Learning, Social, and Psychological Outcomes of Students with Moderate, Severe, and Complex Disabilities in Inclusive Education: A Systematic Review

Figures & data

Figure 1. Selection procedure, adapted from Moher et al. (2015).

Table 1. Included studies in the systematic review and their characteristics.

Study	Sample			Research design	Outcome category
	Country	Grade level	n. of students with MSCD
Alexandersson (2011)	Sweden	Primary	1	Qualitative case study	AS, AP
Ballard and Dymond (2016)	USA	Secondary	1	Case study	AL, AS, SI, WB
Chen (2017)	Taiwan	Secondary	74	Correlational study	AS
de Graaf and de Graaf (2016)	Netherlands	Preschool – Secondary	ca. 285	Quantitative survey study	AL, AS
de Graaf and van Hove (2015)	Netherlands	Preschool – Secondary	Not specified	Quantitative survey study	AL
Dessemontet et al. (2012)	Switzerland	Primary	Not specified	Quasi-experiment	AL, AS
Feldman et al. (2016)	USA	Secondary	108	Interpretative study	AP, SI
Ferreira et al. (2017)	Portugal	Preschool	ca. 47	Correlational study	SI
Hardiman et al. (2009)	Ireland	Not specified	45: 20 mainstream, 25 special	Quantitative survey study	AS, CB
Harkins (2013)	USA	Preschool – Secondary	1	Qualitative case study	AL, AS, SI
Huck et al. (2010)	Australia	Primary	11	Quantitative survey study	AS, SI
Leyser and Kirk (2011)	USA	Preschool – Secondary	ca. 44	Mixed method/multi method	AP, SI
Matzen et al. (2010)	USA	Middle	3	Mixed method/multi method	AP, CB
Naraian (2011)	USA	Primary	1	Qualitative case study	AP, SI
Olsson et al. (2018)	Sweden	Secondary	129: 115 mainstream, 14 special	Quantitative survey study	AP, SI, WB
Potter (2014)	UK	Primary	1	Qualitative case study	SI
Taheri et al. (2017)	Canada	Preschool – Secondary	ca. 197: 90 mainstream, 107 special	Correlational study	AP
Tuersley-Dixon and Frederickson (2016)	UK	Primary	20	Correlational study	SI

AL = Academic Learning Outcomes; AS = Adaptive Skills; AP = Activity Participation; CB = Challenging Behaviour; SI = Social Interactions; WB = Well-being

Table 2. Categories and subcategories of studies.

Category	Subcategory	n. studies
Learning Outcomes	Academic learning outcomes	5
	Adaptive skills	8
Social Outcomes	Activity participation	7
	Social interactions	9
Psychological or Personal Outcomes	Challenging behaviour	2
	Well-being	2

Moher, D., Shamseer, L., Clarke, M., Ghersi, D., Liberati, A., Petticrew, M., … Stewart, L. A. (2015). Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Systematic Reviews, 4(1), 1.

 PubMed Web of Science ®Google Scholar

*Alexandersson, U. (2011). Inclusion in practice: Sofia’s situations for interaction. International Journal of Special Education, 26(3), 114–123.

 Google Scholar

*Ballard, S. L., & Dymond, S. K. (2016). Acquired severe disabilities and complex health care needs: Access to inclusive education. Research and Practice for Persons with Severe Disabilities, 41(3), 191–208.

 Web of Science ®Google Scholar

*Chen, L. J. (2017). Critical components for inclusion of students with moderate intellectual disabilities into general junior high school. International Journal of Developmental Disabilities, 63(1), 8–16.

 Web of Science ®Google Scholar

*de Graaf, G., & de Graaf, E. (2016). Development of self‐help, language, and academic skills in persons with Down syndrome. Journal of Policy and Practice in Intellectual Disabilities, 13(2), 120–131.

 Web of Science ®Google Scholar

*de Graaf, G., & van Hove, G. (2015). Learning to read in regular and special schools: A follow-up study of students with Down syndrome. Life Span and Disability, 18(1), 7–39.

 Web of Science ®Google Scholar

*Dessemontet, R. S., Bless, G., & Morin, D. (2012). Effects of inclusion on the academic achievement and adaptive behaviour of children with intellectual disabilities. Journal of Intellectual Disability Research, 56(6), 579–587.

 PubMed Web of Science ®Google Scholar

*Feldman, R., Carter, E. W., Asmus, J., & Brock, M. E. (2016). Presence, proximity, and peer interactions of adolescents with severe disabilities in general education classrooms. Exceptional Children, 82(2), 192–208.

 Web of Science ®Google Scholar

*Ferreira, M., Aguiar, C., Correia, N., Fialho, M., & Pimentel, J. S. (2017). Social experiences of children with disabilities in inclusive Portuguese preschool settings. Journal of Early Intervention, 39(1), 33–50.

 Web of Science ®Google Scholar

*Hardiman, S., Guerin, S., & Fitzsimons, E. (2009). A Comparison of the social competence of children with moderate intellectual disability in inclusive versus segregated school settings. Research in Developmental Disabilities, 30(2), 397–407.

 PubMed Web of Science ®Google Scholar

*Harkins, S. (2013, June). Full-inclusion as a lived experience: The school career of Martin Schaeffer. Inquiry in Education, 4(1), Article 5. Retrieved from: http://digitalcommons.nl.edu/ie/vol4/iss1/5.

 Google Scholar

*Huck, S., Kemp, C., & Carter, M. (2010). Self-concept of children with intellectual disability in mainstream settings. Journal of Intellectual and Developmental Disability, 35(3), 141–154.

 PubMed Web of Science ®Google Scholar

*Leyser, Y., & Kirk, R. (2011). Parents’ perspectives on inclusion and schooling of students with Angelman syndrome: Suggestions for educators. International Journal of Special Education, 26(2), 79–91.

 Google Scholar

*Matzen, K., Ryndak, D., & Nakao, T. (2010). Middle school teams increasing access to general education for students with significant disabilities: Issues encountered and activities observed across contexts. Remedial and Special Education, 31(4), 287–304.

 Web of Science ®Google Scholar

*Naraian, S. (2011). Teacher discourse, peer relations, significant disability: Unraveling one friendship story. International Journal of Qualitative Studies in Education, 24(1), 97–115.

 Google Scholar

*Olsson, S., Dag, M., & Kullberg, C. (2018). Deaf and hard-of-hearing adolescents’ experiences of inclusion and exclusion in mainstream and special schools in Sweden. European Journal of Special Needs Education, 33(4), 495–509.

 Web of Science ®Google Scholar

*Potter, C. (2014). “I didn’t used to have much friends”: Exploring the friendship concepts and capabilities of a boy with autism and severe learning disabilities. British Journal of Learning Disabilities, 43(3), 208–218.

 Web of Science ®Google Scholar

*Taheri, A., Perry, A., & Minnes, P. (2017). Exploring factors that impact activity participation of children and adolescents with severe developmental disabilities. Journal of Intellectual Disability Research, 61(12), 1151–1161.

 PubMed Web of Science ®Google Scholar

*Tuersley-Dixon, L., & Frederickson, N. (2016). Social inclusion of children with complex needs in mainstream: Does visibility and severity of disability matter? International Journal of Developmental Disabilities, 62(2), 89–97.

 Web of Science ®Google Scholar