Integrated effective service provision for children and young people with physical disabilities: A summary of two research projects Publications
This summary report highlights the aspects of the research which we see as being particularly important for policy, planning and practice.
Author(s): Ministry of Education
Date Published: November 2007
This is a summary of a comprehensive two-part research programme on integrated effective service provision for children and young people with physical disabilities. One study focused on resourcing and the other was a set of case studies. Both studies took place from 2003 to 2004.
The two research projects were developed from a scoping project (the McDonald report)1 that had been commissioned by the Ministry of Education-convened Advisory Reference Group for Students with Physical Disabilities (the Reference Group).
The Reference Group consisted of parents, health professionals, early childhood and school staff, and representatives of disability organisations and education unions. Part of its brief was to promote and support robust research into effective integrated teaching, learning, and therapy practices so that children and young people with physical disabilities successfully overcome barriers to learning and develop their skills for participating effectively in life. The Reference Group and the Ministry of Education commissioned the scoping project to identify the indicators of effective integrated practice and set the research questions for the two-part study summarised here.
Indicators of integrated effective practice
The move towards inclusive education for children and young people with physical disabilities has meant that physiotherapists and occupational therapists have become members of special education teams. This raises questions about the role these specialists can play in this new working environment and about the best ways to integrate practices from a number of occupational groups within an educational context.
The term ‘integrated’ is widely used in education to describe the extent to which children and young people with physical disabilities are a part of their school community. Increasingly, the term has become synonymous with inclusion, and refers to the extent to which an individual has the opportunity to participate in every aspect of life (McDonald et al., 2001, p.15).
‘Integrated practice’, in the context of the scoping project and the research summarised here, refers to therapists, teachers, and families working together to provide services and programmes for children and young people with disabilities in schools, and to the integration of the therapies into their daily activities.
‘Effective practice’ is used in the sense of ‘best practice’. What is effective practice in one context will not necessarily be an effective practice for another student in another setting. However, effective practices must be theoretically and methodologically sound, they must consistently produce desired outcomes, and they must be socially valid (McDonald et al., 2001, p.16).
From its review of the literature, the McDonald report identified a number of indicators to identify integrated and effective practices in New Zealand. These include:
- The student and family are at the centre of practice and individual and family needs are reflected in the development of interventions.
- A range of environmental or ecological assessment2 and evaluation tools is used to identify areas of need and to measure outcomes.
- There is a focus on quality of life issues and the development of functional skills.
- Therapy and interventions are carried out in natural settings across an individual’s day.
- Agencies, organisations, and individuals from a range of disciplines work in collaborative teams in support of students and their families. The collaboration must address issues of overlap to avoid problems of communication, continuity and transition; reduce pressures on families; and be client-centred and culturally sensitive.
- There is a method for measuring change based on mutually agreed outcomes.
The components of integrated effective practice identified by the people interviewed as part of the scoping project were similar to those identified in the literature review. The scoping project also identified ways to measure the success of interventions (outcome measures), based on information from the interviews and on the literature review. Table 1 summarises the indicators and outcome measures identified in the literature review and from the interviews.
As a result of the scoping project, the Reference Group and the Ministry of Education commissioned the two research projects: a database project and a series of case studies.
The database project was a synthesis of existing information from a range of sources that gave a picture of the distribution of resources and funding streams for this group of students, and the quantum of resourcing on a national and regional basis. The research was conducted by a team led by Phillipa Clark, Department of Paediatrics, University of Auckland.
The case studies illustrated approaches to therapy for students with physical disabilities in the compulsory school sector, across different services, settings and locations. This project also looked at the extent to which the approaches to therapy reflected the principles of integrated effective practice, and the effect the therapy and services had on the life and quality of life of students with physical disabilities and their families.
The case studies were researched by a team led by Jude MacArthur, of the Donald Beasley Institute, University of Otago.
Structure of this summary
This summary starts with the database project. It presents the key findings from each of the data sources, including the estimated numbers and characteristics of children and young people with physical disabilities, geographical patterns of distribution, and other information specific to a particular data source. The second part of the summary looks at the key findings from the case studies.
|Integrated Effective Practice||Integrated Effective Practice|
Services and provision can be said to be integrated and effective when:
The literature has identified the following components of integrated effective practice.
|Measuring Outcomes||Measuring Outcomes|
Effective services are said to have been provided when programmes focus on:
The literature has noted that the indicators of effective outcome include:
- McDonald, T., Caswell, P., Penman, M. (2001). Integrated effective service provision for children and young people with physical disabilities: Report to the Ministry of Education’s reference group on physical disability. Wellington, New Zealand: Ministry of Education.
- Ecological assessment recognises that a student’s surroundings and context have an effect on abilities and needs. Ecological assessments include a study of students’ physical environments and students’ interactions with the people in close contact with them.
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