By V. Armineh Babikian
Upon completing my master’s degree in occupational therapy, I traveled to Armenia, a small post-soviet country in the southern Caucasus, to volunteer to gain pediatric experience. I quickly learned that many areas lacked access to specialized services as there was a lingering disability stigma from the Soviet Union (1), and inclusive education was recently developing. Local staff were looking to me for ways to support children with developmental delays and disabilities.
For eight months, I worked in newly inclusive schools in rural villages, often as the first clinician to provide services for disabled youth. I provided individual therapy sessions, consultations with classroom teachers, and caregiver education to increase opportunities for activity participation alongside peers and families. Participation in meaningful activity, or occupation, is a cornerstone of occupational therapy. I naturally fell into advocating for inclusion as occupational engagement is essential for quality of life and wellbeing (2).
Nevertheless, I met frustrated teachers. One teacher stated, “children with disabilities should be in a separate, special school. Not in my classroom.” I thought this was simply resistance to change and continued working with the majority of teachers who welcomed my suggestions. Five years later, as a first-year Ph.D. student, I am exposed to novel perspectives that have me viewing these experiences in a different light.
After learning about the critical social paradigm, which investigates how interactions in society and power relations shape perceptions (3), I realized I was enforcing a Westernized notion of inclusive education. As an Armenian raised in the United States of America, my construction of inclusion varied from local discourses. There were taken-for-granted notions within my education, clinical training, and professional experiences that promoted Western understandings of inclusion differing from the Armenian culture. The following article will dive into varying discourses around inclusion, perceptions of inclusive education, and implications in Armenia.
What is Inclusion and Inclusive Education?
Inclusion is defined as being integrated into the larger group (3). It is now a common term in international policy. The word ‘inclusive’ is mentioned in the 5/17 United Nations (UN) sustainable development goals (SDGs) (4). Specific to SDG number four, which aims to “ensure inclusive and equitable quality education and promote lifelong learning opportunities for all,” (5) inclusion may refer to the act of including students with disabilities with the general student population (6). However, the concept of inclusive education varies by context (e.g., including refugees or language learners, etc.) (7-9). So, why is the UN promoting inclusive education for all within their SDGs? It reduces disparities in access to education and improves learning outcomes (5).
Benefits of Inclusive Education
For students with special learning needs, inclusive education was found to promote reading, language, literacy, memory, and mathematics skills and decrease behavioral problems (11). Students with disabilities who are included are more likely to continue to post-secondary education, be employed, and live independently as adults (11). Additionally, neurotypical students often feel more supported in inclusive settings as teachers accommodate various learning styles, resulting in improved academic performance in the general classroom (11).
Inclusion also impacts health and wellness, a social determinant of health. Disabled people are prone to social vulnerability with decreased access to education (12-14). Learners in inclusive environments have better long-term health outcomes, quality of life, and access to healthcare services, with trickling effects (e.g., decreased poverty and higher employment rates) (15-16).
Inclusive education also impacts social justice (17). Students in inclusive classes accept differences, leading to decreased discriminatory attitudes, prejudice, and disability stigma (11,18).
“I realized the core issue was my shallow assessment of the context. I took for granted the cultural nuances of being an Armenian in a rural village and how this might differ from my experience as an Armenian raised in an urban metropolitan like New York City.”
Disadvantages of Inclusive Education
However, I would be remiss if I did not also look into the pitfalls of inclusive education. Students with significant special needs may be disruptive to other students and the teacher, which can change the pace of learning for the entire class (19). Educators and parents have concerns that this lowers the quality of education (18). In addition, class sizes tend to be larger, thereby limiting individualization, an essential component for special needs learners (19). Furthermore, inclusive education requires more staff (i.e., funding); this can be especially challenging in developing and remote regions.
Reasons for Resistance
It appears the advantages outnumber the disadvantages. Why is there resistance? Researchers found that teachers are often hesitant to change and do not spontaneously accept inclusive education mandates (20). I experienced this firsthand in Armenia, particularly from older, more conservative teachers. They saw inclusive education as a disruption to their classroom, something psychologists and teacher aides were supposed to handle exclusively, an unnecessary and unrealistic expectation in a low-resource setting, and a general waste of time. How could someone not value the benefits of inclusive education?
One factor might be differing conceptualizations of ‘disability.’ As a qualitative researcher, I cannot ignore concepts’ cultural context and social construction. Seven decades of Soviet influence have had significant social implications in Armenia. Disability stigma was very prevalent throughout the USSR; disabled persons were labelled as ‘invalid,’ institutionalized, hidden from the public, and socially excluded (1, 21). While Armenia has been an independent republic for 30 years, these deficit-oriented discourses still exist among older generations, especially in rural regions with less exposure to diversity (22).
Another reason for resistance might be a limited understanding of disability. In Cameroon, Ivan (23) found that autistic students generated anxiety and confusion among teachers due to social and cognitive differences. General educators usually do not have specialized training to help students with disabilities (24), and low-resource settings may not have access to teachers’ aides or specialized services such as occupational therapy. Armenian educators complained that inclusive education was mandated without supplemental training. “We don’t have enough specialized educators. Our school has one teacher’s aide who floats between classrooms.” To remedy this, I hosted workshops on developmental disabilities and provided classroom accommodations and modifications in my book, as teachers who receive education related to disabilities tend to be more accepting of inclusive education (25).
Why were there still teachers who wanted separate schools for disabled youth? I realized the core issue was my shallow assessment of the context. I took for granted the cultural nuances of being an Armenian in a rural village and how this might differ from my experience as an Armenian raised in an urban metropolitan like New York City. I have very strong ties to my culture; I speak the language and practice the traditions, which was very helpful in building rapport with community members and communicating with staff. However, in line with the critical social paradigm, my Western education and training contributed to different conceptualizations of disability, inclusion, and inclusive education. I was engaging in a North American discourse shaped by the social structures I was exposed to (2). I grew up with schools that provided special education from preschool, were accessible to students with physical differences, and allowed extra testing time or due dates for differing cognitive needs. This was a result of a 1975 US policy now known as the Individuals with Disabilities Education Act (26). I was witnessing 42 years of implementation of inclusive education.
On the other hand, Armenia mandated inclusive education in 2014 (27, 28), just three years before my volunteer experience! Compounded with the Soviet legacy of disability stigma, the sociopolitical context was completely different. Therefore, my Western approach to inclusive education was not the best fit for rural Armenia; I needed a more contextually sensitive model.
Additionally, there was a power dynamic at play. I admittedly went to Armenia assuming that interventions from a more developed [American] context would be best. I valued Western approaches to inclusion over local perspectives. I also realize that my positionality greatly impacted interactions. As an Armenian from America, a graduate of Columbia University, and a specialist in this new, unfamiliar field, often my knowledge was valued over others. Younger teachers viewed me as having more expertise, leading to a positive uptake, while older teachers had years of professional experience that I lacked, contributing to resistance.
Reflecting on this experience, I would organize a team to co-create initiatives. While I did perform a needs assessment and conducted interviews with students, parents, teachers, and staff, I did not involve them in designing my intervention. I needed to center local perspectives by having stakeholders identify goals and co-create workshops. What do they think inclusion should look like in a classroom, school, and community? What barriers and facilitators have they noticed? How do they recommend bridging the generational gap? Answers to these questions would represent community-led development and may yield a more positive uptake.
I would also engage in reflexive practices to recognize the influence of my positionality and acknowledge taken-for-granted notions related to disability and rehabilitation. Having a clearer understanding of my standpoint would “identify forces that might be driving certain interpretations” (29, p.5). Additionally, it is important to interpret the Armenian conceptualization of ‘inclusion’ and ‘inclusive education.’ Through interviews, policy analysis, and review of Armenian educational texts, I would learn how key stakeholders perceive these concepts to develop sustainable context-specific interventions.
Ultimately, I was promoting inclusion without being very inclusive. I will admit that I am incredibly proud of my accomplishments in Armenia – publication of the first disability guidebook for caregivers, hosting workshops for 200+ educators, providing occupational therapy services in seven villages, and exposing rural Armenians to the benefits of rehabilitation. My efforts had a more positive reception than not. However, I have learned that local ways of thinking, being, and doing need to be at the forefront of any project. It is crucial to include beneficiaries in the process and codesign plans through an advisory committee or co-researchers. Especially within global health initiatives, community and patient partnership will ensure a relevant valuable output to service users. Going forward, I will continue to explore co-creation models, be critical of structures that contribute to my construction of reality and have continuous discussions with community stakeholders to prioritize local perspectives.
Featured image by Pixaby (Pexels).
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