Opportunities & Barriers in Special Education for Children with Autism

The neurodevelopment of children is highly affected by Autism and it causes social impairment, communication difficulties and restrictive-repetitive challenging behaviors. In addition, this group of children often face several barriers in availing formal education. Therefore, the purpose of the study was to explore the opportunities-barriers and their consequences in the current status of special education in context of Bangladesh. A qualitative design was used for this study. Data was analyzed through content analysis. There were eight respondents purposively selected from special teachers, therapists and parents of children with autism from two special schools. The result showed that school teachers and therapists were cooperative and helpful. Trained teachers, different therapeutic service, health education, primary screening opportunities such as vision, hearing, social and emotional status, general intelligence are helping better academic performance hence considered as opportunities. The fundamental barriers included lack of transportation, expensive learning process and therapeutic charge, lack of knowledge of teachers, social stigma, poor government support and infrastructures of the schools.


Introduction
Autism spectrum disorder is a construct used to describe individuals with a specific combination of impairments in social communication with repetitive behaviors, highly restricted interests and/or sensory behaviors beginning early in life (Lord et al., 2018). The prevalence of Autism is increasing in Bangladesh paralleled to other developing countries (Preity et al., 2017) although the specific prevalence was not known. According to the estimation of the Centre for Disease Control and Prevention (CDC)'s Autism and Developmental Disease Monitoring (ADDM) Network, approximately 1 in 68 children aged 8 years are identified with ASD (Akhter et al., 2018). Even many individuals with autism have the normal level of intelligence, learning difficulties present in a significant proportion of ASD cases. They often show a poor adapting behavior to different situation, face difficulties in interacting others, and show uncontrolled behavior which makes the learning process and the environment challenging (Brien & Pearson 2004). Disability is a natural part of the human experience all over the world, irrespective of gender, race, ethnicity, religion, sexual preference or orientation. Almost everyone will be temporarily or permanently impaired at some point of life and those who survive to old age will experience increasing difficulties in functioning. There are disabled members in most of the extended families, and many non-disabled people take responsibility for supporting and caring for their relatives and friends with disabilities. A number of moral and political conflicts are faced often to include and support people with disabilities in the mainstream society.
Over 1 billion people are estimated to experience disability. This corresponds to about 15% of the world's population, with up to 190 million (3.8%) people aged 15 years and older having significant difficulties in functioning, often requiring health care services (Griffin et al., 2021). If they are properly educated and trained, they can significantly contribute to the development of society. In developed countries, the government takes responsibility for their education, training and rehabilitation and in contrast, the developing country's government does not take those responsibilities. Education is the fundamental human right for all which was represented by the Universal Declaration of Human Rights in 1948. Education is about supporting children to develop in all aspects of their livesspiritual, moral, cognitive, emotional, imaginative, aesthetic, social and physical (Moyles et al, 2017). The United Nations Convention on the Rights of Persons with Disabilities (CRPD), mandated its member countries to improve quality of education and to convey with the right of person with any kind of disability within the education environment which was specially included in article 24 (United Nation, n.d).
Despite there are overall progression of education in global context, children with disabilities are lagging behind in most of the countries. They often do not participate and complete education as they face so many barriers. Estimation in South Asia revealed that 29 million children left school in 2018. Of those, a significant proportion was the children with disability. The government has taken many measures to improve the quality of life of these challenged groups of people. Autism schools are special schools that are equipped to deal with the social and mental development associated with autism students. The teachers are trained to work with the students and help them develop normal social interactions. Autism is one of the few disorders of childhood in which the primary treatment is provided within the context of an educational setting, whether in a home-based setting for young children, or a school-based program for older children and youth (Odom et al., 2021). Therefore, the aim of the study was to explore the opportunities-barriers and their consequences in the current status of special education in context of Bangladesh.

Methodology
The study is qualitative in nature. The focus of this study was to explore the opportunities-barriers for special education and the ways to overcome the situation for the children with autism. The qualitative method was selected for this study as it was the most appropriate design found for the study. Qualitative research is exploratory in nature by which researcher can gain insight into another person's view, opinions, feelings and beliefs within their own natural settings. The study was conducted at Smiling Children Special School (SCSS), Dhaka and Special Education Needs Unit of William Mary Taylor School, CRP, Savar in Bangladesh. The study population was the Parents of children with autism, special teachers and therapists. Purposive sampling procedure was used for this qualitative study because qualitative sampling tends to be purposive rather than using random sampling strategies. The researcher collected data from those parents, teachers and therapists who are more appropriate and fulfilled the study purpose according to inclusion criteria. The data met the saturation level after eight participants (2 special teachers, 3 therapists & 4 parents of children with autism) face to face interviews. The researcher collected data through semi-structured, in-depth interviews. Because semi-structure interview helped for the researcher to obtain all the required information at the same time giving freedom to the participants to respond and illustrate the concept. Before starting the face to face interview a rapport with the participants was developed through a general conversation. The interviewer also explained the title and the aim of the study to promote the trust of the participants. The investigator used a consent form both in English and Bengali and took the participants' consent in English and Bengali. Following initial transcription, the recorded data was reviewed to ensure validity of data. Content analysis was done eventually. The overall contents were divided into two main segments as Opportunities and Barriers. Then under each broad segments the perspective of parents, teachers, Speech and language therapists, and Occupational therapists were narrated. Beside those the researchers' point of view was also described.

Results
The investigated perspectives of parents, therapists and Teachers about the existing opportunities and barriers are described below along with the researchers' discussion.

Opportunities Parents' Perspectives
Parents said that in the autism school, teachers are cooperative and deal with student very carefully. School authority arranges meeting with parent every month so that the parents can share or express their feelings or expectation. For the students' better outcome, the school management provides training to the parents. The parents of children with autism said that children with autism are very different and the in-depth guide helps to familiarize parents with the confusion regarding any particular issue. They have mentioned that the skill of special teachers makes the study easy. The teachers of the schools are skilled to manage the children better than any other normal school which is very important. They feel that special therapeutic service (speech and language therapy, physiotherapy and occupational therapy) made their children physically fit, more communicative and innovative in the learning process.

Teachers' Perspective
They told that in their schools, students are evaluated in all areas of suspected disability which can include health, vision, hearing, social and emotional status, general intelligence, academic performance, communicative status and motor abilities. Eligibility for special education services is determined based on the results of the evaluation. Every student has Individualized Education Program (IEP). In the special school, parent meetings with individual class teacher are arranged monthly therefore parents can easily know about the child's improvement. They mentioned that most of them are specially trained to manage the special need children's education which is very crucial. They strongly believe that teaching a child with autism require special training for everyone dealing them in order to have a better learning outcome. For students' improvement the school authority also arranges training session once in a month to train up the parents. They also praised the therapeutic services provided by the therapists which make their teaching easy. Special education teachers assess students' progress and use that information to adapt lessons to help them learn. They also help general education teachers adapt their lessons to the needs of students with disabilities. They attend to children's basic needs, such as bathing and feeding training. Teachers reported that they provide information sheet that parents receive each week. Also the parents receive constant information on parent involvement from the teachers. The teachers interact with the parents constantly. Special teachers also arrange home visit program. The teachers and the therapists go to the homes of each student regularly. School also provides Information and communication technology (ICT) facilities for children with autism to communicate and connect with friends, which reduces their isolation and can open up opportunities for their participation in political, economic, social and cultural life.

Speech & Language Therapists' Perspective
Speech therapists commented that children with autism have difficulty in communication and socialization. A speech & Language Therapist's main objective is to find out how the child's language and communication problem challenges the ability to progress their learning process. Speech therapist provides individual and group therapy and also provides training to the teacher and parents. For every individual child, SLT improves the child's articulation skills/speech intelligibility, expressive language skills, receptive language skills, listening skills, speech fluency, voice & resonance, social/pragmatic skills, cognitive-communication skills. A speech therapist also provides Augmentative and Alternative Communication (AAC) as child's need. Speech therapists also said that in the school they use different therapy materials which are very low in cost so that parents can afford easily. Therapist provides training to the school educator and parents for better outcome to the child with autism. Therapist modifies the class room as children's attention.

Physiotherapists' Perspective
Being healthy is the key to effective learning. Physiothepy service in the special schools helps the children with autism for being fit physically and mentally. The routine aerobic activates can significantly reduce the stereotyped abnormal behavioral issues which often cause distraction to the learning process.

Occupational Therapists' Perspective
Occupational therapist commented that a collaborative service model works best rather than simply pulling students out of classes. Interventions that may not apply in classrooms, can be provided by key professionals and family services must focus on the students and the environment. Occupational therapy goals are to support the preparation for learning, living and working. Occupational therapy interventions are effective when they improve students' performance in contexts in which students participate. Therapists also said that they try to teach the students to be independent. The therapists work with teachers to help students acquire functional abilities necessary to access educational materials, to help students function better in classrooms, the dining room, or restrooms. Therapists may work with the person adapting or modifying their equipment and materials. Other assistance includes helping students participate in activities outside of the school through mobility on field trips, sports events, on playgrounds and within the community. Eventually Therapists work closely with teachers to promote the highest level of function possible for students pursuing educational goals.

Barriers Parents' Perspectives
A child with autism does not go to school independently that's why he needs other's help or guide. The lack of transportation makes the learning process challenging. Most of the parent are not capable to bear personal transportation cost. Schooling charge and materials for therapy and teaching are so much expensive which is not affordable for most of the parents. They have lack of Parents' waiting room and wide playground. Parent expect better communication from the teacher on the activities in the classroom and their child's progress in the school. Parents claimed that they have limited access to the media emergency services and even simple telephone conversations. Some of dream that their children will communicate freely with all people through the use of assistive technologies but most of the verbal communicative technologies are not available in this country. In addition, parents are facing social stigma while admitting in school. Some of the parents are very depressed about their neighbors'attitude. They mentioned that most of them do not receive enough support from their husbands and other family members. The parents claimed they often face mental stress therefore require psychological counselling. They think that school authority should do something for the parent also. They also become disappointed when they found some teachers with poor skill and experience with lack of patience dealing their children.

Teachers' Perspective
Some of the teachers recommend that their special education system is good but they need more knowledge about special child teaching therefore require advanced training and practical workshop. Teachers often facing lack of special teaching material especially the audiovisual media. The schools might include some vocational training for comparatively older children which are lacking completely. Teacher also said that their salary is low. They are not getting any government support. Many of them have lack of knowledge about autistic children's special behavior, life style, functional limitation therefore management become challenging. Often they are stressed to serve the need for children. Administrative pressure for the development of new skills and knowledge being burden sometimes. Parenting styles often cause poor outcome. Over protective behavior or ignorance of parent often cause problem. Parental beliefs and values, experience with the formal educational system, rural residence impose challenge in the learning process. Lack of patience of family members, frustration, superstition, abnormal behavior of community people is additional burden and often cause inconsistency in learning process.

Speech & Language Therapists' Perspective
The case load management is the main difficulty which is often faced by Speech & Language Therapist. Therefore, the limitation in the number of therapist is an important issue as most of the children require speech and language therapy. In addition, lack of communication instrument, devices and ideal room set up for speech and language therapy are evident. Many students need individual and frequent therapy service but parents are unable to pay.

Occupational Therapists' Perspective
Sensory integration therapy room which is very important for these children are lacking in the school. Often the therapist require assistance from other therapist which is not sufficient. Lack of training, funding, instruments, special clinical setup are disappointing and imposing negative effect in learning process.

Discussion
The current study was aimed to explore the opportunities-barriers in Special Education for Children with Autism and their consequences in the current status of special education in context of Bangladesh. The Qualitative study attempted to find that information from the parents, school teachers and the rehabilitation professionals working there. Most of the parents are satisfied by the teaching and learning process offered by the schools. They specially acknowledged the skill of teachers and the therapeutic facilities of the special schools and they think that these are very helpful for their children's education. According to Stidham (2015) that teacher training provides positive outcomes for the teacher and the students. teacher training not only ensures the inclusion of students in lessons, but can also make teachers feel more confident with children with autism. Training can result the teachers having a more positive attitude towards a special setting for children with autism. The advanced infra-structure and special education classroom modifications should be done using a certified standard. A study by Dillon et al. (2021) found that interdisciplinary team work in special education has a better impact on education. They found that adapted physical educator, special educator, related service providers and parent together can make a strong positive result in learning process. According to the special educator, educating the children with autism is challenging specially in normal school where the special arrangement of special school makes the process easier. The special trained teacher can handle better than the normal mainstream teacher. Besides, they also mentioned some of the limitation such as more special training, poor remuneration, lack of government support and so on. In addition, they are overburdened and stressed due the job pattern. A study by Gersten et al. (2001) found that job design of special educator act as a leading cause of stress in work place and eventually job retention become challenging. Starks and Reiche (2023) found several barriers for special schools such as lacking access to special device, internet facilities, advanced software and digital literacy skill, lacking in technology training and time of teachers, school authority lethargy to technology and so on. The therapists identified physical exercise for physical fitness, environmental and equipment modification, speech and language therapy, communicative therapy, ADL training, health education of parents as the strength of special schools where they also identified the lack of special training for the educator, lack of infrastructure and special instrument, improper environment, case load, social stigma or superstition, frustration of parents and so on as barrier. A study by Cleary et al. (2019) found from the focus group discussion that physical activity is equally important as academic work for special need children. They found that lack of physical activity causes fluctuation in health, school absence and poor rehabilitation. in addition, the unique environment of special school act as a pivotal role to make the student active and collaborative therefore helps in better learning.

Conclusion
Children with autism have need of specialized involvements that argument comprehensive skills development, including social, communication skills, task engagement, physical exercise and work skills, as well as adaptive, cognitive, and motor skills. A continuous awareness-raising is needed not only for parents or caregivers but also for other members of society. The school authorities may provide attention to develop a special environment, skilled teaching staffs, inclusion of rehabilitation professional, health education, advanced technical facilities and so on. The school authority also can be more careful about the even and logical distribution of case load for the teachers and others so that the learning process become optimistic. They also need to be vigilant about the proper remuneration of the staffs.