Perceptions of Parents of Young Children with and without Disabilities Attending Inclusive Preschool Programs

This study aimed to identify the characteristics of parents of children with and without disabilities whose young children attend an inclusive, early childhood education program that influence their perceptions of inclusion and inclusive preschool programs. Participants included parents of preschool children without disabilities (n=64) and parents of preschool children with disabilities (n=84) attending inclusive preschool programs. Participants completed a 120-question survey examining parental characteristics and the impact they have on parent perceptions regarding inclusion and inclusive preschool programs. In addition, child variables (disability status, type of disability, severity of the disability and disability category) were examined to determine their significance regarding parental perception. Analysis revealed that parents of children with disabilities were less likely to favor an inclusive program that served children with severe disabilities, such as autism and behaviour disorders.


Introduction
Inclusive early childhood education programming is advocated as a best practice from the experts in early childhood education and early childhood special education fields (NAEYC-DEC, 2009).However, many public schools do not offer preschool programs for children without disabilities (Lieber, Hanson, Beckman, Odom, Sandall, Schwartz et al., 2000).Local education agencies (LEAs) are not required to operate preschool programs to meet the Individuals with Disabilities in Education Act (IDEA)'s least restrictive environment (LRE) requirements, but the LEA must explore other local options (Education Law Center, 2010).Guralnick (2001) explained that community-based early childhood programs vary in program quality and that high-quality programs can be difficult for parents to locate (Bailey, McWilliam, Buysse, & Wesley, 1998).Head Start is mandated by federal law to have 10% of its population include children that have an Individual Family Support Plan (IFSP) or an Individual Education Plan (IEP).Programs that are available in Head Start, private preschools or targeted preschool programs have long waiting lists, limiting the number of children with disabilities they serve and the programs themselves can vary tremendously in the quality and the extent of their inclusion (Rafferty, Boettcher, & Griffin, 2001;Hurley & Horn, 2010).Federal data show that the majority of preschool children with disabilities are placed in segregated special education classrooms; only 33% of children with disabilities were educated in typical early childhood settings (U.S.Department of Education, 2005).
Characteristics of an inclusive classroom can vary considerably in the areas of the number of students with disabilities in the class, their disability types and severity, and the characteristics of the personnel in the classroom (Gandhi, 2007).Because different educational programs had inconsistent definitions for inclusion and because programs varied in the educational structure and how they provided services, Odom (2000) explained that it would be very complex to actually label programs into specific types.Bailey, McWilliam, Buysse and Wesley (1998) described inclusion as, "...the full participation by children with disabilities in programs and activities for typically developing children."Odom et al. (1996) explain that this definitional ambiguity "has important implications for researchers, in that findings on inclusion may be generated from vastly different program types and contexts" (Odom et al., 1996).While researcher, administrators and practitioners may not be able to define inclusion in strict terms with a specific definition (Schwartz, Sandall, Odom, Horn, & Beckman, 2002), individual characteristics of inclusive programs/schools in research are necessary to study key elements for community, program and child success.
Participation in early childhood education programs is voluntary; therefore, inclusive programs are dependent on parents for the diversity and sustainability of their programs.Parents of preschoolers must not only choose to participate in an early childhood program, but they must choose for their child to participate in an inclusive program (Stoneman, 2001).Understanding the perceptions of parents whose children attend inclusive programs is vital for the ultimate success of the inclusion philosophy (Erwin, Soodak, Winton & Turnbull, 2001;Garrick-Duhaney, & Salend, 2000).Generally, parents of preschool children with and without disabilities have positive perceptions concerning inclusion (Miller & Strain, 1992;Bennett, Deluca, & Bruns, 1997;Rafferty & Griffin, 2005).Parents sited an increased awareness and acceptance of children with disabilities, teacher-child ratios and extra services as positive components of the inclusive educational setting (Bailey & Winton, 1987;Guralnick, 1994).However, parents of children with and without disabilities may have concerns regarding the risks associated with their child attending an inclusive program including the integration of children with more severe disabilities (Green & Stoneman, 1989;Serry, Davis, & Johnson, 2000;Garrick & Salend, 2000;Peck, Staub, Gallucci, & Schwartz, 2004, Hewitt-Taylor, 2009).The perception of parents regarding inclusion and the impact it has on their child is vital to comprehending the overall benefits and drawbacks to the inclusion experience.
The purpose of this study is to identify parental and child characteristics that impact the perceptions of parents of children with and without disabilities attending inclusive preschool programs.By understanding the perspectives of these families, policy makers and professionals can help to implement policies that increase program participation, increase parent satisfaction, decrease parental stress and meet the needs of families while maintaining appropriate intervention and education methods.This study also clearly defines the individual characteristics of the inclusive programs included in this study secondary to the inconsistency of the definition of inclusive programming in the literature.

Participants
Participants were 149 parents of children with (n=84) and without (n=65) disabilities ages 6 months to 6 years who attended one of seven inclusive preschool programs in Alabama (1 program), Colorado (1 program), Oklahoma (1 program) and Texas (4 programs).All of the preschool programs in the study relied on parent tuition, private donations and fundraising; although Alabama and Oklahoma had partial funding from state agency contracts (Alabama-Part B, section 619; Oklahoma-State Legislature).
In these programs, children attend the preschool five days a week for six hours a day.Children with disabilities comprise approximately 60% of classes while 40% of the preschool children do not have disabilities.Each classroom has a lead teacher with a completed Master's degree in education, early childhood education or special education or they must be working toward their Master's degree.In addition, each classroom has two teacher assistants.Classrooms have an average of ten to twelve children, depending on the age of the classroom.The programs in the study did not use any commercially-packaged curriculum.Each program implements a unique curriculum, based on early childhood education philosophies (constructivism) which are blended with recommended practices from early childhood special education (DEC).The curriculum emphases each child's development in the areas of gross and fine motor skills, independence, cognitive skills, social competence and emotional growth and communication; this results in specially designed instruction, curricular adaptations and accommodations that are embedded in the daily activities of the classroom.
Integrated therapy services (Music Therapy, Occupational Therapy, Physical Therapy and Speech-Language Therapy) were available within the classroom as part of their preschool program for any child identified with developmental delays.Services were designed around an individualized intervention plan (IFSP/IEP or program plan, depending on the individual child's needs and age) consisting of goals and outcomes based on family's concerns and the child's strengths and needs.Two of the schools (Alabama & Dallas) employ a nurse full-time, while the remaining programs have consultant relationships with medical personnel to meet the medical needs of the children attending the program.
Eighty-four participants were parents of children with a disability, as determined by IFSP/IEP review and/or physician diagnosis.Thirty percent of participants were parents of children with a mild disability, 58% were parents of children with moderate disabilities and 12% were parents of children with severe disabilities.Down syndrome was the primary disability type reported by parents (n=52).Other Disability (includes genetic syndromes, global developmental delays and other disabilities not specified) (n=15), Cerebral Palsy (n=7), Autism (n=4), speech impairment (n=3), spinal bifida (n=1) and hearing impairment (n=1) were also reported.
Eighty-four percent of participants identified their ethnicity as being Caucasian, 9% Black/African American, 4% Asian American, 4% Hispanic/Latino and 1% Native American.Eighty nine percent (n=132) of parents participants were female while nine percent were male (n=13).Sixty-seven percent of participants report an income of greater than $75,001 per year and seventy-two percent of participants had earned at least an associate's degree.

Procedure
A 120-question survey was distributed to all families of children with and without disabilities at all seven participating program sites (N=289).Each envelope contained the survey and an Institutional Review Board (IRB) information sheet.Envelopes were distributed by the director of each site to each family.Completed surveys were returned to the director in a sealed manila envelope and mailed back to the researcher.A total of 149 surveys were completed and returned.Participations rates at each individual site varied from 26-75%, with a 52% overall return rate.The overall participation rate was negatively impacted by summer vacation at some sites.

Instrumentation
Participants completed a Likert-type survey slightly modified from a questionnaire developed by Rafferty, Boettcher and Griffin and used in subsequent studies in 2001 and 2005 (Rafferty, Boettcher & Griffin, 2001;Rafferty & Griffin, 2005).Modifications were limited only to semantics to reflect current terminology in the education field (inclusion/integration replaced mainstreaming).The survey consisted of six sections: 1) demographic information of the participant (4 questions); 2) demographic information of the child (6 questions); 3) the 27-item Parental Attitudes Toward Inclusion/Integration Scale; 4) the 4-item Impact of Inclusion on Typically Developing Children Scale (IITDC); 5) the 6-item Impact of Inclusion on Children with Disabilities Scale (IICD) and 6) 73-questions concerning program expectations and quality.The Impact of Inclusion on Typically Developing Children Scale (IITDC) and the Impact of Inclusion on Children with Disabilities Scale (IICD) were developed "to assess the perceived benefits and risks of inclusion for children with disabilities and typically developing children" (Rafferty, Boettcher, & Griffin, 2001).The IITDC and IICD scales were based on items from the Parental Attitudes toward Mainstreaming Scale (Green & Stoneman, 1989) and the Benefits and Drawbacks of Mainstreaming Scale (Bailey & Winton, 1987).The Parents Attitudes toward Inclusion/Integration, 13-questions scale was created by Rafferty, Boettcher and Griffin (2001) and based on items from the Attitudes about Integration Opportunities for Children with Special Needs by Miller, Strain, Boyd, Hunsicker, McKinley and Wu (1992).
According to Rafferty, Boettcher and Griffin (2001), the scales have high internal consistency.The Cronbach's alpha coefficients for each scale were reported as follows: Benefits for Children with Disabilities (alpha = .90),Risks for Children with Disabilities (alpha =.87), Benefits for Typically Developing Children (alpha = .83),and Risks for Typically Developing Children (alpha = .88)and Parents' Attitudes toward Inclusion/Integration (alpha = .94).Rafferty and Griffin (2005) also reported Cronbach's alpha coefficients with high internal consistency.Perceived Benefits for Children with Disabilities (alpha = .87),Perceived Risks for Children with Disabilities (alpha = .86),Perceived Risks for Typically Developing Children (alpha = .79)and Parents' Attitudes toward Inclusion/Integration scale yield a Cronbach alpha coefficient of .93.

Results
Parents in both groups agree with statements that inclusion is beneficial for children with disabilities which is consistent to the findings of Rafferty and Griffin (2005).The groups also indicate that they disagree that inclusion would have a negative impact on children with disabilities.Parents believe that inclusive settings help children with disabilities become prepared for the real world, develop independence and learn from typically developing peers, similar to the research findings of Guralnick (1994).As with previous research by Seery, Davis and Johnson (2000) and Guralnick (1994), sixty-three percent of parents of children with a disability did respond that they believe that in inclusive classrooms, teachers are not likely to be qualified or trained to deal with the needs of children with disabilities and fifty-one percent agree that children without disabilities might be frightened by the strange behaviour of some children with disabilities.Twenty-nine percent of parents of children without disabilities report that they believed that in inclusive classrooms, children with disabilities are more likely to be rejected or left out by other children (Appendix Table 1).
Parents of children with and without disabilities agree that inclusion is beneficial for children without disabilities and disagree with most statements indicating that inclusion is a risk for children without disabilities.Twenty-seven percent of parents of children without disabilities agree that a child with disabilities would present a number of behaviour problems when integrated with children without a disability.Forty-three percent of the group agreed that in an inclusive classroom, children without disabilities may copy children with disabilities and learn negative behaviours from them (Appendix Table 2).
An independent t-test indicated that parents of children without disabilities perceive more risks concerning the impact of inclusion on child with disabilities than parents of children with disabilities.The study also found that parents of children without disabilities perceive more risks associated with the impact of inclusion on families of children without disabilities (Appendix Table 3).
A possible relationship could exist between parent perceptions and a child's level of disability.Parents of children with disabilities support of inclusive placements for children with mild disabilities is 45% higher than for children with severe disabilities.Overall, both groups' support of inclusive placements for children with disabilities decreases as the severity of the disability increase (Appendix Table 4).
An independent-samples t-test was conducted to compare the mean perception scores for parents of children with mild disabilities and parents of children with moderate disabilities, parents of children with mild disabilities and parents of children with severe disabilities and parents of children with moderate disabilities to parents of children with severe disabilities.The test was significant on two variables: the impact of inclusion on children with disabilities (risks) and impact of inclusion on families of children without disabilities (benefits).Parents of children with moderate or severe disabilities perceive more risks associated with inclusion on the child with a disability.Parents of children with a mild or moderate disability identify the impact of inclusion as beneficial on families of children with disabilities (Appendix Table 5).These findings also suggest that level of disability may significantly influence parental perceptions of inclusion.
Parents of young children with and without disabilities are more likely to support an inclusive placement for children with an orthopaedic impairment, speech impairment or visual impairment.They are least likely to support inclusive placement of a child with autism, emotional/behavioural disorder or a cognitive impairment.These findings are similar to those of previous researcher concerning the inclusive educational placement for children with certain disabilities (Appendix Table 6).

Summary
As in previous studies, this study found that parents of children with and without disabilities agree, in general, that inclusion is a positive educational practice for children with and without disabilities.However, parental optimism decreases when children with challenging behaviours are placed in an inclusive environment.Parents of children with and without disabilities are not as supportive of inclusion placements for more moderate-to-severe disabilities, emotional impairments and cognitive impairments.This relationship is critical because one would assume that a parent of a child with disabilities that supports inclusion for their child would be supportive of the inclusion of other children with disabilities, but this may not be the case.Just as previous researchers cautioned against developing a "one-size-fits-all" mentality regarding inclusion (Fuchs and Fuchs, 1994) because of different outcomes for different children, we must also seek to understand the relationship between parental perceptions and disability, not just draw conclusions.While it appears our quest to increase inclusive opportunities for children with mild disabilities is experiencing success, we now need to expand our mission, training and services to meet the changing needs of children with moderate-to-severe disabilities.

Discussion
Early childhood professionals need to acknowledge of the perceptions of parents of children with and without disabilities regarding inclusive early childhood programming.Early childhood program teachers and administrators should be knowledgeable of the perceptions of parents of children with and without disabilities.While the benefits of inclusion may draw some parents to enrol their child in such a program, the perceived risks of an inclusive environment could negatively impact not only enrolment in general, but the diversity of enrolment.Early childhood programs should collaborate with families to develop effective strategies to address these concerns.
In addition, understanding the perception of inclusive placements concerning children with more severe disabilities such as behaviour/emotional disorders and autism is especially important.As the number of children with autism and other developmental disabilities continue to rise, it is vital that we are prepared to provide positive, effective inclusive educational opportunities for these children.Early childhood programs should consider the characteristics of their program, including ratios of students with and without disabilities, staffing ratios and availability of specialized service providers when planning for quality inclusion.Early intervention is critical for these populations, though they are less likely to be viewed by some parents of children with and without disabilities as being appropriate for inclusive preschool settings.Inclusive early childhood programs should actively target parent and community education in order to increase awareness and knowledge of more severe disabilities as well as decrease misconceptions concerning inclusive education.

Limitations, Implication, and Future Research
The generalizability of this study is limited secondary to the sample consisting of parents of preschool-age children.In addition, the use of parent report on the survey instrument is impacted by variables including the parent's feelings at the moment they completed the study and the fidelity in which the questions were read and considered.
Research in the area of inclusion continues to be difficult secondary to inconsistent definitions of what constitutes an inclusive classroom.Future research should clearly define the severity and type of disabilities served in the inclusive classrooms.Unrealistic expectations occur when practitioners attempt to generalized data from studies that targeted populations different than those they are serving.Future research should examine inclusive programs that serve children with moderate-to-severe disabilities, including children with autism and behavioural disorders.Research should also examine inclusive programs that successfully serve children with a true range of disabilities in terms of teacher qualifications/training, family programming and available resources.
Parents of children with and without disabilities have voiced concerns regarding teacher preparation and training to meet the needs of children with special needs.Early childhood teacher preparation programs should incorporate positive professional philosophies regarding inclusion and inclusive placements in all aspects of their programming, not just special education coursework.Strategic planning is needed to incorporate coursework and high-quality internship experiences throughout the teacher preparation program that focus on meeting the needs of children with varying types and severity of disabilities at the collegiate level.Early childhood administrators need a clear understanding of the position statements and recommendations regarding inclusion in order to assist them in maintaining the fidelity of inclusive education programming.Individuals in leadership positions within early childhood centres and public school (PK-6) buildings need professional development opportunities to increase their knowledge and understanding of inclusive educational practices in the early years.Lastly, all individuals who served children with disabilities and their families would benefit from professional collaborations with mentors in the community who embrace, practice and advocate for inclusive placement for all preschool children.

Table A1 .
Parents of children with (N=84) and without (N=65) disabilities perceptions of the impact of inclusion of children with disabilities

Table A2 .
Percentage of parents of children with (N=84) and without (N=65) disabilities who agreed with statements regarding the perceptions of the impact of inclusion on children without disabilities

Table A3 .
Total parental perception scores of parents of children with and without disabilities

Table A4 .
Percentage of parents of children with disabilities (N=84) and without disabilities (N=64) who agreed with inclusion based on the severity of the disability

Table A5 .
Parental perceptions of inclusion by severity of disability

Table A6 .
Percentage of parents of children with disabilities (N=84) who agreed with inclusion based on the type of disability