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46
© 2002 The Down Syndrome Educational Trust. All Rights Reserved. ISSN: 1463-6212
http://www.down-syndrome.net/library/periodicals/dsnu/02/02/
Down Syndrome News and Update 2(2), 46-54
Meeting the educational needs of teenagers
I
n 1987, two of the authors of this
article published information
on the development and lives of a
large and representative group of
90 teenagers with Down syndrome.
[1]
In some ways, the progress of the
teenagers was disappointing – very
few had made any useful progress
at all with reading, writing, number
and money, and social independence
skills such as crossing roads and
travelling alone were very limited.
Most led rather isolated social lives
and only 42% had speech that was
intelligible to those meeting them for
the fi rst time (for example in a shop
or café). The authors commented
that their fi ndings should not be
taken as indicating what teenagers
with Down syndrome could achieve,
but rather, that the fi ndings may be
due to the nature of the curriculum
in special schools, low academic
expectations, being bussed out of
their own communities every day
to school and social attitudes which
did not allow children with Down
syndrome into clubs and activities
in their communities. In 1987 94%
of the teenagers were in schools
for children with severe learning
diffi culties (SLD), 6% in schools
for moderate learning diffi culties
(MLD).
In 1988, as a result of this study
and in line with legislative change
towards inclusion in education in
the UK, the Portsmouth team began
to develop inclusive education in
local mainstream schools for the
children with Down syndrome start-
ing school in the southeast part of
the county of Hampshire. In the
rest of the county most children
with Down syndrome continued to
be placed in special schools. The
Down Syndrome Educational Trust
funded a psychologist to work with
the schools, parents and the Educa-
tion Authority to develop successful
inclusion. This work has provided a
unique opportunity to compare the
outcomes of special versus main-
stream education for two groups
of children with Down syndrome of
similar backgrounds and ability. It
enables us to test out our view that
the teenagers in 1987 were undera-
chieving and socially isolated as a
result of segregated special educa-
tion. Are the teenagers who have
been included in mainstream educa-
tion showing the predicted benefi ts
of going to school with their typi-
cally developing local children?
Specifi cally, we hoped that
included children would be more
likely to have friends in the neigh-
bourhood and better social lives as
teenagers, with better social inde-
pendence skills for getting around
their communities, more friends
and more involvement in clubs and
activities, that their speech, lan-
guage, behaviour and social devel-
opment would benefi t from being
with typically developing peers and
that their academic achievements
would improve. Does the evidence
demonstrate these benefi ts?
In 1999 we repeated the survey
[2]
that we had carried out in 1987
with the current group of teenagers,
including some additional measures.
This enables us to compare the
benefi ts of mainstream and special
education for the 1999 teenagers
and also to ask if, as a group, they are
benefi ting from changes in social
attitudes and better education when
compared to the 1987 teenagers.
Many of the results of the study
were not as the researchers might
have predicted, and the fi ndings
raise some important issues for par-
ents and educators of teenagers with
Down syndrome to consider.
The 1999 study
In 1999, information was collected
for 46 teenagers, 28 in special
schools (24 in SLD and 4 in MLD
schools) and 18 in inclusive schools.
The young people in the two groups
A comparison of mainstream and
special education for teenagers
with Down syndrome: implications
for parents and teachers
Sue Buckley, Gillian Bird, Ben Sacks and Tamsin Archer
(1)
The Down Syndrome Educational Trust
(1)
Now at the National Foundation for Educational Research
Inclusion in mainstream education has been expected to deliver many benefits
– what does the evidence actually show?
47
© 2002 The Down Syndrome Educational Trust. All Rights Reserved. ISSN: 1463-6212
http://www.down-syndrome.net/library/periodicals/dsnu/02/02/
Down Syndrome News and Update 2(2), 46-54
Meeting the educational needs of teenagers
were placed in mainstream or
special schools on the basis of where
they lived; they were from similar
social and family backgrounds and
were likely to be of similar potential
abilities when they started school.
The results we report are unlikely
to exaggerate any advantages of
inclusive education for the following
reasons.
1. When we compared the progress
of the two groups, to ensure that
we were comparing young people
of potentially similar abilities, the
5 ‘least able’ teenagers from the
special schools were taken out of
the comparison group, before the
two groups were compared. These
5 ‘least able’ teenagers are those
with signifi cantly more develop-
mental delay and health problems
than the rest of the group. Two
of them have autism in addition
to Down syndrome and 3 of the
5 have signifi cantly high rates of
diffi cult behaviours. These young
people have had multiple diffi cul-
ties since childhood, and children
with this level of diffi culty would
not have been placed in main-
stream classes in any part of the
county at the time of the study.
2. The average age of the main-
stream group is two years
younger than the average age of
the special school group. This
would reduce the likelihood of
fi nding higher scores on any
measures for the total main-
stream group, as we know from
our 1987 study that the teenag-
ers in all groups are likely to
be progressing with age on the
measures we used.
It is also important to note that
the teenagers in the mainstream
schools have been fully included in
age-appropriate classes in their local
schools, supported by a Learning
Support Assistant for the majority
of the day. They have not been in
special classes or resource rooms
in mainstream schools and, usually,
they have been the only child with
Down syndrome or a similar level
of learning diffi culty in school until
they reached secondary schools.
In secondary school, some have
continued to be the only teenager
with Down syndrome, but some have
been with one or two others with
Down syndrome.
In both 1987 and 1999, the infor-
mation was collected by surveys.
In both studies, parents completed
a questionnaire designed by the
authors, the Sacks & Buckley
Questionnaire (SBQ). In the second
study, additional standardised
questionnaires were also used, the
Vineland Adaptive Behaviour Scale
(VABS)
[3]
and the Conners Rating
Scales (CRS).
[4]
The two main ques-
tionnaires (the SBQ and VABS) both
contain measures of personal inde-
pendence skills – Daily Living Skills
– which include measures of skills in
dressing, toileting, bathing, clean-
ing, laundry and meal preparation,
also time, money, telephone use and
road safety. They also both contain
measures of speech, language and
literacy skills – Communication
Skills, and measures of friendship,
leisure and social skills – Socialisa-
tion Skills. The Vineland Adaptive
Behaviour Scale provides normative
data which allows scores achieved
on the scales to be translated into
age equivalent scores. This is useful
because it allows us to compare the
progress of the teenagers across dif-
ferent aspects of their development.
We would expect progress to be even
for typically developing teenagers,
that is, all skills will be at approxi-
mately the same age-level. Previous
research suggests that we will fi nd
an uneven profi le for teenagers with
Down syndrome, with Communi-
cation skills lagging signifi cantly
behind Daily Living and Socialisa-
tion skills. The age equivalent scores
also allow us to identify the extent of
progress with age during the teenage
years and this is illustrated in the
fi rst set of histograms in Figure 1.
Progress with age
The fi rst two histograms in Figure
1 indicate that Daily Living Skills
and Socialisation Skills can be
expected to improve signifi cantly as
young people with Down syndrome
progress through their teens
(though with the caution that these
fi gures are for different teenagers
in each age group, not the same
teenagers as they get older). When
we look at the third histogram in
Figure 1, for Communication Skills,
we see signifi cant progress for
the oldest group of mainstreamed
teenagers but no signifi cant progress
with age for the teenagers in special
education. These differences in
progress in speech, language and
literacy will be explored in more
detail in the next section.
The fi rst important conclusion we
can draw from this piece of research
is that we can expect signifi cant
progress in all areas of develop-
ment during the teenage years.
There is no evidence for a ‘plateau’
being reached, or even a slowing of
progress.
The reader will also have observed
that there are no signifi cant over-
all differences in the Daily Living
Skills or Socialisation Skills of the
Vineland Total Daily Living Skills
0
20
40
60
80
100
120
140
160
Mainstream Special school
Vineland Total Socialisation Skills
Mainstream Special school
0
20
40
60
80
100
120
140
160
Vineland Total Communication Age Skills
Mainstream Special school
11 years - 13 years 11 months
18 years - 20 years
14 years - 16 years 11 months
11 years - 13 years 11 months
18 years - 20 years
14 years - 16 years 11 months
11 years - 13 years 11 months
18 years - 20 years
14 years - 16 years 11 months
0
20
40
60
80
100
120
140
160
Figure 1. Progress with age for Daily Living Skills, Socialisation
and Communication Skills (group means for Vineland Age
Equivalent Scores – 1999 study)
48
© 2002 The Down Syndrome Educational Trust. All Rights Reserved. ISSN: 1463-6212
http://www.down-syndrome.net/library/periodicals/dsnu/02/02/
Down Syndrome News and Update 2(2), 46-54
Meeting the educational needs of teenagers
teenagers educated in special or
mainstream schools, though there
is a difference on one measure
which contributes to the Socialisa-
tion Skills score - the Interpersonal
Relationships Scale. This difference
may be important and is discussed in
more detail in the next section.
A more detailed look
For each main scale on the VABS
there are 3 subscales which
contribute to that score and the
information for these subscales is
illustrated in Figure 2.
Daily Living
The fi rst histogram illustrates that
for Daily Living Skills the teenagers
were performing at a similar level
in personal and practical skills in
the Domestic (e.g. preparing meals,
cleaning, taking care of laundry),
Personal (e.g. independence in
toileting, bathing, dressing) and
Community (e.g. staying at home
alone, time, money, telephone and
road skills) areas. It also illustrates
that there were no signifi cant
differences in skills between the
teenagers in the mainstream or the
special school groups.
Socialisation
The second histogram, however,
illustrates that for the Socialisation
Skills measure there is a difference
for the Interpersonal Relationships
subscale, which covers social
interaction, dating and friendship
skills. There were no differences on
the Play and Leisure (going to clubs,
games, hobbies, leisure activities)
or on the Coping skills (awareness
of manners, social sensitivity and
social rules) subscales.
On the Interpersonal Relation-
ships subscale, the teenagers edu-
cated in the special schools scored
signifi cantly higher, largely due to
differences in scores for the oldest
age groups. The older teenagers in
special education were more likely
to have a boyfriend or girlfriend, a
special friend and to belong to clubs
than those from mainstream educa-
tion.
This was the only measure of the
many measures used in this research
which showed a signifi cantly better
outcome for teenagers in special
education.
The numbers of teenagers in the
study are quite small - 18 in main-
stream education and 23 in special
education - so that further research
is needed to explore the signifi cance
of this fi nding. However, one possi-
bility is that the teenagers in special
education have had more opportu-
nity to develop mutually supportive,
reciprocal friendships with peers
of similar abilities and interests
than those included in mainstream
schools.
Communication
The third histogram in Figure 2
illustrates the results for the three
subscales in the Communication
Skills score. For the teenagers in
mainstream schools, the results
indicate that their receptive and
expressive language is progressing
at the same rate and that reading
and writing is a specifi c strength
and better than might have been
predicted from their other language
abilities. Their expressive language
is 2 years and 6 months ahead of the
special school group. Some 78% of
the mainstream teenagers are rated
as being intelligible to strangers
compared with 56% in special
schools in 1999 and 42% in 1987. For
the teenagers in special education,
their receptive language is at a
similar level to those in mainstream
school but their expressive language
is more than 2 years behind their
receptive language. Their reading
and writing abilities are at the same
level as their receptive language but
signifi cantly behind the reading and
writing skills of the mainstreamed
teenagers, the difference being more
than 3 years.
It is possible that the improved
expressive language of the teenagers
in mainstream schools is linked to
their reading and writing progress.
Researchers suggest that expres-
sive skills are delayed by hearing,
speech motor diffi culties, auditory
memory and auditory processing
diffi culties.
[5-8]
Therefore, it may be
easier for young people with Down
syndrome to learn vocabulary and
grammar from written language,
than from spoken language. In
addition, phonics work plus reading
practice may improve speech-motor
production skills and speech intel-
ligibility.
The teenagers being educated in
mainstream classrooms, with the
individual help of a Learning Sup-
port Assistant, will have received
daily literacy teaching with their
typically developing peers. They will
also have recorded their learning in
all lessons by writing it down and
reading it - with whatever level of
support was needed to achieve this.
Therefore the level of engagement in
Figure 2. The relationships between the subscales for Daily
Living, Socialisation and Communication skills (group means
for Vineland Age Equivalent Scores – 1999 study)
Daily living skills - subscales
Mainstream Special school
Domestic
Personal
Community
0
20
40
60
80
100
120
Socialisation skills - subscales
Mainstream Special school
Interpersonal
relationships
Social coping skills
Play and leisure time
0
20
40
60
80
100
120
Communication skills - subscales
Mainstream Special school
Reading and writing
0
20
40
60
80
100
120
Receptive
language
Expressive
language
49
© 2002 The Down Syndrome Educational Trust. All Rights Reserved. ISSN: 1463-6212
http://www.down-syndrome.net/library/periodicals/dsnu/02/02/
Down Syndrome News and Update 2(2), 46-54
Meeting the educational needs of teenagers
literacy activities for all the teenag-
ers in the mainstream classrooms
will have been much greater than
that experienced by teenagers in the
special school classrooms.
Overall profiles
In Figure 3 the histograms show
the overall results for the main
developmental areas – Daily Living,
Socialisation and Communication
Skills. For the teenagers in the
mainstream schools there are
no signifi cant differences in the
progress being made in each
of these areas of development.
Communication Skills are good,
largely due to their progress with
expressive language and literacy. For
the teenagers in the special schools,
their Communication Skills are
signifi cantly delayed relative to their
Daily Living and Socialisation skills.
As already noted, this special
school profi le is, in fact, the one that
researchers would expect to see for
teenagers with Down syndrome. A
number of studies have found that
speech and language skills, particu-
larly expressive skills, are specifi cally
delayed relative to both non-verbal
cognitive abilities and to social and
independence skills.
[7,8]
The results of our study suggest
that it is possible to bring communi-
cation abilities in line with social and
practical abilities for teenagers with
Down syndrome, by including them
in mainstream classrooms. The
results indicate that a major factor
may be the development of reading
and writing and the use of literacy
activities to teach and to support
spoken language development.
Another major factor may be that
the mainstreamed teenagers have
been surrounded by typically devel-
oping competent spoken language
users since they entered preschools
at 3 years of age, and this spoken lan-
guage and communication environ-
ment will have been very different
to that experienced by the teenagers
in the special schools. Almost all of
the special school group have been
in special schools for children with
severe learning diffi culties for their
entire school career and this means
that they have been with children
the majority of whom have very sig-
nifi cantly impaired language.
Comparison with out-
comes in 1987
Perhaps the most surprising and
important fi nding of this study
was the lack of progress in special
school education between 1987 and
1999. We confi dently predicted that
all teenagers would be doing better
in the 1999 group as we know that
the special schools have had higher
expectations and more academic
programmes in the past ten years
than they did 15-20 years ago.
However, we found no improvements
in 1999, when compared with 1987,
for spoken language skills, reading,
general knowledge and overall
school achievement – achievements
were the same as in 1987. There were
small gains in writing and number.
It is important to remind the
reader that the children in the spe-
cial schools were not less able than
the earlier cohort. At the time that
these children entered school there
was very little mainstreaming where
they lived and our data confi rms this
point, as in many areas of develop-
ment their skills are the same as
both the 1987 group and the 1999
mainstream group.
Our fi ndings suggest that it is not
possible to provide optimal learning
environments in special schools and
classrooms, however hard the teach-
ers work. It suggests that learning
within a typically developing peer
group may be essential for optimal
progress for two main reasons:
1. the typical spoken language of the
peer group because this provides
a stimulating language learning
environment
2. the classroom learning envi-
ronment and curriculum – the
pace of learning has been much
greater for those in mainstream
because they have been in all
academic lessons with individual
support for their learning.
We can use the example of literacy
to explore this further, the included
teenager has had daily literacy
lessons with his or her typically
developing peers. The classroom
curriculum is set for the mainstream
children and their learning provides
role models for literacy for the
student with Down syndrome. He
or she will be working with support
within the class on individually set
targets for literacy. A literacy lesson
in a special school classroom will, of
necessity, be very different. In the
special school, the teacher will have
perhaps 6 pupils, all with signifi cant
learning diffi culties, and will design
a literacy activity for
this group – 2 of whom
may be autistic, two
with severe behaviour
diffi culties and 2
with Down syndrome
– all have signifi cantly
delayed speech and
language and only
three are able to write their names.
Sharing a story together may be
an appropriate literacy activity for
this group of children, rather than
formal literacy instruction. The aim
of this example is not to criticise
special schools – it is to try and give a
real picture of the different demands
and resources of the two situations
and to try to explain our fi ndings.
The same comparison
would apply to
numeracy lessons in
mainstream or special
classrooms.
There were no gains
between 1987 and
1999 in Daily Living
Skills for teenagers in
mainstream or special
education and sig-
nifi cant gains in Social Contacts and
Leisure activities for both groups.
We suggest that Daily Living Skills
are mostly learned at home and
therefore not infl uenced by school
placement and, similarly, that the
improvement in social inclusion
refl ects a general change in social
attitudes and social acceptance in
Figure 3. The relationship between the three aspects of
development, Daily Living, Communication and Socialisation
(group means for Vineland Age Equivalent Scores – 1999 study)
Mainstream Special school
Daily living
Socialisation
Communication
0
20
40
60
80
100
Vineland Age Equivalent Scores
Perhaps the most
surprising and important
finding of this study was
the lack of progress in
special school education
between 1987 and 1999.
Our findings suggest
that it is not possible to
provide optimal learning
environments in special
schools and classrooms,
however hard the
teachers work.
50
© 2002 The Down Syndrome Educational Trust. All Rights Reserved. ISSN: 1463-6212
http://www.down-syndrome.net/library/periodicals/dsnu/02/02/
Down Syndrome News and Update 2(2), 46-54
Meeting the educational needs of teenagers
the community rather than school
placement effects. Social lives out
of school are also more likely to be
infl uenced by families than schools.
Personality and behaviour
Another major area of developmental
importance that was looked at in
these Hampshire teenage studies
was the extent of behaviour
diffi culties, whether any behaviour
diffi culties change with age and if
school placement has any infl uence
on behaviour.
We were aware from our inclusion
support work that diffi cult or disrup-
tive behaviour is a major cause for
the breakdown of mainstream school
placements. We were also concerned
to fi nd out if the demands of coping
in a mainstream classroom actually
increased behaviour diffi culties.
Signifi cantly diffi cult behaviour
affects the learning and social
opportunities of a teenager with
Down syndrome and can create con-
siderable stress for teachers and for
families. Conversely, teenagers who
can behave in a socially acceptable
and competent manner will be more
likely to have friends, to have active
social lives and to be successful in
work as adults, than those who do
not.
Diffi cult behaviours need to be
considered in relation to the helpful
and socially sensitive behaviour and
the positive personalities that are
characteristic of most teenagers with
Down syndrome. Many references to
the positive aspects of teenagers
personalities were made by parents
during the recent Hampshire survey,
for example:-
“J. is a happy and content girl,
very understanding, helpful and has
a great personality - she brings out
the best in everyone.”
“He is happy and outgoing and
lots of people know him so we talk to
more people because of him.”
“She is a wonderful, happy and
most loved member of our family.
She is kind, caring, happy and
thoughtful.”
“A. has a positive approach to life
and brings that to the family. His
caring nature and enthusiasm are
infectious. I think he has made the
family dynamics easier than they
would have been, especially the
teenage years.”
“She is good company, always
happy, funny and content.”
“Good point is, he is a happy lad
who is good fun and has taught us
a lot.”
“Very loving, trusting and happy
boy - enjoys life and is very socia-
ble.”
“Our daughter brings more love,
fun and laughter to family life and
though she will never be ‘academic’
there are other qualities she has
which cannot be measured.”
“He is popular, friendly and
non-judgemental… he has added
another dimension to our lives.”
“Brings a lot of happiness to our
lives. Her disruptiveness – being
rude or awkward – can cause par-
ents and sister to get cross and
upset.”
The last quote highlights the fact
that diffi cult behaviours occur only
sometimes and do not defi ne the
person’s character. Someone with a
positive personality can be diffi cult
at times and this would characterise
most of the teenagers in the survey.
However, this does not mean the dif-
fi cult behaviours are not distressing
when t hey do occur and most parents
and teachers are pleased to obtain
advice on how to handle them.
Several measures were used to
collect information about any behav-
iour diffi culties that the teenagers
had. There were behaviour questions
on the original Sacks and Buckley
Questionnaire
[1]
and a Maladaptive
Behaviour Scale on the Vineland
Adaptive Behaviour Scales.
[3]
In
addition, the Conners Behaviour
Rating Scale
[4]
provides measures
of several different aspects of behav-
ioural diffi culties, hyperactivity,
cognitive problems or inattention,
oppositional behaviour and Atten-
tion Defi cit/Hyperactivity Disorder-
ADHD.
All the measures illustrated that
diffi cult behaviours tend to improve
with age for most individuals, with
only one teenager over 18 years in
the mainstream schools comparison
group having even a moderate level
of diffi culties. This strongly sug-
gests that many of the behaviours
reported for the younger teenagers
may be linked to general cognitive
delays and immaturity.
Our concerns about the demands
of mainstream placements increas-
ing behaviour diffi culties were not
confi rmed. There was only one
measure on which the teenagers
from the different school systems
scored signifi cantly differently – The
VABS Maladaptive Behaviour Scale
– and these results are illustrated in
Figure 4. The scores can be classifi ed
in terms of the severity of the behav-
iour diffi culties. As the data below
shows, signifi cant behaviour dif-
fi culties only affect a minority. The
teenagers in the mainstream schools
were less likely to have diffi culties,
with 63% having no signifi cant dif-
fi culties compared with 41% in the
special schools, 25% having a mod-
erate level of diffi culties compared
with 27% in the special schools and
12% (one in eight) having signifi -
cant behaviour diffi culties compared
with 32% (one in three) in special
schools.
The reader is reminded that the 5
‘least able’ teenagers in the special
schools are not included in this com-
parison. Three of these 5 had very
high scores for diffi cult behaviours
and the remaining 2 had low scores.
This means that in the whole
sample of teenagers, and the whole
sample is representative of the
full range of teenagers with Down
Mainstream Special school
Insignificant
Significant
Moderate
0
10
20
30
40
50
60
70
80
Vineland maladaptive score (%)
Figure 4. The significance of reported behaviour difficulties
(percentage of teenagers in each category)
51
© 2002 The Down Syndrome Educational Trust. All Rights Reserved. ISSN: 1463-6212
http://www.down-syndrome.net/library/periodicals/dsnu/02/02/
Down Syndrome News and Update 2(2), 46-54
Meeting the educational needs of teenagers
syndrome, 26% (one in four) have
some signifi cant behaviour diffi cul-
ties which will be probably causing
problems at home and at school on
a daily basis.
The Vineland Maladaptive Behav-
iour Scale predominantly includes
questions about two main types of
behaviour, those that may refl ect
anxiety and nervousness and those
that refl ect conduct disorder and
poor attention.
On the Conners Behaviour
measures, which focus on conduct
disorders and attention diffi culties,
there were no signifi cant differences
between the levels of diffi culties for
the teenagers in mainstream or spe-
cial schools. When the scores of the
teenagers with Down syndrome are
compared with norms for typically
developing teenagers, the propor-
tion of the total group who had
serious diffi culties was 16% on each
of the Oppositional Behaviour, the
Cognitive problems/inattention and
the ADHD measure and 37% on the
Hyperactivity measure. (The reader
should note that some 5% of the
typically developing population of
teenagers of the same age will score
in the serious diffi culties range as
defi ned by the Conners Scales).
The hyperactivity measures
include, being always ‘on the go’,
hard to control while shopping,
runs about or climbs excessively in
situations where it is inappropri-
ate, restless in the squirmy sense,
has diffi culty waiting in line or
taking turns, has diffi culty playing
or engaging in leisure activities
quietly. The high score here may
refl ect immaturity and improve with
age, as similar fi ndings have been
reported by other researchers and
interpreted in this way.
[9,10]
The link between behaviour
and poor communication
skills
Similar to other studies, and the
authors’ 1987 study, there was a
signifi cant relationship between
expressive communication skills
and behaviour diffi culties – the
more limited a teenager’s expressive
language ability, the more likely he or
she is to have behaviour diffi culties.
The implication here is that at least
some diffi cult behaviours are the
teenager’s way of communicating
when he/she does not have the
language to do so. In addition, some
behaviours may be the result of the
frustration that arises when an
individual is not understood.
Has inclusion achieved
what we hoped for?
We stated at the beginning of the
article that we hoped that included
children would be more likely to have
friends in the neighbourhood and
better social lives as teenagers, with
better social independence skills for
getting around their communities,
more friends and more involvement
in clubs and activities, that their
speech, language, behaviour and
social development would benefi t
from being with typically developing
peers and that their academic
achievements would improve,
when compared with the teenagers
receiving special education in
segregated schools. Does the
evidence demonstrate these
benefi ts? The answer is “yes” for
spoken language, behaviour, social
development and academic benefi ts
and “no” for the social inclusion
benefi ts.
The language and academic ben-
efi ts were greater than we expected.
The big gains for the included teen-
agers were for expressive language,
literacy and, to a lesser degree,
numeracy and general academic
attainments. The average gain for
expressive language was 2 years and
6 months and for literacy, 3 years
and 4 months. These age-related
scores are based on
norms for typically
developing children
who are expected to
progress 12 months
on the measures in
a school year. Chil-
dren with Down
syndrome usually
progress about 4-5
months on these
measures in a year
– they are making progress but at
a slower rate than typical children.
Therefore, considered in relation
to expected gains, the teenagers in
mainstream school have gained the
equivalent of 5-6 years progress in
spoken language and literacy when
compared to the teenagers educated
in special classrooms.
There were some gains in social
development and behaviour. The
teenagers in mainstream schools
were more socially mature, with
more age-appropriate social behav-
iour and more social confi dence.
However, the social inclusion gains
were not as great as we expected.
On the standardised measures
there were no gains for the included
teenagers and the suggestion of a
disadvantage. There were no signifi -
cant differences in social independ-
Does the evidence
demonstrate these
benefits? The answer
is “yes” for spoken
language, behaviour, social
development and academic
benefits and “no” for the
social inclusion benefits.
52
© 2002 The Down Syndrome Educational Trust. All Rights Reserved. ISSN: 1463-6212
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Down Syndrome News and Update 2(2), 46-54
Meeting the educational needs of teenagers
ence skills, social contacts, leisure
activities and community inclusion.
Parents were as concerned about the
social isolation of their teenagers as
they had been in 1987, even though
there was evidence of some improve-
ments for everyone since that time.
The benefi ts of having daily con-
tact with typically developing chil-
dren and teenagers in the local area,
during the school day, did not result
in more inclusion and friendships
during the teenage years. In addi-
tion, the included teenagers seemed
to be less likely to have special
friends, boyfriends or girlfriends and
a social life of their own in their late
teens, perhaps as the result of having
less contact with peers with similar
intellectual disabilities or peers with
Down syndrome in school.
What are the
implications for parents
and for teachers?
1. That all children with Down
syndrome should be educated
within mainstream classrooms
to ensure that they are able to
develop their speech and lan-
guage to the level that is optimal
for each child.
The importance of speech
and language development for
cognitive and social develop-
ment cannot be over empha-
sised. Words and sentences are
the building blocks for mental
development – we think, reason
and remember using spoken
language, either silently ‘in our
minds’ or aloud to others. Words
provide the main source of knowl-
edge about our world.
Any child with speech and
language delay will have mental
delay (unless a signing baby in
a deaf signing family, when sign
will be as good as speech for
mental development). In addition,
speech and language skills infl u-
ence all aspects of social and emo-
tional development – the ability
to negotiate the social world and
to make friends, share worries
and experiences and be part of the
family and community.
2. That all children with Down
syndrome should be educated in
mainstream classroom to learn
alongside their peers and to
access the academic curriculum
adapted to their individual rate of
progress.
Full inclusion in the curriculum
leads to much better literacy and
numeracy skills, and general
knowledge. The level of supported
literacy experience across the cur-
riculum also provides an impor-
tant support for spoken language
development.
3. Our research indicates that it is
not possible to provide a maxi-
mally effective learning envi-
ronment in a special education
classroom.
Children with Down syndrome
need to learn with their non-
disabled peers with the necessary
individual support to make this
successful.
4. The social aspects of inclusion
need to be addressed.
Children with Down syndrome in
mainstream schools need more
opportunities to socialise with a
peer group of children with simi-
lar levels of intellectual disability.
This can be achieved by closing
special schools and classes and
including all children with learn-
ing disabilities in mainstream
school communities – at present
many children who would provide
this peer group in the UK are still
in special schools. The children
with Down syndrome have had a
parent lobby and more of them
are fully included than their peers
with similar levels of intellectual
disability. It can also be achieved
out of school, by ensuring that
children with Down syndrome
have friends with similar disabili-
ties out of school.
5. Friendships with non-disabled
peers need more support within
school communities.
Teachers and parents need to do
more to ensure that these friend-
ships carry on outside school. We
wish to see an improvement in
understanding and support for
teenagers and adults with Down
syndrome in their homes, work-
places, shops and leisure activities
as a result of inclusion. This is
not yet happening and needs to be
addressed within schools.
These are statements supported
by the evidence, and the evidence
of earlier reviews of the benefi ts of
inclusion.
[11]
No study has provided
evidence for any educational
advantages of special education, only
disadvantages, and the practical daily
living and social skills are as good or
better in mainstream education. The
only benefi t seems to be contact with
a peer group of similar disability
– and, considering the signifi cant
disadvantages of special education,
that need is better met out of school,
and in better planned inclusion.
Our conclusions are uncompro-
mising and if we are to achieve the
full benefi ts of inclusive education
for all our children we need to
implement effective support and
training programmes. We may also
need some variety of provision.
Most children with Down syndrome
will benefi t from the full classroom
inclusion that we describe, sup-
53
© 2002 The Down Syndrome Educational Trust. All Rights Reserved. ISSN: 1463-6212
http://www.down-syndrome.net/library/periodicals/dsnu/02/02/
Down Syndrome News and Update 2(2), 46-54
Meeting the educational needs of teenagers
ported by a learning support team.
In many schools, a learning resource
area which provides for small group
work is needed for some children and
can provide a place to meet the peer
group with similar levels of intellec-
tual disability.
If we include all children with
Down s yndrome and a ll ch ild ren wit h
intellectual disabilities, then some
children may benefi t from being
in a resourced school. For those
children with the greatest levels of
disabilities, planning and providing
for them may be best done within
a specifi cally resourced school. This
does not mean being educated in a
special class or resource room – it
means that we concentrate skills and
human resources in some schools to
develop the necessary expertise for
successful inclusion of those with
the greatest needs. It also means
that the children have access to a
similar ability peer group as well as
benefi ting from being included in
the mainstream community.
There can be no single prescrip-
tion for successful inclusion as the
school systems in different countries
and communities vary widely. The
way to move towards full inclusion
may be different in different com-
munities and, importantly, different
models may work equally well if the
attitudes of the school community
towards inclusion are positive and
the aim is to seek the full inclu-
sion of the child into the social and
educational world of the school,
while also meeting his or her learn-
ing and developmental needs.
Postscript
Some critics of our work have
suggested that inclusion in
Hampshire is ‘special’ and only
successful because the Trust staff
support the schools. In fact, from
1988, the teachers and the Trust’s
psychologists learned together year
by year. It was the teachers in the
schools who showed us how to make
inclusion successful. We did not visit
more than once a term on average,
unless asked to help with a problem.
We did not start workshops on
inclusion for teachers until 1993 and
they were based on sharing what we
were learning from the teachers. The
children in the study differ widely in
ability, behaviour, social needs and
family backgrounds. The children
studied have been spread through
some 25 primary schools (infant
and junior) and some 12 secondary
schools, in inner city, urban and
rural areas – these schools are likely
to be representative of schools across
the UK.
For the past 9 years, we have
been running training for inclusion
throughout the UK and across the
world and we see many, many exam-
ples of similarly successful inclusion
everywhere. Our schools experienced
problems at times, like all schools
developing inclusion, but the posi-
tive staff attitudes towards inclusion
and the support of the Education
Authority meant that problems were
solved – not seen as a reason to move
a child to a special school. At transi-
tion points from infant to junior to
secondary it was assumed that the
children would stay in the main-
stream system and everyone planned
accordingly. On the basis of parental
choice two teenagers moved to MLD
provision for secondary education
and two moved to mainstream from
MLD at this point!
It may be important to note that
these teenagers were included before
the introduction of IEPs (Individual
Education Plans) or SENCOs (Spe-
cial Educational Needs Co-ordina-
tors) into UK schools. Schools are
much better resourced to succeed
now – though we do need to be sure
that too much planning and special
needs expertise does not result in
lowered expectations.
54
© 2002 The Down Syndrome Educational Trust. All Rights Reserved. ISSN: 1463-6212
http://www.down-syndrome.net/library/periodicals/dsnu/02/02/
Down Syndrome News and Update 2(2), 46-54
Meeting the educational needs of teenagers
An overview of the development of teenagers with Down syndrome (11-16
years). By Sue Buckley and Ben Sacks (2002). Portsmouth, UK: The
Down Syndrome Educational Trust. ISBN: 1-903806-04-6
Speech and language development for teenagers with Down syndrome (11-
16 years). By Sue Buckley and Gillian Bird (2002). Portsmouth, UK: The
Down Syndrome Educational Trust. ISBN: 1-903806-07-0
Reading and writing development for teenagers with Down syndrome (11-16
years). By Gillian Bird and Sue Buckley (2002). Portsmouth, UK: The
Down Syndrome Educational Trust. ISBN: 1-903806-12-7
Number skills development for teenagers with Down syndrome (11-16
years). By Gillian Bird and Sue Buckley (2000). Portsmouth, UK: The
Down Syndrome Educational Trust. ISBN: 1-903806-16-X
Social development for teenagers with Down syndrome (11-16 years). By
Gillian Bird, Ben Sacks and Sue Buckley (in press). Portsmouth, UK: The
Down Syndrome Educational Trust. ISBN: 1-903806-24-0
Count us in – Growing up with Down syndrome. By Jason Kingsley and
Mitchell Levitz. (1994). Harcourt Brace & Company. ISBN: 0-15-
622660-X
Adolescents with Down syndrome: Toward a more fulfilling life. By Siegfried
Pueschel & Marie Sustrova (1997). Paul H. Brookes. ISBN: 1-55766-
281-9
The adolescent with Down syndrome – Life for the teenager and for the
family. By Sue Buckley and Ben Sacks (1987). Portsmouth, UK: The
Down Syndrome Educational Trust. ISBN: 0-900234-19-9
Teenage resources
The following items are available from The Down Syndrome Educational Trust’s Resources brochure:
We asked teachers to fully include
the children in the class activities
and told them we would help them
to adapt once it was necessary. The
children tended to surprise us all
and fewer adaptations were needed
in infant school than we had antici-
pated. There is the danger that an
IEP could reduce expectations,
depending on who writes it and their
experience of working with children
with Down syndrome in mainstream
education. The children in this study
also had no signing in their class-
rooms and, at fi rst, no speech and
language therapy service. They had
to cope and make themselves under-
stood in a spoken language environ-
ment and we encouraged teachers
to use reading activities to develop
their spoken language. We have no
way of knowing how much this con-
tributed to their signifi cant speech
and language gains, but we are very
cautious about the current wide-
spread use of symbols and signing in
primary school years – for some chil-
dren it is necessary and appropriate
but not for all just because they have
Down syndrome.
You might sum up our approach
as focusing on children fi rst – seeing
children with Down syndrome as full
members of the class and community
and playing down differences. They
do have special needs and teachers
need to know how to address these
but we still need to change public
and professional attitudes so that
they really do treat our children as
children fi rst. When we achieve this,
we will really see the full benefi ts of
inclusion.
References
1. Buckley, S. & Sacks, B. (1987) The
Adolescent with Down Syndrome:
Life for the Teenager and for the
Family. Portsmouth, UK: Port-
smouth Polytechnic.
2. Buckley, S.J., Bird, G., Sacks, B. &
Archer, T. (in press). A comparison
of mainstream and special school
education for teenagers with Down
syndrome: effects on social and aca-
demic development. Down Syndrome
Research and Practice, 8.
3. Sparrow, S.S., Balla, D.A. & Cic-
chetti, D.V. (1984). Vineland Adaptive
Behaviour Scale. Minnesota, USA:
American Guidance Service.
4. Conners, C.K. (1997). Conners
Rating Scales-Revised. Toronto,
Canada: Multi-Health Systems Inc.
5. Chapman, R.S. (1997). Language
development. In S.M. Pueschel &
M. Sustrova, (Eds.) Adolescents
with Down Syndrome: Towards a
More Fulfi lling Life (pp. 99-110).
Baltimore, USA: Paul H. Brookes
Publishing.
6. Gunn, P. & Crombie, M. (1996).
Language and speech. In B. Stratford
& P. Gunn, (Eds.) New Approaches
to Down Syndrome (pp. 249-267).
London, UK: Cassell.
7. Fowler, A. (1999). The challenge of
linguistic mastery. In T.J. Hassold
& D. Patterson, (Eds.) (1999) Down
Syndrome: A Promising Future
Ttogether (pp. 165-184) . New York,
USA: Wiley-Liss.
8. Chapman, R.S. (2001). Language,
cognition, and short-term memory
in individuals with Down syndrome.
Down Syndrome Research and Prac-
tice, 7 (1), 1-7.
9. Cuskelly, M. & Gunn, P. (1997).
Behaviour concerns. In Pueschel,
S.M. & Sustrova, M. (Eds.) Adoles-
cents with Down Syndrome: Towards
a More Fulfi lling Life (pp 111-128) .
Baltimore, USA: Paul H. Brookes
Publishing.
10. Stores, R., Stores, G., Fellows, B. &
Buckley, S. (1998). Daytime behav-
iour problems and maternal stress in
children with Down syndrome, their
siblings, and non-intellectually disa-
bled and other intellectually disabled
peers. Journal of Intellectual Dis-
ability Research. 42 (3) 228-237.
11. Cunningham, C. C., Glenn, S.,
Lorenz, S., Cuckle, P. & Shep-
perdson, B. (1998). Trends and
outcomes in educational placements
for children with Down syndrome.
European Journal of Special Needs
Education, 13(3), 225-237.
