General Education Teachers’ Experiences with

Inclusion of Students who use Augmentative and

Alternative Communication

JENNIFER E. KENT-WALSH and JANICE C. LIGHT*

Department of Communication Sciences and Disorders, 110 Moore Building, The Pennsylvania StateUniversity, University Park, PA 16802, USA

A qualitative interview methodology was used to investigate the experiences of 11 generaleducation teachers who had included students with augmentative and alternative commu-nication (AAC) in their classes. Information was gathered from participants in the followingareas: (a) the benefits of including students who use AAC in general education classes, (b) thenegative aspects of including these students, (c) the barriers to successful inclusion outcomes,(d) the supports required for successful inclusion, and (e) recommendations for other teachersand professionals (e.g., speech-language pathologists). Participants described barriers thatthey faced related to schools, teams, teachers, educational assistants, classmates, students,curricula, and AAC. Participants also emphasized the benefits of including students to thestudents themselves (e.g., increased classroom interactions with peers), classmates (e.g.,increased acceptance of individuals with disabilities), and themselves as teachers (e.g.,personal growth and learning). Results are discussed with reference to the literature as well asdirections for future research.

Keywords: Assistive Technology; Augmentative and Alternative Communication; Inclusion;Interviews; Teachers

Increasingly, students with complex communica-tion needs are being included in general educationsettings. In working to support students who useaugmentative and alternative communication(AAC) in inclusive classroom settings, generaleducation teachers are faced with a complex task.They must be the principal facilitators of learningfor the students who use AAC in their classrooms,as well as for the rest of the students in the classwho also have a wide range of needs and abilities.General education teachers must identify appro-priate curriculum goals and determine how thesegoals can be met by all of their students, includingthose who use AAC. Research has shown that theroles played by such general educators, inaddition to those played by special educationteachers, are integral to the successful inclusion ofstudents who use AAC (Giangreco, 2000; Locke& Mirenda, 1992). Since communication isfundamental to the educational process (Beukel-man & Mirenda, 1998; Cumley & Beukelman,1992), it is essential that all teachers are able tocommunicate effectively and efficiently withstudents with complex communication needs.

Despite this necessity, there has been only onestudy to date in which there has been an attemptto examine the experiences of general educationteachers who have included students using AACin their classes. Soto, Muller, Hunt, and Goetz(2001), in a qualitative investigation, conductedfive focus groups comprised of representativesfrom the following key stakeholder groups:general education teachers, inclusion supportteachers, instructional assistants, parents, andspeech-language-pathologists in the San Francis-co Bay area. The researchers examined the criticalissues for each of these stakeholder groups in theinclusion of students who use AAC. Each of thefive focus groups identified issues relating to teamcollaboration, AAC training for inclusion teammembers, participation of effective educationalassistants, and administrative support as beingprerequisites for successful inclusion programs.Participants in each of the five focus groups werereported to recognize the feasibility of inclusiveeducation for students who use AAC and thebenefits of inclusion for these students, theirpeers, their parents, and the school community-

*Corresponding author. Tel: 814-863-2010. Fax: 814-863-3759. E-mail: jcl4@psu.edu

Augmentative and Alternative Communication, June 2003 VOL. 19 (2), pp. 104–124

ISSN 0743-4618 print/ISSN 1477-3848 online # 2003 Taylor & Francis LtdDOI: 10.1080/0743461031000112043

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at-large. The general education teachers in thisstudy were reported to place less emphasis on thepositive outcomes of a successful inclusionprogram for the students using AAC (which hadbeen emphasized in the other focus groups) andmore emphasis on classroom-wide benefits. Theseteachers also placed a unique emphasis on theimportance of such practices as team teachingand using group-centered classroom activities.This initial investigation by Soto et al. (2001)

provided valuable insight into the types ofissues that appear to be central to theexperiences of a group of general educationteachers who have included students using AACin their classes. Such documentation of thepriorities and needs of these teachers ispredicted to facilitate the successful implementa-tion of inclusion programs for students who useAAC. Soto et al. however, did not seek toinvestigate the potential negative impacts ofincluding students who use AAC in generaleducation classrooms. Furthermore, only sixteachers participated in this study, and theywere all from the same state and metropolitanarea (the San Francisco Bay area).As suggested by Pugach (2001), in order for the

use of qualitative inquiry to investigate issuesrelated to the education of students with specialneeds to result in maximum benefits, it isimportant to increase opportunities for stake-holders in the inclusion process to be heard. Todate, such opportunities have been limited forgeneral education teachers. In light of this gap inthe literature, further investigation into theexperiences of general education teachers iswarranted. Cumley and Beukelman (1992), forexample, asserted that, ‘‘Both regular and specialeducators must share educational responsibilitiesif mainstreamed students with AAC systems areto achieve success’’ (p. 115).Therefore, in the current investigation we

sought to interview general education teachersin the United States who had experience inincluding students who use AAC in their generaleducation classes. Our overall purpose was todescribe general educators’ self-reported experi-ences with inclusion of students who use AAC.Specifically, information was gathered fromteachers in the following areas: (a) the benefitsof including students who use AAC in generaleducation classes; (b) the negative impact ofincluding these students; (c) the barriers tosuccessful inclusion outcomes; (d) the supportsrequired for successful inclusion; and (e) recom-mendations for other teachers, professionals (e.g.,speech-language-pathologists), and school admin-istrators who are involved in the inclusion ofstudents who use AAC.

METHOD

Design

A qualitative interview methodology was chosenfor this investigation for two reasons. First,there has been limited research examininggeneral education teachers’ experiences withincluding students who used AAC in theirclasses, and qualitative research designs havebeen identified as appropriate inductive vehiclesfor data analysis in new areas of research(Patton, 1990). Second, it was anticipated thatthe general education teachers’ ease of includingstudents using AAC in their classes would beclosely linked to the specific circumstancesrelated to individual classroom and studentsituations (Lincoln & Guba, 1985). Therefore,a methodology that would afford participantsopportunities to provide rich descriptions of thecontextual situations associated with theirindividual experiences was most appropriatefor this study (e.g., Gubrium & Holstein,1997; Patton, 1990; Strauss, 1988).

Participants

Recruitment of participants

The recruitment of general education teacherswas accomplished through (a) direct phone callsto special educators and speech-language pathol-ogists who were known by the investigators tohave worked with individuals who used AAC; (b)solicitation of participant nominations throughan electronic mail message sent to cliniciansknown to provide AAC services; and (c) use ofsnowball, or chain, sampling (Patton, 1990, p.182), whereby secured participants identifiedother special and general education teacherswho had experience teaching students who usedAAC. Written informed consent was obtainedfrom each participant.

Criteria for participation

Eleven teachers in the United States who met thefollowing criteria were interviewed: individualswho had (a) been trained as general educationteachers in public schools; and (b) had experi-ence in the previous 5 years teaching at least onestudent who used an AAC system and who wasincluded in general education programming forany portion of the school day or week. Table 1provides a summary of the participatingteachers’ demographic information and Table 2provides a summary of the demographic infor-mation of their students who used AAC (i.e.,target students1).

105GENERAL EDUCATION TEACHERS’ EXPERIENCES

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TABLE1

Dem

ographic

Data

forGeneraleducationTeacherswhoTaughttheTarget

Students

whousedAAC

Participant

Amanda

Beth

Cynthia

Deb

Erin

Farrah

Gina

Heather

Iola

Judy

Keri

State

PA

PA

CA

PA

PA

PA

MN

AK

PA

PA

AK

Age

48

46

33

46

48

32

58

49

45

49

43

Highestform

al

educationlevel

attained

Master’s

equivalent

2Master’s

level

courses

Master’s

degree

Several

Master’s

level

courses

Master’s

degree

Master’s

degree

Master’s

degree

Bachelor’s

degree

Bachelor’s

degree

Master’s

equivalent

Master’s

degree

Specialeducation

training

None

None

1class

Bachelor’s

degree

None

Master’s

degree

None

5+

in-services

5+

in-services

3 in-services

1course

Trainingin

AAC

None

None

Lim

ited;

inform

al

None

None

DynaVox

None

None

None

None

3h

DynaMyte

Years

ofteaching

experience

27

24

10

14

10

625

614

28

12

Years

ofexperience

teachingtarget

students

(TSs)

11

62

12

11

11

1

TS’timeincluded

42min./

day

10min./

day

half-tim

e2–3

periods/

day

45min./

day

full-tim

efull-tim

e50min./

day

alm

ost

full-tim

efull-tim

e4h/day

Subjectstaughtin

whichTSwere

included

(gradelevel)

Foods&

Nutrition

(gr.9-12)

Home-

room

(gr.8&10)

Allexcept

Math

(gr.4)

Family&

Consumer

Sciences

(gr.6&

7)

Home-

room

(gr.6)

All(gr.1)

Social

Studies&

Reading

(gr.6)

Home

Economics

(gr.7)

Allexcept

Lang.Arts

(gr.2)

All(gr.3)

Allexcept

Reading&

Math

(gr.5)

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TABLE2

Dem

ographic

Data

forTarget

Students

(TSs)

whousedAAC

andwereIncluded

intheParticipatingTeachers’Classes

TS

April

Billy

Cara

Dara

Evan

Faye

Gillian

Heath

Ida

James

Kelly

Teacher

bAmanda

Beth

Cynthia

Deb

Erin

Farrah

Gina

Heather

Iola

Judy

Keri

Age

17

15

10

12

12

612

14

810

11

Primary

diagnosis

aa

CP

CP

Autism

(non-

verbal)

CP

CP

MR

Down

Synd.

CP

CP

a

Cognitive

challenges

Significant

Significant

Some

Some

Some

Some

Some

Some

Significant

Some

Some

Physical

challenges

Significant

Wheelchair

None

apparent

Significant

Wheelchair

Lim

ited

finemotor

Significant

Wheelchair

None

apparent

Wheelchair

Paraplegia

Wheelchair

Quadri-

plegia

Somemus-

clecontrol

issues

Diffi

culties

withgait

Significant

Wheelchair

Somefine

motor

issues

AAC

system

(s)

used

Unaided

Unidenti-

fied

VOCA

DynaMyte

DynaVox

withhand

switch

DynaVox

DynaMyte

sign

DynaVox

withhead

switch

Unidenti-

fied

VOCA

Gestures

sign

Gestures

Alpha-

Talker

DynaMyte

DynaVox

withhead

switch

DynaMyte

sign

System

competency

cNotatall

competent

Somew

hat

competent

Competent

Very

competent

Competent

Somew

hat

competent

Notatall

competent

Expertuser

Somew

hat

competent

Very

competent

Very

competent

Facility

with

curriculum

dWellbelow

N/A

Below

Below

Below

Atgrade

level

except

inMath

Wellbelow

Below

Below

Wellbelow

Wellbelow

aInform

ationthatparticipants

did

notknow.

bIn

casesin

whichparticipantshadmore

thanoneexperience

teachingstudentswhousedAAC,they

primarily

discussed

theirexperienceswiththestudentthey

taughtmostrecentlyduringthe

interview.

cTeacherswereasked

tocharacterizetarget

students’competency

withusingtheirAAC

system

(s)to

meettheircommunicativeneeds,usingthefollowingsemanticdifferentialscale:[notatall

competent–somew

hatcompetent–competent–verycompetent–expertuser].

dTeacherswereasked

tocharacterizetarget

students’abilitiesto

functionin

thecurriculum,usingthefollowingsemanticdifferentialscale:[wellbelow

gradelevel–below

gradelevel–atgrade

level–abovegradelevel–wellabovegrade-level].

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Materials

A Sony TCM-465VTM hand-held cassette recor-der was used, in conjunction with its externalmicrophone and its telephone pickup adapter.Recordings were made on Sony High Fidelity90 min cassette tapes.

Procedures

A semi-structured interview method wasemployed (Kvale, 1996). Each participant wasinterviewed once, in-person or over the telephone,by the principal investigator. Interviews ranged induration from 30 min to one hour. In-personinterviews were conducted at a convenientlocation for each participant (e.g., a teacher’sschool). An interview guide (Appendix A),consisting of a series of themes to be coveredthroughout the interview, was used. The interviewthemes were developed through a review of theliterature relating to the inclusion of students withsevere disabilities (e.g., Gemmell-Crosby &Hanzlik, 1994; McGregor & Pachuski, 1996;Smith & Smith, 2000; Todis, 1996). There was,however, flexibility in the sequence of the themescovered and the exact wording of the questionsasked in each interview. At the beginning of theinterview, each teacher was informed that theinvestigator had no set agenda with reference tospecific questions to be asked or response choicesto be given during the interview, other than anoutline of themes that might be covered. Theprincipal investigator reminded the teachers thatshe was interested in finding out anything andeverything with respect to their experiencesrelating to including students who use AAC intheir class(es).

Data Analysis

The audio-taped interviews were transcribedverbatim into written texts by the principalinvestigator. Analysis procedures then followedBoyatzis’ (1998) five-step procedure for induc-tively developing codes, with the addition of afurther step to validate the results of theinvestigation (Kvale, 1996).In Step 1, an outline of paraphrased items was

generated, based on each interview text (i.e.,synopses based on the raw material). Thistransformed the raw data into more manageablethought units for analysis and allowed an initialindication of the contents of each transcript. InStep 2, each transcript outline was examinedseparately for the occurrence of themes within it,which began to provide some organization to thedata. The patterns identified within the transcripts

were then compared across transcripts in Step 3.Overall themes and corresponding operationaldefinitions were then developed in Step 4, in orderto itemize a meaningful coding system (seeAppendix B for the operational definitions ofthe final coding themes). Subsequently, these finalcoding themes were used to analyze the entiresample of raw data. Following these codingprocedures, sub-themes were identified withineach coding theme in an attempt to best describethe issues discussed in the interviews.A summary of each participant’s interview was

then compiled in a format consistent with thecoding system and the identified sub-themeswithin each coding category. In an effort to ‘‘givethe interpretations back to the subjects’’ (Kvale,1996, p. 190), these summaries were forwardedvia e-mail or read to each participant over thephone. Following the presentation of this infor-mation, participants were asked to comment onthe accuracy of the summary in depicting theirexperiences and opinions. Participants were alsoasked to add any additional information orqualifications to their summaries. All participantsindicated that they were in agreement that thesummaries accurately reflected their contributionsto this investigation and some participants addedadditional qualifying remarks, which wereincluded in the final presentation of the results.Finally, Step 5 involved determining the

reliability or consistency of judgment of thecoders. A graduate student was trained in theapplication of the operational definitions for thecoding of themes. This student coded andreceived feedback on a few pages of transcriptsamples. Following this brief training session, thegraduate student then independently reviewedand coded 10% of the data. Cohen’s Kappa wasused to determine inter-rater reliability andyielded a level considered to be almost perfect(kappa=0.87) (Landis & Koch, 1977).The final coding themes were (a) benefits of

inclusion; (b) negative impacts of inclusion; (c)barriers to inclusion; (d) supports for inclusion;(e) recommendations; (f) descriptive informationabout teachers, students, class, or school; and (g)unrelated or uncodable statements.

RESULTS AND DISCUSSION

The findings are presented as they relate to thefive main coding themes that emerged from theeleven participants’ varying experiences. Table3 provides a summary of the themes, sub-themes, and examples of the specific issuesdiscussed by the participants within each sub-theme.

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TABLE 3 Coding Themes, Sub-Themes, and Examples of Issues Discussed by Participants

Themes Sub-themes Examples of issues discussed by participants

Benefits of educational For students who used AAC & . Satisfaction with inclusion experiences.inclusion parents . Skill development.

. Increased classroom interaction with peers.For classmates . Increased awareness, acceptance, and/or

compassion for individuals with disabilities.For teachers . Positive teaching experience.

. Personal growth and learning experience.Negative impact of educational For students who used AAC . Lack of educational gains.inclusion . Social exclusion.

. Unequal status relationships with classmates.For classmates . Classroom disruption caused by student using

AAC.For teachers . Time-consuming nature of inclusion

Barriers to educational School-related barriers . Architectural barriers.inclusion . Priority on fulfilling legal obligations instead of

helping students to meet their individualizedgoals.

. Placement of students in large classes.Team-related barriers . Lack of team communication/collaboration.

. Lack of home support.Teacher-related barriers . Teachers’ training/skill limitations related to

AAC/special education.. Insufficient preparation time.. Negative teacher attitudes.. Teacher ‘‘burnout.’’

Educational assistant-relatedbarriers

. Educational assistants’ disregard for job-related responsibilities.

. Educational assistants’ training/skilllimitations related to AAC/specialeducation.

. Insufficient educational assistant classroomcoverage time.

. Lack of consistency of educational assistants/turnover.

Classmate-related barriers . Student-peer interest mismatch.. Negative student attitudes.. Tendency of students not to communicate

directly with student who uses AAC.Target student-related barriers . Students’ communication skill limitations.

. Lack of student motivation/effort to use AACsystem.

. Attendance issues.Curriculum-related barriers . High curriculum skill demands.

. Difficulty in modifying certain curricula.AAC-related barriers . Technology limitations.

. Breakdown & repair issues.

. Access issues.Supports for educational School-related supports . Architectural supports.inclusion . Placement of students in small classes.

. Use of ‘‘merit’’ grading system when studentsare included in classes that require skills thatexceed their abilities.

. Allowing teachers necessary time to becomecomfortable with idea of having studentswith disabilities included in their classes.

Team-related supports . Effective team communication/collaboration.. Adequate transition planning and preparation.

(continued overleaf )

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Benefits of Educational Inclusion

The benefits reported by participants includedbenefits for almost all individuals in the generaleducation classroom: that is, target students whoused AAC, their classmates, and the generaleducation teachers themselves.

Benefits for students who used AAC and theirparents

The general education teachers discussed threemain issues related to positive outcomes for theincluded students who used AAC. First, partici-pants indicated that the target students and theirparents were satisfied with the inclusion experi-ences. As Judy explained, ‘‘The parents were veryappreciative at the end of the year. They both toldme that and it meant a lot. They said that theyknew he came into school happy every day andcame home happy every night.’’ Farrah alsoreported student enjoyment of the inclusionexperience: ‘‘She really wanted to come to school.In fact, she enjoyed it so much that on days thatshe was sick or we had off, the mother expressedhow much Faye wished she were at school.’’Second, the general education teachers noted

skill development. They mentioned that the targetstudents’ speech and skill at operating their AACsystems improvedduring the time the studentswereincluded in their classes. Farrah also commentedon the academic gains made by a student who wasincluded in her class: ‘‘She has done so many morethings than we ever expected her to do.’’Finally, participants commented on the benefits

of students interacting with their typically devel-oping peers during classroom activities. Oneteacher described some peer interactions as a

‘‘bright spot’’ in the inclusion process. Keri notedthat the target student in her class, Kelly, made a‘‘really strong connection’’ with one of herclassmates. She further noted that all of thestudents in her class seemed to ‘‘accept Kelly asKelly for who she was . . . She was just anotherstudent. She couldn’t speak, but she had herdevice and she used it.’’ Amanda indicated thatAndrew had been ‘‘working in a group, just likeany other kitchen member’’ in her cooking class.She described instances in which Andrew’skitchen teammates encouraged him to do thingson a project ‘‘. . . so that he would feel involvedwith the rest of the group.’’

Benefits for classmates

The general education teachers overwhelminglystressed the positive effects of inclusion for theother students in their classes. The teachersreported that these students became more awareof students with disabilities as well as morecompassionate, tolerant, and accepting of diver-sity. Erin asserted: ‘‘You can talk about it all youwant with them, but until they really experiencewhat it’s like to have someone in their classroomwho is in a wheelchair, or can’t talk, or has alearning disability, they don’t really know.’’ Judycommented that she thought it was good forchildren to realize that other children ‘‘. . . may bedifferent, but they are really still the same.’’Cynthia noted that her students developedimportant skills because Cathy, a student whoused AAC, was included in her fourth grade class:‘‘Everybody in the class, I think, was a lot moreopen to really listening to each other and reallygiving everybody space to sort of think aboutthings before talking. I know a lot of that was

TABLE 3 (continued )

Themes Sub-themes Examples of issues discussed by participants

. Support and knowledge of individual teammembers (e.g., speech-language pathologist,educational assistant).

. Consistency of educational assistant workingwith student using AAC.

Teacher-related supports . Maintenance of a positive attitude.. Knowledge of individual students’ needs.. Prior training in topics related to special

education.Classmate-related supports . Peer acceptance of student and willingness to

assist in the inclusion process.Curriculum-related supports . Realistic academic goals for student.

. Applied nature of subject matter.

. Inclusion of students in lower grade levels.AAC-related supports . Provision of means to participate in classroom

activities.

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because they were used to waiting for Cathy [tospeak, using her AAC system].’’ Another teacher,Beth, even suggested that long-term effects of theinclusion experience might be possible and stated,‘‘A lot of the students enjoy working with Billy . . .you can tell some of them are going to go out intocareers where they’re going to work with people.’’

Benefits for teachers

The teachers stated that they enjoyed theexperience of including a student with complexcommunication needs in their classes. Participantspraised the experience for offering them oppor-tunities to learn. Erin expressed a desire to take acourse in sign language, after working with astudent who required AAC and stated, ‘‘I grew, Iwanted to learn more.’’ Similarly, Farrahexplained that she decided to pursue training atthe Master’s level in special education and stated,‘‘Just to make me a better person and a betterteacher, I decided that I had better learn moreabout the needs of some of these children.’’ Iolaalso commented that she felt that her inclusionexperience was ‘‘a good lesson, for a teacher, intrying to meet the needs of all your students.’’

Negative Impacts of Educational Inclusion

Despite identifying many benefits relating toeducational inclusion, participants also presentedsome negative effects of including students whoused AAC in their classes. Again, three subthemesrelating to negative impacts emerged for thestudents who used AAC, their classmates, andtheir teachers.

Negative impacts for students who use AAC

Participants identified three major negativeimpacts of inclusion for these students: lack ofacademic gains, social exclusion, and unequalstatus relationships with classmates. Participantsreported that they did not feel that they werecompetent to assess whether or not students whoused AAC made educational gains because theywere not skilled in modifying evaluation methods.As Amanda stated, ‘‘It was hard to measure howmuch he was getting.’’ Another participant saidthat while she thought the social needs of thetarget students were being ‘‘at least partiallyaddressed’’ in the general education classroom,she felt that the target students’ academic needsdid not receive the attention they deserved. Theseissues seemed to be more salient for the teacherswho taught target students at higher grade levelsthan those who taught students in lower gradelevels.

The general education teachers also expressedconcern about interactions of the included studentswith their classmates. They reported that some-times the students who used AAC were beingexcluded by their peers in social situations outsideof the classroom. This was the case for Gina’sstudent, Gillian, for whom socialization withtypically developing peers was an educational goalthat was ‘‘not happening.’’ Participants also spokeof this social exclusion as having obvious effects onthe included students. Keri gave the followingdescription of her student, Kelly, and her reactionto the mismatch between her interests and theinterests of her peers on the playground:

We discovered during the year that Kellywas taking longer and longer to eat herlunch, so that she would avoid going outside. . . At this level, they really didn’t want toslide on the slide or they didn’t want toswing on the swings. They were all in theirlittle groups talking about boys and doingthat kind of thing. . . Sometimes some kidswould play with her and it’s not that theydidn’t try to include her, but for her, justwalking around wasn’t fun.

Finally, the teachers highlighted the unequalstatus relationships that classmates developedwith included students who used AAC. Asevidenced in Keri’s comment above, the teachersnoted that students demonstrated an obligationto socialize with the target student, rather than adesire to do so. Heather explained that with hertarget student, the classmates were playing morethe role of ‘‘helpers’’ or ‘‘teachers’’ than that offriends. As Iola noted, target students’ classmatessometimes took the ‘‘helper’’ role too far: ‘‘Theywanted to be very helpful and supportive of herand we would have to stop them and say, ‘No, shecan do that; she can do that herself’ – forexample, tying her shoes, carrying her tray, ormaking sure her food was broken up.’’

Negative impacts for classmates

Participants also expressed concern about class-room disruptions related to noise caused by thetarget students. Judy recounted her experiencewith a target student’s AAC system causingproblems for another student with a significantdisability. She explained that there seemed to beno way to turn off, turn down, or to activate theAAC system without it saying ‘‘I choose thatone’’ before speaking the name of the itemselected by the target student. She stated, ‘‘I hadanother child in the class with a psychoticdisorder and every time that switch was triggered

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[and] it would say, ‘I choose that one,’ this boywould say ‘I can’t stand that sound, I can’t standthat sound’ . . . I came home at night saying, ‘Ichoose that one, I choose that one, I can’t standthat sound, I can’t stand that sound.’’’

Negative impacts for teachers

Other than Judy’s above description of the stressshe experienced on a daily basis, the generaleducation teachers reported only one negativeimpact for themselves. Some teachers said that itwas very time-consuming to learn to use the AACsystems and to plan to include target students in theactivities for each of their classes. Teachers statedthat theywerenotgivenextra time in their schedulesto accommodate these demands. Erin explained,‘‘For me, it was the preparation. It was the time. Ineed time and although I’m really, really interestedand itwasapriority forme, itwasanother layer thatI had to do to prepare.’’ Judy added, ‘‘Many days Iwas there past my time . . . It just took the planningfor me to come up with how to get [the targetstudent] included as much as possible.’’

Barriers to Educational Inclusion

All participants encountered barriers to theinclusion of students who used AAC in theirclasses. Specifically, the participants discussedeight types of barriers that related to schools,teams, teachers, educational assistants, classmates,target students themselves, curricula, and AAC.

School-related barriers

Participants discussed three different types ofschool-related barriers, the first of which relatedto the physical setup of their classroom environ-ments. In illustrating this point, Amanda spokeabout the lack of accessible kitchen stations in herclassroom: ‘‘We don’t even have the necessaryadjustments for the handicapped. We don’t havelower sinks or counters that would be accessible.’’The teachers also spoke of the difficulties targetstudents experienced when they tried to movefreely throughout the small and often crowdedclassrooms.The second issue was the tendency of schools to

‘‘stick pretty close to the legalities’’ of providingservices for students with disabilities, withoutnecessarily meeting the educational needs of thesestudents. Teachers discussed instances in whichthey were physically present at goal settingmeetings solely to meet the requirement of havinga general education teacher at the meeting, andattending other meetings, during which they werecompletely excluded from the planning process.

Finally, participants discussed problems thatcan occur when children with special needs areplaced in regular classrooms with large numbersof students. Amanda stated that large class sizeswere problematic in high school as well as inelementary school. On this issue, Beth stated: ‘‘Iknow that the biggest problem with inclusion isthat they put too many kids in the class. Whathappens when you put too many kids in theclassrooms is that you can’t help them as much asyou should and they become lost and frustratedand become disruptive.’’

Team-related barriers

The team-related barriers discussed by partici-pants fell into two main categories: (a) colla-boration/communication issues among schoolteams, and (b) lack of home support. Theteachers expressed their concerns about the factthat they could not problem-solve with teammembers on an on-going basis. Participants alsoindicated that consistent methods for sharinginformation were often not in place. Ginacommented that she never received any informa-tion on the abilities, needs, educational back-ground, or current educational goals of a studentwho appeared in her class, saying, ‘‘I’ve neverbeen told that she has cerebral palsy, but shedoes. Though she has an educational assistantwith her in the room, I know nothing – zero. Ifanything were to cause the educational assistantnot to be there, I wouldn’t know the first thingabout even pushing her wheelchair, much lessgetting her to understand or speak.’’ Ginafurther described the experience of finding outthat a student who used AAC would be includedin her class: ‘‘It was a shock. The door opened,as I was calling off the attendance to make sureall my students were there on the first day, andshe was wheeled in.’’The participants were also concerned that they

were not actively involved in the process ofdeveloping individualized educational goals forstudents included in their classes. Some teachersdescribed themselves as being completely ‘‘out ofthe loop.’’ These teachers were also not involvedin developing strategies for how goals should bemet in the general education classroom. Amandastated that the agenda of the goal setting meetingshe attended ‘‘didn’t apply to anything that I havedealt with in class.’’One of the participants also discussed the

challenges that occur when more than oneinstitution is involved with a given student (e.g.,rehabilitation institution and school). Farrah, forexample, explained that one of her studentsparticipated in a number of therapy sessions in

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an external facility. She noted that, althoughthere was communication between personnel inthe two facilities, it was difficult to maintaincomplete streamlining of goals and activities (e.g.,on a number of occasions unanticipated program-ming changes were made to the student’s AACsystem).The second team-related barrier that was

discussed was a lack of parental support in theinclusion process. Teachers reported that theysometimes had different expectations comparedto the parents of the target students. Iolaexplained that, although Ida had been makinggood progress with reading skills, ‘‘her father wasconvinced that she couldn’t read.’’ Some teachersalso indicated that students’ AAC systems werenot used at home, with parents reporting thatstudents did not complete their homeworkbecause they ‘‘couldn’t do it.’’

Teacher-related barriers

Participants also identified the following barriersrelated to themselves as teachers: (a) their owntraining and skills were sometimes limited, (b)time constraints resulted in inadequate planningand preparation, (c) negative teacher attitudeswere problematic, and (d) teacher ‘‘burnout’’.Teachers described how their lack of training

relating to special education and AAC limitedtheir ability to meet the needs of target students.Gina explained that she ‘‘. . . had no idea aboutGillian’s equipment or how to assess whether shewas learning or not.’’ Similarly, Erin describedhow she was completely dependent on Evan’seducational assistant to operate his AAC system.Teachers also discussed the time required to

learn how to use a high-tech AAC system and toplan classroom accommodations. They commen-ted that if additional time was not built into theirregular schedules to complete necessary trainingand planning, it was often impossible to fulfill allof their obligations. Therefore, time wasfrequently not available to learn about the AACsystems that their students were using.Participants reported that it was possible for

teachers’ attitudes to change with time andencouragement from other teachers; however,they also stated that general education teacherswho resisted including students with significantcommunication disabilities in their classes wereunlikely to provide these students with positiveinclusion environments. Farrah, who had morethan one experience in teaching a student whoused AAC, added that ‘‘teacher burnout’’ mightbe a problem if the same small group of teacherswas repeatedly asked to teach students who usedAAC in general education classroom settings.

Barriers related to educational assistants

Four specific issues related to educationalassistants were raised. First, there were reportsof some negative experiences with educationalassistants. Gina gave examples of how herassistant had acted as a ‘‘babysitter’’: ‘‘Whenthe class goes to the library, the para wheelsGillian’s wheelchair down there. Gillian sits in themiddle of the library while the para reads thenewspaper and the other children go and findbooks.’’ Gina explained that she viewed thisbehavior as the educational assistant’s completedisregard for job-related responsibilities thatinvolved the target student’s academic goals.Gina further proposed that the educational

assistant’s disregard for her responsibilities couldhave been related to her lack of training and skillsin AAC– the second issue related to educationalassistants that was raised by the participants. Inaddition, participants expressed concern about alack of educational assistant coverage. Heatherexplained that Heath had to return to his‘‘intensive needs’’ classroom when his educationalassistant was not available to assist him in thegeneral education classroom.The fourth and final issue related to educational

assistants concerned staff turnover. Erindescribed how her school had a difficult timefinding a person to commit to working with Evanover an extended period of time. She said that itseemed like ‘‘there was a new educationalassistant every couple of days.’’ With this lackof consistency, she explained that it was difficultto develop effective long-term routines with Evanin the general education classroom.

Barriers related to classmates

The participants also discussed three barriers tosuccessful inclusion that were related to the otherstudents in the class. The first issue was amismatch between target student and classmateinterests. Participants reported that althoughclassmates were not ‘‘mean spirited,’’ they oftenexcluded the target student from social activities.The teachers noted that classmates’ interestsbecame ‘‘more and more different’’ from thoseof the target students as they got older. Heatherdescribed a widening ‘‘maturity gap’’ between herGrade 7 student, Heath, and his typicallydeveloping classmates. Several participantsdescribed a shift in the interests of typicallydeveloping classmates from playing games towalking around and talking about social relation-ships (e.g., having a ‘‘crush’’ on a classmate).The second issue raised related to the difficulty

the general education teachers sometimes encoun-

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tered in facilitating interactions between targetstudentsand their classmates.Cynthianoted, ‘‘Youdidn’t always want to ask the same students overand over [to work with their classmate who usedAAC],but then thereare someotherkidswho itwasjust not going to be ideal with, for whatever reason.Either they seemed uncomfortable or they didn’treally get it.’’ Erin also spoke of some studentshaving a fear of the target student in her class.The final issue raised concerned the tendency of

some classmates not to communicate directly withthe target students who used AAC. Instead, theyspoke to the educational assistants or completelyavoided the target students. Deb described hertypical reaction to students who spoke to theeducational assistant (Donna) instead of thetarget student (Dara): ‘‘I say ‘Don’t look atDonna, look at Dara! You’re talking to Dara!’’’She also recounted incidents in which studentstried to exclude Dara from school assemblyactivities ‘‘because she was different.’’

Barriers related to the students who used AAC

Three issues were raised within this subtheme.First, participants discussed students’ communica-tion skill limitations. Iola explained that Idatypically used her system at a very basic level andtherefore, did not fully participate in all classroomactivities. Participants also noted that studentslacked the communication skills necessary in socialsituations: For example, Erin reported that Evan’sslow rate of communication hindered his interac-tions with his classmates. Similarly, in commentingon Ida’s attempts to form friendships, Iola noted,‘‘She would go about things all wrong – like, shethought that coming up and hitting somebody onthe back during the game of tag or whatever was away to get somebody’s attention.’’The second issue that was raised within this

subtheme related to students’ lack of motivationto use AAC systems. Iola reported that she foundit ‘‘. . . very difficult to try and motivate [Ida] touse [her system].’’ Iola indicated that Ida did notwant to take the time to access the messages sheneeded from her AAC system. This was an issuethat caused frustration for Iola.The final student-related barrier related to

school attendance. Teachers noted such problemsas frequent student absences and tardiness. Theyexplained that these issues presented barriers intheir attempts to provide consistent and inclusiveclassroom experiences for the target students.

Curriculum-related barriers

Two specific issues emerged under this subtheme:(a) high curriculum skill demands, and (b)

difficulty in modifying certain curricula. Teachersindicated that certain academic content areasrequired students to use high level thinking skillsthat were not always consistent with the targetstudents’ abilities. Several teachers reported thatsome of the target students’ educational goalswere not appropriate. Keri, for example,explained that her inclusion team struggled withhow to involve Kelly in a fifth grade unit on theRevolutionary War. She stated that modificationshad been made so that Kelly could relate to thecurriculum at a very basic level. Unfortunately,the modifications did not allow the best use ofinstructional time because, according to Keri,Kelly had potential for more skill development inother areas, such as reading. Farrah alsoexpressed concern about the fact that somestructured curricular programs and standardizedtests that she was required to use with her classdid not present options for adaptations. Althoughshe stated that she was able to make someadaptations for most classroom activities, shewas concerned about being unable to find anypossibilities for modifications with some specificcurriculum programs and tests relating to literacyskills.

AAC-related barriers

Participants raised three issues related to AAC:technology limitations, breakdown and repair,and access. Although some teachers consideredhigh tech, voice ouput-based AAC systems to bebeneficial to the inclusion of students withcomplex communication needs, others high-lighted the fact that these communicationsystems had limitations as well. In describingEvan’s use of his computerized communicationsystem, Erin said, ‘‘Frequently, there wereproblems with it. Frequently, it wasn’t operatingor it didn’t have what he wanted to say or whathe needed to communicate in it. He would alsoleave it at home sometimes.’’ Keri emphasizedthe difficulties that breakdowns caused (i.e.,students still needed to be able to communicate,even if the AAC system was not working). BothErin and Keri stated that they preferred theirstudents to have some signing skills to augmentcommunication with their computerized AACsystems.

Supports for Educational Inclusion

Although the general education teachers high-lighted many real and potential barriers to theeffective inclusion of students who use AAC, theyalso identified school, team, teacher, classmate,curriculum, and AAC supports they believed

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would facilitate successful educational inclusion.These subthemes mirrored those identified asbarriers to inclusion.

School-related supports

Four issues were raised within this subtheme.First, the teachers emphasized the importance ofstudents having access to all classrooms andmaterials, including computers. This accessseemed to be particularly relevant to theparticipants who taught family and consumerscience classes (e.g., cooking, sewing).Second, the participants frequently spoke of the

advantages of including students who use AAC insmall classes (e.g., increased opportunities forinteraction with teachers and classmates).The third issue that emerged in this subtheme

related to the use of a ‘‘merit’’ grading system,which Heather felt was appropriate to use withincluded students. Although Heather modifiedstudents’ assignment and test requirements, shestill gave them ‘‘real’’ grades for the work theydid, rather than simply giving her includedstudents ‘A’s’ on all of their assignments. Shereported that parents had positive reactions tothis grading system: ‘‘The parents love it whenyou come to the [planning] meetings and whenyou talk about what their kids do.’ They are soproud of either that C-plus or the B-minus oreven the D-plus because their child earned anactual grade!’’The fourth issue raised in this subtheme related

to the importance of providing teachers with thenecessary time to adjust to the idea of havingstudents with disabilities in their classes. Partici-pants spoke of the advantages of not forcingteachers to take students into their classes beforethey felt positively about such a prospect. As Erindescribed, time and experience were very helpfulin preparing teachers to include students withspecial needs in their own classes: ‘‘What happensis that when I’m willing to take a student, anotherteacher is willing to take her also. Maybesomeone else will be willing to try then. Theymight say, ‘I’ll try but if it doesn’t work, can wepull her?’ We say, ‘Absolutely! If it doesn’t work,we’ll pull her.’’’

Team-related supports

Participants noted that an educational teamapproach was a positive factor in the inclusionof students who used AAC. Participants high-lighted four specific issues related to teamsupport. First, effective team communication/collaboration was identified as a crucial elementin the inclusion process. The teachers repeatedly

discussed the necessity of constantly maintainingopen lines of communication. They highlightedthe importance of each team member being keptcurrent about student goals and experiences in allsettings. Additionally, a critical need for groupproblem solving and planning was identified. Keridescribed that time was allocated for this type ofcollaboration in her school on a weekly basis andthat substitute teachers were provided to ensurethat general education teachers could attendcollaborative meetings.Second, participants identified a specific need

for transition planning as students who use AACmoved from class to class. They gave examples ofvaluable supports that were put in place for thembefore they actually had the target students intheir classes. Teachers spoke of the benefits thatresulted from meeting with students’ previousteachers to gain insight into their experiences. AsErin noted, ‘‘Sitting down and going over thegoals before you get the student is key because itsets the path you are going to follow.’’ Teachersalso spoke of the advantages of observing, at theend of the year, students who would be coming totheir classes at the start of the next school year.This practice allowed the teachers to see students’strengths and limitations as well as the types ofaccommodations being made. Finally, theteachers described the benefits of receivingdetailed written notes on classroom experiencesfrom students’ previous teachers. As an example,Erin described a procedure adopted in her school,in which ‘‘passports’’ containing summaries ofindividualized goals, background information,and potential curriculum modifications weremaintained for each student with special needs.Third, participants identified key team

members who greatly assisted them throughoutthe course of the year, during which students whoused AAC were included in their classes.Stakeholders, such as physical therapists, occupa-tional therapists, special education teachers,autism support teachers, life skills teachers, andparents, were reported to provide valuablesupport. Furthermore, educational assistants,speech-language-pathologists, and assistive tech-nology consultants were identified as being crucialto the continuous implementation of an inclusionprogram for students who use AAC.In addition, speech-language-pathologists and

assistive technology consultants were commonlytouted as providing crucial assistance withcurriculum adaptation, AAC system operation,and vocabulary selection for AAC systems. Judydescribed her experiences this way: ‘‘Our speechteacher was wonderful. She looked into otherresources for James. I think she’s the one thatreally pulled it all together with him.’’

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Participants cited educational assistants asproviding ‘‘invaluable supports for inclusion.’’Amanda stated, ‘‘Without the aide, I think[including a student who uses AAC] would reallybe impossible.’’ Educational assistants werepraised for their depth of knowledge about thestudents who used AAC, for providing thestudents with the individual attention they oftenrequired, for the knowledge they had of how tooperate and maximize the benefits of AACsystems, and for their ability to assist withcurriculum adaptations. Cynthia spoke aboutthe role played by the educational assistant, Cara,who worked with a student who used AAC in herclass, ‘‘It was definitely crucial that there wassomebody like Cara that not only was reallyexperienced, but just handled everything so easily.She made a lot of on-the-spot decisions abouthow to reinterpret an assignment.’’Some teachers also pointed out that they found it

very beneficial to have an educational assistantwho worked with a student consistently from yearto year. Teachers stated that the knowledge theseeducational assistants had about students andtheir academic programs allowed them to makesuggestions to teachers about how to includestudents in various activities. Erin asserted thatstudents with autism, in particular, can benefitfrom the stability that comes with having the sameeducational assistant. ‘‘It made a big difference inEvan’s life to have that consistency. It would bewonderful if the same educational assistant couldfollow him all the way through school,’ she said.

Teacher-related supports

The general education teachers identified threekeys to successful inclusion. First, they frequentlycited a positive attitude and an ‘‘open mind’’ asrequisite characteristics for teachers attempting tosupport students in positive inclusion experiences.Second, it was important for teachers to be

informed about individual students’ skills andabilities as well as the education goals included instudents’ individualized education programs.Finally, although none of the participants in thisstudy had formal training in AAC, some teachersdid have training in special education in the formof university courses, workshops, and inservices.As Farrah explained:

Having a special ed. background reallyhelps. I’m not fearful when these kids comein. I’m not afraid to fail. I understand thatit’s going to be different with each child thatcomes in. Even though they may have simi-lar needs, it doesn’t mean that the samethings are going to work with everyone.

Classmate-related support

Participants stressed the important role class-mates played in the inclusion process. Teachersindicated that they were surprised by howaccepting the classmates had been and by theefforts classmates had made to include the targetstudents in various ways. Heather indicated thather students ‘‘knew the boundaries and what wasappropriate’’ in terms of how to interact with astudent who used AAC who was included in herclass. Another teacher, Iola, explained that sherelied on her target student’s classmates becausesometimes they ‘‘could tell [her] more about whatIda was saying than [she] understood. After beingwith them for so long, they understood her a lotmore than I think we gave them credit for.’’

Curriculum-related supports

Participants discussed three major issues relat-ing to the curriculum. First, realistic academicgoals were cited as being critical. Beth assertedthat educational inclusion can be successful‘‘as long as the goals are realistic, so it’s nota dumping ground.’’ Realistic goals were oftenmentioned in conjunction with the other twoissues raised in this subtheme: the nature ofthe classes in which students were includedand the grade level at which the students wereincluded.Keri recounted some successful and some

unsuccessful attempts to include Kelly in differentclasses. She stated that the success seemed todepend on the subject: ‘‘Science is hands-on andwe were able to take all the science objectives andmaterials and scale them down so that Kellycould participate in all the experiments we did,but the focus for her was a little bit different.Science actually went very well.’’ Teachersfrequently identified such subjects as math andlanguage arts as being less conducive to includingstudents at a variety of levels. Highly experientialsubjects (e.g., cooking, sewing, art) were oftendescribed as encompassing more possibilities forcurriculum adaptation.Participants also argued that it was most

appropriate to include target students in classeswhere similar skills are being targeted with theirclassmates. They explained that, in some cases,this would mean that older target students, wholagged behind their age-matched peers inacademic skills, would be included in lower gradelevels. According to these participants, in theearly grades it is often possible to target the sametypes of skills for both included students and theirclassmates. After describing her experience withincluding students in higher-level classes, Heather

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stated, ‘‘Special ed. students blend pretty easilywith kindergartners. They really do.’’ Participantsexplained that, while they understood that itcould be difficult to include older students inlower level classes, they still thought it wasinappropriate to try to target lower level skillsin advanced classes because physical presencedoes not automatically translate into activeinvolvement in the curriculum.

AAC-related supports

Finally, AAC as a specific form of assistivetechnology was noted to be crucial to students’active participation in class. Judy asserted that forher student, access to a voice output communica-tion aid ‘‘opened up a whole new world.’’ Accessto the AAC system alone, however, was notreported to be beneficial. Participants repeatedlystressed the importance of students and teammembers having adequate training and knowl-edge of how to operate the systems.

Recommendations

Based on their positive and challenging experi-ences, participants had a number of recommenda-tions related to the educational inclusion ofstudents who use AAC. These recommendationsare summarized in Table 4.

Recommendations for general education teachers

The numerous recommendations participants hadfor other general education teachers who mightface similar experiences in their classes included:(a) honestly communicating personal capabilitiesand limitations throughout the process, (b)developing competencies with AAC systemoperation, (c) requesting additional planningtime, (d) remembering students’ ‘‘humanity’’ atall times, (e) including students in all classroom

activities, (f) carefully matching assistive technol-ogy to individual activity demands, and (g)providing classmates with information through-out the inclusion process.

Recommendations for teams

The general education teachers also providedrecommendations for inclusion teams serving theneeds of students who use AAC (including suchteam members as special education teachers,educational assistants, speech-language patholo-gists, occupational therapists, and physical thera-pists). These recommendations included (a)maintaining effective team collaboration, (b)providing adequate training for all teammembers, (c) ensuring individual team memberssupport general education teachers on an ongoingbasis, (d) implementing effective transition plan-ning, and (e) selecting AAC systems withfunctions that are appropriate for individualstudents. Erin offered the following, based onher experiences with an effective inclusion team:

I think the whole team needs to be involvedjust the way we were. We communicated andeveryone was aware of what was happeningin my classroom, in the support classroom,and at home. We tried to keep those commu-nication lines open, so that we were reallyproviding the best support for the student.I think that’s very important.

GENERAL DISCUSSION

The 11 general education teachers who partici-pated in this investigation were from fourdifferent states and taught students using AACwho had varying strengths and needs. Therefore,the teachers’ diversity of experience was apparentin the results. Some teachers, for example,

TABLE 4 Summary of recommendations to facilitate educational inclusion of students who use AAC

Suggestions for . Communicate capabilities and limitations with respect to the inclusion process honestly.teachers . Develop competencies with AAC system operation.

. Request additional planning time.

. Remember students’ ‘‘humanity’’ at all times.

. Include students in all classroom activities.

. Carefully match assistive technology to individual activity demands.

. Provide classmates with information related to the inclusion of student using AAC.Suggestions for teams . Maintain effective team collaboration.

. Provide adequate training for team members.

. Provide the general education teacher with supports from individual team members (e.g.,speech-language pathologist, paraprofessional).

. Implement effective transition planning.

. Select an AAC system with functions appropriate for the individual student.

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reported that educational assistants providedvaluable supports throughout the inclusionprocess; others described experiences in whichthey did not feel that the educational assistantsthey worked with offered much support to themor their students. However, the varying positiveand negative teacher experiences reported in thisinvestigation were consistent in their descriptionof the impacts of inclusion and components ofsuccessful inclusion.

Impacts of Inclusion

For students using AAC

The teachers’ discussion of the benefits andnegative impacts of inclusion on students usingAAC fell into two broad categories: academicimpacts and social impacts. Participants’ concernregarding the lack of academic gains for theirstudents using AAC appears to be in contrast torecent findings in the general disability literature.For example, participants in the current studyindicated that although they felt that studentsusing AAC developed some scholastic, speech,and AAC system operational skills, they wereuncertain about whether or not these studentswere being academically well-served, overall.Recent findings in the general disability literaturesuggest that inclusion has some beneficial effectson academic outcomes for all students withdisabilities (e.g., Baker, Wang & Walberg, 1995;Fisher, 1996).These differing results may be a reflection of the

fact that academic assessment is heavily depen-dent on students’ abilities to communicate theirknowledge. Participants’ discussions aboutstudents’ lack of academic progress in the presentstudy centered on their own difficulties inmodifying assessment techniques to monitor theacademic progress of students who used AAC;therefore, a lack of concrete documentation ofacademic gains might have been at the root ofteachers’ perceptions of minimal academic gains.In contrast, as reported in a number of generaldisability related studies on inclusion, the major-ity of participants who took part in these studiesand who made at least small academic gains, werenot reported as having complex communicationneeds (e.g., Baker et al., 1995; Fisher, 1996). Itwould appear, therefore, that it is not onlynecessary to support students who use AAC toparticipate in classroom activities, but it is alsocritical to support general education teachers intheir efforts to assess students’ academic gains viaalternative means.Another explanation for differences between

the present study’s results and those of the

general disability literature might be participants’suggestion that the lack of academic gains mayhave been the result of inappropriate placementsof students. Some teachers stated that they feltthat educational inclusion of students usingAAC was more appropriate for younger ratherthan older students, unless the students had keptpace with their peers in reaching academicmilestones.Such notions need to be weighed carefully

against evidence provided by past researchindicating that students using AAC can maketheir greatest progress when expectations areappropriately high (McNaughton, Light, &Arnold, 2002). Individuals who use AAC haveasserted that such high expectations are often notput in place in special education settings(McNaughton et al., 2002). It will be importantfor students using AAC, their families, and theireducators to evaluate both the costs and thebenefits of inclusion and to make decisions onindividualized bases.In addition to identifying academic concerns,

participants discussed frankly the social impactsof educational inclusion of students who useAAC. The initial perusal of the benefits andnegative impacts of inclusion for these studentscould create the illusion of conflicting teacherexperiences relating to peer interaction. Closeexamination of the teachers’ experiences,however, suggests an important distinction. Keri,for example, described her student Kelly’s class-room interactions with her peers as a ‘‘brightspot’’ in the inclusion process. On the other hand,she also recounted stories of Kelly attempting toavoid socialization with her peers on the play-ground because Kelly’s peers were not interestedin playing the types of games she wanted to play.Instead, Kelly’s peers preferred to walk aroundthe playground and discuss dating. It wasapparent from experiences such as these that thesocial benefits described by Keri and otherparticipants were limited to positive classroominteractions between students using AAC andtheir classmates, who appeared to be willing toinclude and assist students using AAC in thesesituations.In contrast, when discussing socialization

outside of the classroom, participants explainedthat students using AAC were socially excludedand had differing interests from their classmates.This is a sobering finding, given that (a) many ofthe participants identified increased socializationas a formal education goal for students usingAAC; and (b) social interaction has been reportedto affect ‘‘virtually all aspects of development –physical, cognitive, social, and emotional’’ (Sigel-man & Shaffer, 1995, p. 360). This finding is

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consistent, however, with previous evidence thatsupports the notion that physical proximity ofchildren with disabilities to children withoutdisabilities does not necessarily create a positiveenvironment for all involved (Armstrong, Rosen-baum & King, 1987; Beck & Dennis, 1996;Ferguson, 1999; Voeltz, 1980, 1982). Interpreta-tion of this finding must take into account the factthat all of the students who used AAC in thecurrent study were reported to have had cognitivechallenges that may have influenced their ownsocial experiences.

Impacts for classmates

Teachers also identified academic and socialimpacts of inclusion on classmates of studentswho used AAC. Although the classroom disrup-tions that were identified by participants aspotentially affecting classmates’ learning environ-ments were noteworthy, they did not present asinsurmountable. As an example, configuringstudents’ AAC systems to say only selectedvocabulary instead of repeated statements (e.g.,‘‘I choose that one’’) would be an easy change tomake for educational personnel who havereceived the necessary instruction and have accessto personnel support. In fact, overcoming suchbarriers could be predicted to result in academicbenefits for the students using AACs as well as fortheir classmates. These findings illustrate thepotentially widespread positive effects of ensuringthat general education teachers have the necessarytraining, skills, and support to address commonclassroom issues that arise from the inclusion ofstudents with severe disabilities who use AAC.In contrast to academic impacts, the identified

social impacts of inclusion on classmates ofstudents who used AAC were significant. Theparticipants in the present study placed greatemphasis on classmates’ increased knowledge ofdisabilities in general and awareness of theimpacts of living with a disability specifically.These results are in keeping with those reportedby other researchers who have investigated thebenefits of inclusion of students with a wide rangeof severe disabilities. Giangreco, Dennis, Clonin-ger, Edelman, and Schattman (1993), for exam-ple, reported that teachers identified similarpersonal growth benefits for classmates ofincluded students with severe disabilities.Furthermore, Peck, Donaldson, and Pezzolie(1990) and Helmstetter, Peck, and Giangreco(1994) found that high school students themselvesreported positive outcomes from having relation-ships with students with disabilities (e.g.,increased awareness, tolerance, and understand-ing of individuals with disabilities). It appears

that the increasing inclusion of students with awide range of disabilities in general educationclassrooms (e.g., Sobsey & Cox, 1996) may have awide-reaching societal impact, as a new genera-tion of citizens mature who have learned to valueand respect individuals with disabilities.

For teachers

Participants reported similar social impacts tothose reported for target students and classmatesthemselves. The teachers discussed their increasedawareness of disabilities and disability-relatedissues as well as the job satisfaction theyassociated with learning to meet the needs of awide range of students. That they found theseinclusion-based experiences to be very positiveand transformative is also consistent withprevious findings in the severe disability literature(e.g., Giangreco et al., 1993).In contrast, the other immediate effect the

teachers identified for themselves was difficultyperforming all of their job-related duties in theallotted time. Although providing teachers withadditional release time or educational assistantsto assist with curriculum adaptations, materialpreparations, and AAC system setup are twoviable options for lessening such effects, theseoptions are often precluded by budgetary andhuman resource constraints. Therefore, it isapparent that the effects of including studentswho use AAC are not limited to students’classrooms or even their schools. Rather, supportmust also be present at the school district level toensure the success of such inclusion.In summary, participants identified both posi-

tive and negative effects of inclusion for the targetstudents who used AAC, the classmates of thesestudents, and themselves. Furthermore, partici-pants discussed more elaborately the benefits forother individuals in the classroom (i.e., classmates& teachers) than they did the benefits for thestudents who used AAC (although benefits forthese students were described by each teacher).These findings are similar to those of Soto,Muller, Hunt, and Goetz (2001), who includedintegration support teachers, parents, speech-language-pathologists, and instructional assis-tants as well as general education teachers intheir participant groups.

Components of Successful Inclusion

When describing their positive and negativeexperiences, participants identified numerouscomponents of successful inclusion, which fellinto five major categories relating to the team,classmate, curriculum, AAC system, and school.

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Team elements

The three major team-related components ofsuccessful inclusion identified by participantswere: (a) effective team communication andcollaboration; (b) adequate classroom supportprovided by educational assistants with training,skills, and dedication to the inclusive education ofstudents who use AAC; and (c) appropriategeneral education teacher training and prepara-tion time.The finding that effective team communication

and collaboration is essential to the inclusion ofstudents who use AAC is in keeping with thegeneral disability literature, which has documen-ted teacher reports of team collaboration beingimportant but not always successfully implemen-ted. Smith and Smith (2000), for example,indicated that the general education teacherswho participated in their qualitative interviewsidentified a need for more reliable collaborativesupport on an on-going basis. As Kavale andForness (2000) stated: ‘‘The reality of generaleducation suggests that the requisite attitudes,accommodations, and adaptations for studentswith disabilities are not yet in place’’ (p. 290). Inan effort to ensure that the general educationclassroom is a supportive and appropriateenvironment for students with severe disabilities,it is apparent that additional mechanisms must beput in place to facilitate ongoing communicationand collaboration between all inclusion teammembers, including general educators andparents.The findings of the present study also provide

support for the finding in the general disabilityliterature that appropriate training for educa-tional personnel is critical to the inclusion process(e.g., Gemmell-Crosby & Hanzlik, 1994; Gian-greco, Edelman, & Broer, 2001; Roll-Pettersson,2001; Smith & Smith, 2000). The currentinvestigation and the work of Soto et al. (2001)provide evidence that educational personnelworking with students who use AAC in generaleducation classroom have unique training needs.In addition to learning about their students’individual disabilities, they also have trainingneeds related to the operation and effective use ofAAC systems, which, in some cases, can berelatively complex computerized systems. Giventhe fundamental nature of communication in theclassroom (Beukelman & Mirenda, 1998; Cumley& Beukelman, 1992), it is essential that educa-tional personnel who interact with students whouse AAC on a daily basis are able to commu-nicate effectively and efficiently with them. Thisability may require that educational personnel beable to troubleshoot in instances of AAC system

failure, alter their communication patterns tofacilitate the communication of their students,and/or model the use of AAC systems, all ofwhich are tasks that require training and skilldevelopment.

Classmate component

Classmate willingness to assist in the inclusionprocess through direct interactions with targetstudents was identified as a key component tosuccessful inclusion. Because participantsexplained that the physical proximity of childrenwho use AAC to children without disabilities doesnot necessarily ensure successful peer interaction,inclusion teams need to attempt to facilitatepositive interactions between target students andtheir peers. Some evidence exists to suggest thatcommunicative interaction training for classmatesand target students may be effective in this regard(e.g., Hunt, Alwell, Farron-Davis, & Goetz, 1996;Staub & Hunt, 1993).

Curriculum component

As previously discussed, participants explainedthat they felt inclusion was more appropriate atlower, rather than higher grade levels. Theteachers further identified subjects of an appliednature (e.g., classes like family studies andscience) as being more conducive to inclusion ofstudents with severe disabilities using AAC. Inthese instances, the teachers explained that moreappropriate goals for target students that weresimilar to those of their classmates could beidentified and that curriculum adaptations weremore feasible and reasonable. These findings aresimilar to those of other studies in whichindividualized education program characteristicsof students with all types of severe cognitive andphysical disabilities have been examined (e.g.,Giangreco, Dennis, Edelman, & Cloninger,1994).While these curriculum-related issues are note-

worthy, they may not be relevant considerationsfor all students (e.g., students without or withonly mild intellectual disabilities). The need forindividualized decision-making becomes appar-ent. It may be that providing general educationteachers with ongoing classroom support ortraining in curriculum adaptation methods couldalleviate concerns associated with such curricu-lum components of the inclusion process. Speech-language-pathologists, for example, as experts incommunication disabilities, need to provideconsistent support for AAC system developmentin order to facilitate participation in classroomactivities.

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AAC component

Technology limitations, including the break-downs and failures of computerized AAC systemsthat were discussed by the participants, may neverbe completely eliminated. Nonetheless, continuedtechnological improvements are vital to theimprovement of quality of life for individualswho use AAC. Furthermore, access to multiplemodes of communication can be very effective inensuring students who use AAC have consistentmeans to participate in classroom activities. Thiscomponent of consistent access to an augmenta-tive or alternative means of communication isrelevant only to students with complex commu-nication needs and, because of the essential natureof communication in the classroom, it is one ofthe utmost importance. Principles of best practicesuggest that speech-language pathologists mustfacilitate interventions that emphasize multi-modal communication (e.g., Beukelman & Miren-da, 1998).

School components

Finally, successful inclusion programs must bemaintained beyond the confines of the generaleducation classroom. In the current study, thefollowing actions on the part of the schooladministration were identified as essential compo-nents of successful inclusion programs: (a)making necessary architectural adaptations toallow participation of students with severedisabilities, and (b) placing students in smallclasses to ensure the feasibility of adequatestudent support by educational personnel. Largeclass sizes have been noted in the generaldisability literature to be detrimental to theinclusion of students with severe disabilities(e.g., Harrington, 1997; Smith & Smith, 2000;Vaughn, Schumm, Jallad, Slusher et al., 1996).In summary, there are a number of implications

for educational practice that can be gleaned fromthe current study. Recommendations for inclu-sion teams and professionals who are striving tosupport general education teachers and studentswho use AAC include the following: (a) effectivelycoordinate team collaboration and informationdissemination; (b) arrange for team members toreceive adequate and individualized trainingrelated to AAC system operation and commu-nication with individuals who have complexcommunication needs; (c) provide on-going class-room support (e.g., assistance with curriculumadaptations); (d) provide additional planningtime for general education teachers; (e) providestudents with access to appropriate and variedAAC systems for all classroom activities; (f)

facilitate interactions between students who useAAC and classmates; (g) ensure the classroomenvironment is accessible for students who useAAC; (h) facilitate transitions by communicating/collaborating with new teachers before studentsare placed in new classes; (i) ensure the formula-tion of adequate and appropriate goals forstudents who use AAC; and (j) ensure appro-priate educational placements are made for targetstudents.

Limitations of the Study

The primary limitation of the current study is thatthe results are not generalizable to the populationof general education teachers who have includedstudents who use AAC in their classes because oftwo factors. First, the study was qualitative innature. Second, the sample was not representativeof the target group, in that (a) it was small; (b)participants were drawn from only four states inthe US; and (c) with the exception of twoteachers, the participants had taught only onestudent who used AAC.

Directions for Future Research

Given the fact that this investigation is one of thefirst to examine the experiences of generaleducation teachers with respect to the inclusionof students with AAC in their classrooms,additional research is required to ensure that bothteachers and students receive adequate andeffective support throughout the inclusionprocess. Based on the types of issues raised bythe participants in the current study, a survey of awider range of general education teachers inadditional geographic locations would provideinformation on whether the issues raised werespecific to the participants in the present study orare representative of those located throughout theUS. Further research is required to investigate theexperiences of teachers who have more experiencein teaching students who use AAC and sometraining in AAC. Moreover, future research isneeded to examine the experiences of teachers whohave taught students using AAC with a greaterrange of communication and cognitive skills.Additionally, the present investigation provides

data to support the notion that educationalassistants are crucial to the process of includingstudents who use AAC in general education class-rooms and carry a great deal of responsibility in theprocess.Therefore, it is important to investigate theexperiences of educational assistants.Finally, future research is needed to evaluate

the outcomes of implementing the components ofsuccessful inclusion identified in the present

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investigation. In particular, an investigation intothe effects of providing educators with AACtraining and ongoing classroom support forcurriculum adaptations and socialization issueswould provide directions for professional devel-opment. Further research will help to advance theunderstanding and practice of inclusion ofstudents with AAC needs in general educationsettings.

Acknowledgments

This paper was completed in partial fulfillment ofthe requirements for the Ph.D. program in theDepartment of Communication Sciences andDisorders at The Pennsylvania State University,University Park, PA, USA. Preliminary resultsfrom this study were presented at the annualconvention of the American Speech-Language-Hearing Association in New Orleans, Louisiana,November 15, 2001. The research was supported,in part, by a graduate scholarship in commu-nicative disorders from the SERTOMA Founda-tion and a graduate scholarship from theAmerican Speech-Language-Hearing Founda-tion. The authors would like to offer their sincerethanks to the teachers who gave of their time andexperience to participate in this project. Theauthors would also like to thank Ms. StephanieGulla for her assistance with coding the data, aswell as Dr. Katherine Hustad, Mrs. Glenda Kent,Dr. David McNaughton, and Dr. Carol Millerfor their assistance and suggestions throughoutthe duration of this project.

Note

1 Pseudonyms are used for participants and their targetstudents and were selected to begin with the same letter(e.g., Amanda & April refer to the teacher and her targetstudent, respectively).

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APPENDIX A. Interview Guide Themes

Theme Issues to be probed Sample probe

Activities/goals Information related to activities or goals that weremore difficult and/or easier when including studentsusing AAC in class(es).

Can you talk about the kinds of goalsthat were set for the student who usedAAC and how challenging these goalswere?

Benefits Information related to benefits of including studentsusing AAC in class(es)

How did the inclusion process go overall?

Difficulties Information related to difficulties encountered whenattempting to include students using AAC inclass(es).

Did you experience any roadblocks toinclusion?

Recommendations Recommendations for such individuals as schoolteachers, specialists, or administrators involved inthe educational inclusion of individuals who useAAC.

What would you say to other educatorsinvolved in the inclusion of studentswho use AAC?

Strategies Information related to strategies that were found to be(not) effective when attempting to include studentsusing AAC in class(es) (e.g, teaching strategies).

Was there anything (for example, ateaching strategy) that you tried in theinclusion process that really worked?

Support Information related to supports received whenincluding students using AAC in class(es).

Can you tell me about the kind of supportyou received in the inclusion process?

Note. The probes relating to these themes were framed in reference to each teacher’s personal experiences

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APPENDIX B. Operational Definitions ofCoding Themes

1. Benefits of inclusion. Positive outcomesresulting from an AAC user’s engagementin general education programming,including academic, personal, physical,psychological, or social gains.

2. Negative impact of inclusion. Negativeoutcomes resulting from an AAC user’sengagement in general educationprogramming, including academic,personal, physical, psychological, or socialimpacts.

3. Supports for inclusion. Any action, attitude,device, organization, person, phenomenon,policy, practice, preference, strategy, orsituation that enables or assists an AACuser to participate in general educationprogramming. Supports can includeattitudes, information dissemination,knowledge, personal characteristics, orskills.

4. Barriers to inclusion. Any action, attitude,device, environment, organization, person,phenomenon, physical limitation, policy,

practice, or situation that impedes anindividual’s ability to participate ingeneral education programmingadequately or to the individual’s fullestpotential. Barriers can include attitudes,information dissemination, knowledge,physical/medical conditions, or skills.

5. Recommendations. Suggestions for othersregarding ways of overcoming barriers tothe educational inclusion of AAC usersbased on participants’ personal experiences.

6. Descriptive information. Comments aboutteachers, students, classes, or schools thatprovide information about thecircumstances surrounding the inclusion ofindividual students, but do not includerelated benefits, negative impacts, barriers,or supports (e.g., description of a student’sdisability, educational program, AACsystem, class, family situation, physicalstatus, or of a teacher’s background,experiences etc.).

7. Unrelated or uncodable statement. Acomment or question that is unrelated tothe educational inclusion of students whouse AAC or is unintelligible within in thecontext provided.

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