14 Jul Inclusive education: It’s time to flip the thinking on educating young people with disabilities
A group of Monash University researchers report that over the past 20 years, there have been monumental shifts in the way we work with young people with disability and their families.
Back in the 1990s, when a child was diagnosed with autism it followed a sad formula:
Diagnosis > label > hand a tissue to sad and confused parents.
After that, there was little support.
And if your child had attention-deficit/hyperactivity disorder, it looked like this:
Disruptive child > query bad parenting > medication.
And again, little support after that.
In 2006, there was a shift, with children and families able to receive mental health care under Medicare’s Better Access plans. By 2013, the National Disability Insurance Scheme – the biggest social reform since Medicare – was rolled out.
In 2020 came Disability Inclusion by the Victorian Department of Education and Training (DET), with a new strengths-based process, tiered funding model, and investment in support roles and capacity building across Victorian schools.
In 2021, the Australia’s Disability Strategy 2021-2031 was released, outlining a vision for a more inclusive and accessible society.
The community voice is getting louder in demanding us to change the way we conduct research and engage with children and their families.
Inclusion is positive mental health
The good news is that barriers for children with disability are slowly coming down. Increasingly, they can participate and feel a sense of belonging in those places that are a part of the natural landscape of childhood such as kindergarten, school, sports and social clubs.
But this isn’t happening fast enough.
Even before the pandemic, autistic children were missing out on vital social experiences – one in five children we surveyed had never been invited to ‘spend time’ with other children, and half had never stayed overnight for a sleepover, camp or holiday.
Now, amid the pandemic, we’ve seen an enormous spike in mental health problems. Parents have realised for the first time their child might have autism, ADHD, or a learning disorder.
If living ‘an ordinary life’ before the pandemic was an everyday struggle for children with disability and their families, the journey back to living an ordinary life is going to be even more challenging now.
Anxiety disorders are by far the most prevalent presentation for autistic children or those with ADHD. Psychological therapy can treat anxiety disorders, and the earlier we treat anxiety, the better the long-term prognosis and ability of the child to participate in everyday life.
Alongside anxiety, the pandemic has put a spotlight on childhood sleep disorders. In the largest-to-date NHMRC-funded treatment study of sleep disorders in children on the autism spectrum, we reported a brief, cost-effective behavioural intervention (two 50-minute face-to-face sessions, plus follow-up phone call) can treat not only sleep problems, but also has the potential to reduce childhood anxiety.
Completed on the eve of the pandemic and recently accepted for publication in the Journal of Child Psychology and Psychiatry, the inclusion of a telehealth component in this treatment study was to foreshadow what would become a ubiquitous platform for delivering healthcare in 2020 and beyond.
We want all children to not just survive, but to thrive.
Services are difficult to access
However, despite major disability, Medicare, NDIS, and educational reforms, it’s almost impossible to access psychological services due to the pandemic.
In response to the increased mental health needs brought about by COVID-19, the federal government announced in late 2021 that psychological telehealth services subsidised by Medicare would be made available for the next four years to increase accessibility to mental health services at this critical time.
Mental health delivered via telehealth was a ‘lifesaver’ for the many children and adolescents who experienced moderate-to-severe mental illness during the Melbourne lockdowns. With digital healthcare platforms here to stay, we need to urgently harness the potential of this pandemic silver lining by working with the underserved disability community to answer some simple but powerful questions:
What works? For whom? Why? And where do we go from here?
This is a moment in time when the African proverb “If you want to go fast, go alone. If you want to go far, go together” has never been more apt.
Community-based interventions show great promise
One of the greatest failings of both research and disability health services is that we commonly work in silos. Medical models of disability are pitched against social models of disability.
This has resulted in a piecemeal approach of bringing the best of research evidence from psychology, education and neurobiology to promote good mental health outcomes in all children.
The relatively new field of community-based intervention can change this. This approach brings together medical and social models of disability support, and opens possibilities for treating mental health issues in children.
These types of interventions show great promise, because at its heart it’s all about creating multiple social conditions with multiple ways and pathways for children to engage, and improve both mental and physical developmental outcomes.
It’s exactly these kinds of programs that the Krongold Clinic will champion in the coming years.
Why we all need to flip our thinking
Education is not only a fundamental human right, it also acts to amplify other rights – this is called a multiplier effect.
Inclusive education must go beyond simply including children with disability in a space, as there’s often an invisible door that stops a true sense of belonging.
This ‘exclusion within inclusion’ also has negative psychological and biological impacts, poor sleep, reduced or excessive eating or exercise.
Good mental health outcomes come from taking a strengths-based approach, and holding the dignity of a child in one hand and their developmental and psychological needs in the other. Coupled with a truly inclusive approach to education, it has a powerful effect on our communities.
It means we can move away from a ‘fix the child’ approach to demanding change from society, to ‘fix’ the environments where we all live, plan and learn.
Put simply, we don’t try to change the child to fit the world; rather, change the world to help all children thrive.
The role of researchers
After all these years, why are we still not satisfied with inclusion, and what needs to change? How do we rise to the challenges?
As researchers, we can change the conversations we have with the communities we serve. We must move from:
“Would you like to collaborate so that we bring our expertise together to create solutions and interventions for you.”
“Hello. Inclusion, education and mental health is a basic human right. Can we join you to wrap our research engine and expertise around your great thinking, programs and initiatives to ensure better outcomes for all children?”
As the old saying goes, if we want a different outcome, we need a different approach. And as researchers, it’s time to change the way we engage with our communities.
Note: This article uses the term “autistic child” or “child on the autism spectrum”, in line with the preferences of many members of the autism and autistic community in Australia.
(See “It defines who I am” or “It’s something I have”: What language do [autistic] Australian adults [on the autism spectrum] prefer?, Journal of Autism and Developmental Disorders, 1-11.)
Nicole Rinehart, Professor and Director, School of Educational Psychology and Counselling; Ana Mantilla, Senior Research Fellow, School of Educational Psychology and Counselling; Nicole Papadopoulos, Senior Research Fellow, School of Educational Psychology and Counselling; Katherine Bussey, Research Fellow, School of Educational Psychology and Counselling; Bethany Devenish, Research Fellow, School of Educational Psychology and Counselling