2: This revealed that there was no statistically significant change in Scale One or Scale Two scores between the two time points.
Table 1: Mean AQ scores by background variables
Background Variable Time 1 Time 2
Scale 1 Scale 2 Scale 1 Scale 2
male 12.46 16.07 12.39 16.20
female 12.16 15.55 12.16 15.75
9 years and under 13.17 16.50 14.83 16.83
10 years 12.28 16.19 12.33 16.58
Over 10 years 12.80 15.80 12.60 16.20
Position in Family
oldest 12.55 15.95 12.45 16.10
youngest 12.19 15.58 12.02 15.65
middle child 11.93 15.72 11.83 16.03
only child 13.17 16.50 14.83 16.83
Number of children in family
1 13.29 14.86 13.86 15.57
2-3 12.19 15.84 12.19 16.01
4-5 12.32 16.02 12.26 16.30
Friend/Relative with Down Syndrome?
Yes 12.24 15.76 11.95 15.47
No 12.33 15.80 12.41 16.19
(group as a whole) 12.30 15.79 12.26 15.96
The finding of greater sociability amongst the older females in the group is consistent with other research showing females to be generally more sociable than their male counterparts (Gash 1993; Gash et al 2000). It is possible that this also increases with age, although it has been suggested by Nowicki (2005) that girls and boys may differ in how they respond to attitude measures that relate to specific types of responses and that these differences may be more indicative of gender-based response biases rather than gender differences in their opinions. This may also explain, at least in part, the lack of differences between the younger males and females in the current study. However, the research findings in this respect are mixed and it is not clear at this stage if age and attitudes are related to any great extent (Gash and Coffey 1995; Diamond, Hestenes, Carpenter and Innes 1997; Tamm and Prellwitz 2001). Nowicki (2005) also asserts that within gender, age differences in attitudes may be greater than any attitudinal differences across gender.
One finding of particular interest in the current study was the absence of any differences between those children who had a friend or relative with Down Syndrome and those who did not. It was thought that those with such contact might hold more favourable attitudes, particularly in relation to sociability, but this was not the case. This finding contrasts with some other work including a study by Helmstetter et al (1994) who found that non-disabled children who had previous contact with a child with SEN had a more positive attitude towards those with SEN and viewed their inclusion as more favourable than those without such experience. By contrast, however, Scheepstra et al. (1999) reported that almost half of 23 students with Down Syndrome in an integrated mainstream school were rejected by their peers. Furthermore, contact alone between children with Down Syndrome (and other learning disabilities) and their non-disabled classmates may not automatically lead to enhanced social interaction, or to the development of positive attitudes (e.g. Lyons 1991).
A substantial body of evidence has suggested that children and early adolescents can provide reliable information regarding their personal relationships and their social and emotional functioning (Elliot, Huizinga and Ageton 1985; Jolliffe, Farrington, Hawkins, Catalano, Hill and Kosterman 2003; Lynch and Cicchetti 1997). Consequently, the above finding (and perhaps some additional findings also) may be due, in part, to the possibility that some of the items on the AQ may not accurately reflect the ways in which children relate to each other in social or school settings. Gash et al (2000) and Gash (1996) argue that the AQ reflects attitudes in observable ways and has good reliability, and validity, but further work is needed to establish the full range of psychometric properties of the AQ. Nonetheless, the AQ was chosen because it was brief and easy to complete (eg. containing ‘yes’ and ‘no’ answers only) and contained age-appropriate language. No other similar such measure could be identified from the literature.
It was also thought that the number of other children in the family or a child’s place in the family might have a bearing on overall levels of sociability, in particular, and perhaps also attitudes toward other children with Down Syndrome. For example, children in larger families may be generally more tolerant of differences. Again, however, no differences in sociability or inclusion were found with respect to this variable.
The current study was cross-sectional in nature and necessarily constrained by time and resources. The data were gathered from a convenience sample of children attending schools in rural settings. Whilst the sample was of a reasonable size, it is possible that the attitudes of children in larger schools based in cities or towns may differ from those of children in typically smaller rural settings. Again, future research should expand data collection beyond one geographical location (in this case rural areas) and across different settings, thereby enhancing the generalisability of the findings. For example, Nowicki (2005) argues that studies of attitudes similar to the present study might yield different results if conducted in other contexts, such as playgrounds or sports venues.
A larger, longitudinal study would also be more beneficial in assessing any changes in attitude over time (perhaps also using the AQ) across a number of different settings. Only these kinds of studies can add to the current uncertainties surrounding age and attitudes in the research literature. More specifically, as stated by Nowicki (2005), longitudinal designs provide an opportunity to examine the consistency of results across measures and potential interactions between factors that may not be uncovered when potential attitude-related variables are investigated in isolation.
Another limitation of the current study and one that was beyond the researcher’s control (owing to time constraints and restricted access to schools) was the short time period between the video and the second AQ. Ideally, the second AQ should have been administered at a greater length of time after presentation of the video (e.g. two weeks later), but this was not possible in the current study. This may also have led to some degree of response bias in that some children (particularly the older group) may have become aware of the purpose of the video (because it was administered so soon after the first AQ) and perhaps adjusted, or declined to adjust, their responses accordingly. However, there were a number of measures put in place to try to control for this (insofar as possible). For example, the children were instructed to provide their own responses without consulting others or viewing the questionnaires of other participants. Both the class teacher and researcher were also present at all times.
It is also noteworthy that difficulties arise when attempting to compare results across studies because of the variety of measures and designs available. For example, according to Gash (1996), there is considerable uncertainty surrounding whether an improvement in attitudes is due to a change in the feelings about a child with learning disability (LD) or if a child’s view of LD changes depending on the nature of the disability (eg. mild or profound). The image of a profound LD may evoke fear in children with little experience of others with LD. Therefore, if a child’s idea or image of LD changes from profound to mild, the attitude may be expected to improve.
Additional research is required to disentangle the potentially complex interplay of factors that impact on overall attitudes. There is considerable scope, in particular, for conducting qualitative research. For example, a study by Francis and Muthukrishna (2004) used unstructured interviews as a means of investigating and understanding the experiences of primary school children with disabilities in South Africa. This paper raised some interesting issues in relation to growing up with a disability including cultural attitudes toward disabilities and social relationships. Similar research conducted in Ireland could prove valuable.
Gilmore et al (2003) state that accurate knowledge and positive, but realistic, expectations are important for enhancing the acceptance of children with learning disabilities (including Down Syndrome) within their schools and in their communities. Reassuringly, Gash et al (2000) found that Irish children (and their Spanish counterparts) were found to be more favourably disposed toward inclusion than children from either France or Portugal. However, the findings of the current study and other work in this area illustrate, above all, that the attitudes of non-disabled children toward their peers with Down Syndrome and other learning disabilities are complex. Previous inconsistencies and methodological variations in research carried out in this area are common and a need for further research is highlighted.