Changing teachers' negative attitudes toward persons with intellectual disabilities.

559929 research-article2014

BMOXXX10.1177/0145445514559929Behavior ModificationHassanein

Article

Changing Teachers’ Negative Attitudes Toward Persons With Intellectual Disabilities

Behavior Modification 1–23 © The Author(s) 2014 Reprints and permissions: sagepub.com/journalsPermissions.nav DOI: 10.1177/0145445514559929 bmo.sagepub.com

Elsayed Elshabrawy Ahmed Hassanein1

Abstract The current study aims at changing teachers’ negative attitudes toward persons with intellectual disabilities. The intervention is based on the argument that providing information is not sufficient to achieve lasting change of attitudes toward people with disabilities, and that contact is required as an additional element to show positive results. A pretest-posttest intervention was conducted using three conditions: (a) cognitive intervention, (b) cognitive and behavioral intervention involving contact with the target group, and (c) no-intervention control. The participants comprised 18 teachers, with 6 teachers in each group. Following baseline assessments of attitudes, attitude change was measured immediately following the intervention and at a follow-up 12 weeks postintervention. The cognitive intervention provided information about intellectual disability and challenged stereotypic conceptions about persons with intellectual disabilities. The behavioral intervention involved being engaged in work with and training persons with intellectual disabilities in sheltered workshops. The results showed that the cognitive intervention alone did not result in significant changes in attitudes toward persons with intellectual disabilities. However, the combined cognitive-behavioral intervention resulted in greater attitude change than the no-intervention condition, both immediately postintervention and at a 12-week follow-up. The findings are discussed with regard to models of 1Al-Azhar

University, Cairo, Egypt

Corresponding Author: Elsayed Elshabrawy Ahmed Hassanein, Faculty of Education, Al-Azhar University, Nasr City, Cairo, Egypt. Email: [email protected]

Downloaded from bmo.sagepub.com at FRESNO PACIFIC UNIV on December 20, 2014

2

Behavior Modification

attitude change. The study concludes with some recommendations for teacher training programs to be attended to. Keywords attitude change, prejudice, intellectual disability, contact hypothesis, teacher training

Introduction Traditionally, individuals with intellectual disabilities have not been treated properly by society. Over many centuries, they have been subjected to varying degrees of pity, ridicule, rejection, and seclusion as the result of being different. Some societies perceived disability as punishment by the gods, whereas in other societies, children and adults with disabilities were detested, left to die, or indeed killed through fear and ignorance (Barnes, Mercer, & Shakespeare, 1999; Linton, 1998; Oliver, 1990). Indeed, public perception about people with disabilities is still largely negative (see Pruett, Lee, Chan, Wang, & Lane, 2008). Feelings of discomfort, rejection, or fear during interactions with persons with disabilities are still prevalent, let alone the misconceptions about the behavior, personality, and achievement potential of such people (Krahe & Altwasser, 2006). However, open dislike toward people who are intellectually different is no longer socially desirable. Disability advocates are working to change such negative attitudes toward persons with disabilities in many countries. Furthermore, there are currently several laws and norms to ensure equal opportunity and treatment of people with disabilities. With this in mind, it will not escape the reader that such reservations cannot be overcome solely by legal regulations and integration/inclusion policies. Instead and based on insights from social-psychological research on prejudice and stereotypes, actions are required that target individuals’ cognitions, emotions, and behaviors toward persons with intellectual disabilities (Krahe & Altwasser, 2006). Targeting individuals’ cognitions, emotions, and behaviors in training is consistent with the three-component model of attitudes that suggests that attitudes are comprised of three components, namely, affective, cognitive, and behavioral (Olson & Zanna, 1993). The affective component represents the emotional domain of an attitude, whereas the cognitive component refers to ideas, beliefs, and opinions. The behavioral component entails a persons’ willingness to interact with the subject at hand and the manner in which they do so (Eagly & Chaiken, 1993; Olson & Zanna, 1993). Whereas general attitudes toward people with intellectual disabilities are seen as negative,


3

Hassanein

effective interventions should address all these components to enable significant changes in teachers’ attitudes. The role of the teacher (as a significant intervention agent) in such a context has been of great concern for many researchers based on the argument that teachers’ attitudes toward students with disabilities in general and students with intellectual disabilities in particular influence the likely success or failure of policies aimed at increasing their educational and social inclusion (Hastings & Oakford, 2003; Hassanein, 2010). Research literature related to teachers’ attitudes toward inclusion suggests that teachers’ attitudes are influenced by the type of disability they are asked to accommodate within their classroom, indicating that teacher support for inclusion varies with the severity of the disability (Avramidis, Bayliss, & Burden, 2000; Center & Ward, 1987; Dupoux, Wolman, & Estrada, 2005; Forlin, 1995; Hastings & Oakford, 2003; Heflin & Bullock, 1999; Scruggs & Mastropieri, 1996). Such results were recently replicated in the Egyptian context. Hassanein (2010) found that Egyptian teachers were reluctant to include children with intellectual disabilities in their classrooms in spite of the fact that Egyptian educational authorities now advocate for the inclusion of children with special needs, specifically children with mild intellectual disability, within regular classrooms. According to Campbell, Gilmore, and Cuskelly (2003), such advocacy alone, however, cannot ensure that the policy is favorably accepted by those most responsible for its effective implementation, namely, classroom teachers. The literature indicates that teachers’ attitudes toward disability per se may affect teachers’ attitudes toward inclusion, and the effectiveness of their inclusive practices. A considerable number of studies have been undertaken to probe teachers’ attitudes toward disability (Forlin, Tait, Carroll, & Jobling, 1999; Tait & Purdie, 2000). Most of these studies demonstrated that attitudes are more negative toward persons with intellectual disabilities. Furthermore, the research literature on teachers’ attitudes toward disability indicates that negative attitudes “lead to low expectations of a person with a disability” (Forlin et al., 1999, p. 209), which in turn could lead to reduced learning opportunities, beginning a cycle of impaired performance and further lowered expectations, both by the teacher and the child. Research also indicates that negative attitudes interfere with the employment, self-esteem, and health care of persons with disabilities (Pruett et al., 2008). Teachers’ attitudes and expectations might have a severe impact upon their students’ educational outcomes (Myklebust, 2006), and this is of particular concern where teachers hold less than positive attitudes toward individuals with a disability or the educational policy of inclusion (Buell, Hallam,


4


Gamel-McCormick, & Scheer, 1999; Forlin, Douglas, & Hattie, 1996; Kalyva, Gojkovic, & Tsakiris, 2007; Semmel, Abernathy, Butera, & Lesar, 1991). Tait and Purdie (2000) argued the importance of developing positive attitudes in teachers toward students with disabilities in their initial and continuing professional development. Therefore, several studies have examined ways of promoting more positive attitudes in teachers toward persons with disabilities. It is argued that traditional information-based training programs have little influence on attitudes toward disability (Hastings, Hewes, Lock, & Witting, 1996; Lee & Rodda, 1994; Seccombe, 2007; Tait & Purdie, 2000). Similarly, direct contact with people with disabilities does not necessarily lead to favorable changes in attitude (Rees, Spreen, & Harnadek, 1991), although, in general, the level of contact has emerged as a significant factor in determining positive attitudes toward people with disabilities (Forlin et al., 1999; Hastings et al., 1996). The combined strategy of both information and contact, however, holds considerable potential in changing attitudes (Campbell et al., 2003; Ford, Pugach, & Otis-Wilborn, 2001; Krahe & Altwasser, 2006; Lee & Rodda, 1994; Rees et al., 1991). Yet, controlled interventions using an experimental pretest-posttest design to examine the effectiveness of a combined approach, especially in the area of attitudes toward persons with intellectual disabilities, is not a frequently trodden area of research. With this in mind, the current study tried to attend to such a scarcity of research.

Purpose of the Study The intervention was designed to compare a purely cognitive intervention with a combination of cognitive and behavioral intervention, and to contrast both with a no-intervention control condition. The cognitive intervention focused on encouraging participants to think about intellectual disability and to question their stereotypic conceptions of people with intellectual disabilities. The combined cognitive-behavioral intervention was thought to introduce an additional element that would facilitate personal contact with members of the target group. A training context was chosen for the contact situation between persons with intellectual disabilities and nondisabled teachers. The main hypothesis of the present research was that the combined cognitive (information-based) and behavioral intervention would be more effective in changing negative attitudes toward persons with intellectual disabilities than the cognitive intervention alone. This prediction was based on Allport’s (1954) contact hypothesis, reasoning that combining information about an out group with personal contact in a cooperative framework would lead to


5

Hassanein

greater and more sustained attitude change than providing information alone. Therefore, this hypothesis is formulated in a directional way. Due to the contradictory results regarding the role of the information-based programs in changing attitudes, null hypotheses are used. Following are the research hypotheses: 1. There are no significant differences between the mean ranks attained by the cognitive group on the posttest and the pretest on attitude scale. 2. There are no significant differences between the mean ranks attained by the control group on the posttest and the pretest on attitude scale. 3. There are no significant differences between the mean ranks attained by the cognitive group and that of the control group on the posttest of attitude scale. 4. There are no significant differences between the mean ranks attained by the cognitive group on the posttest and that of the same group on the follow-up test on attitude scale. 5. There will be significant differences between the mean ranks attained by the cognitive-behavior group on the posttest and the pretest on attitude scale in favor of the posttest. 6. There are significant differences between the mean ranks attained by the cognitive-behavior group and that of the cognitive group on the posttest of attitude scale in favor of cognitive-behavior group. 7. There are significant differences between the mean ranks attained by the cognitive-behavior group and that of the control group on the posttest of attitude scale in favor of cognitive-behavior group. 8. There are no significant differences between the mean ranks attained by the cognitive-behavior group on the posttest and that of the same group on the follow-up test on attitude scale.

Method Participants A total of 18 teachers (9 male and 9 female) who participated in the study were selected randomly (out of 96 teachers) from two primary schools in New Cairo Educational District, based on their scores on the attitude scale used in the current study.

Measures Attitude scale. The 60-item Likert-type scale, Attitudes Towards People with Disabilities (Alkoreity, 1992), which includes 24 positive statements and 26


6


negative statements about people with intellectual disabilities, was used to measure attitudes toward disability in general. Each item was rated on a 5-point scale (from strongly agree to strongly disagree). The scale is divided into three subscales: (a) characteristics and value of people with disabilities, (b) social interaction with people with disabilities, and (c) education and training of people with disabilities. Appropriate levels of reliability and validity have been established for this scale (Alkoreity, 1992). Face validity of the scale is reported, and Cronbach’s α = .737. The training program. The training program was designed to enable attitude change by addressing the cognitive level in both experimental groups and by providing firsthand behavioral experience in the “cognitive and behavioral intervention” group. The cognitive information-based training program was designed to address participants’ knowledge and beliefs about people with intellectual disabilities in accordance with recommendations provided by Hunt and Hunt (2004), Krahe and Altwasser (2006), and Lee and Rodda (1994). In particular, the cognitive intervention consisted of the following elements: (a) talking about personal experiences in interacting with people with disabilities, especially persons with intellectual disabilities. This section was designed as a warming-up exercise to introduce the participants to the topic of intellectual disability; (b) providing basic information, such as the definition of disability and the categories and types of disabilities. Participants were introduced to the World Health Organization (WHO) definition of disability, differentiating between impairment, disability, and handicap; (c) discussing the labeling of people with intellectual disabilities. Participants were presented with two denominations (i.e., “intellectually disabled people” and “people with intellectual disabilities”) and were encouraged to discuss whether there was a difference in meaning between the two. Also, other related labels such as mental retardation and its social and psychological connotations were discussed; (d) discussing the different theoretical models in understanding disability (the medical model, the social model, the interactive model, and the impact of each in the life of people with intellectual disabilities); (e) increasing awareness of the extensiveness of disability in Egypt and worldwide; (f) describing the kinds of barriers people with disabilities face in different aspects, mainly education and work; (g) identifying myths and misperceptions about people with disabilities. Social and religious beliefs about intellectual disability were critically discussed; (h) describing the basic tenets of the intellectual disability and other related developmental disabilities, such as autism. Also, characteristics and causes of intellectual disability were discussed; (i) discussing the rights of people with intellectual


7

Hassanein

disabilities and discussing some controversial issues such as independent life and marriage; (j) presenting an historical overview of how people with intellectual disabilities were treated by society in the past, providing information about the causes of various disabilities, and about how different disabilities affect everyday functioning; (k) dispelling stereotypic conceptions about persons with intellectual disabilities and correcting myths about people with disabilities in the education and workplace contexts; (l) providing some guidance on how to interact with people with disabilities; and (m) discussing the philosophy, assumptions, and benefits of social and academic inclusion.

Procedures Using a quasi-experimental design, the participants were allocated randomly to one of the following three experimental conditions after controlling for other potential influences, such as gender and prior contact with people with disabilities: (a) cognitive intervention (6); (b) combined cognitive and behavioral intervention (6); and (c) no intervention control (6). Teachers were selected mainly because they are more likely to be in positions to work with children and adolescents with disabilities once inclusive education policy was approved. Participants’ attitudes toward people with intellectual disabilities were assessed at three different occasions: First, at pretest, immediately prior to the start of the intervention, baseline measures were collected. Then, the effect of the intervention was measured twice: at posttest, immediately following the intervention, and in a follow-up test 12 weeks later. The cognitive intervention consisted of 12 sessions (60 min each). The cognitive intervention was administered to both intervention groups. In contrast, the combined cognitive-behavioral intervention group engaged in work with and training of people with intellectual disabilities in sheltered workshops. These workshops included agriculture, kitchen, and art and handcraft workshops. The participants in this group worked with persons with intellectual disabilities for 3 working days a week (from 9 a.m. to 4 p.m.) for 6 weeks. The participants had the opportunity to interact in different occasions with people with intellectual disabilities and explore their skills and potentials. Furthermore, they had lunch and spent break time together in a more friendly way and on an equal status contact style. The control group did not receive any intervention, but completed the attitudinal measure at the baseline and at the posttest. At the baseline assessment, there were no significant differences among the participants in their attitudes toward people with intellectual disabilities, as highlighted below.


8


Table 1. Results of the Mann-Whitney U Test to Compare the Groups’ Pretest (Cognitive and Cognitive-Behavior) Attitude Scores. Variable

Group

Characteristics and Cognitive value Cognitive-behavior Social interaction Cognitive Cognitive-behavior Education and Cognitive training Cognitive-behavior Total score Cognitive Cognitive-behavior

Sum of N M rank ranks 6 6 6 6 6 6 6 6

6.08 6.92 6.33 6.67 5.75 7.25 5.58 7.42

36.50 41.50 38.00 40.00 34.50 43.50 33.50 44.50

U

Z

p

15.500 −0.402 .699 17.000 −0.162 .937 13.500 −0.724 .485 12.500 −0.882 .394

Examination of the findings in Table 1 reveals that the results of the MannWhitney U test for the pretest attitudes scores of teachers in the cognitive and cognitive-behavior groups did not show any statistical difference (characteristics and value Z = −0.402; p = .699 > .05; social interaction Z = −0.162; p = .937 > .05; education and training Z = −0.724; p = .485 > .05; and the total score Z = −0.882; p = .394 > .05). The rank average of the pretest scores of the cognitive group teachers was (6.08; 6.33; 5.75; 5.58) whereas teachers in the cognitive-behavior group had a pretest score rank average of (6.92; 6.67; 7.25; 7.42) for the three subscales and the total score, respectively. The close rank averages of the groups’ pretest attitudes scores indicate that before the experimental application, teachers in the cognitive and cognitive-behavior groups had somewhat equal pretest attitude scores. Examination of the findings in Table 2 reveals that the results of the MannWhitney U test for the pretest attitudes scores of teachers in the cognitive and control groups did not show any statistical difference (characteristics and value Z = −0.321; p = .818 > .05; social interaction Z = −0.964; p = .394 > .05; education and training Z = −0.322; p = .818 > .05; and the total score Z = −0.320; p = .818 > .05). The rank average of the pretest scores of the cognitive group teachers was (6.83; 7.50; 6.17; 6.17) whereas teachers in the control group had a pre-test score rank average of (6.17; 5.50; 6.83; 6.83) for the three subscales and the total score, respectively. The close rank averages of the groups’ pretest attitudes scores indicate that before the experimental application, teachers in the cognitive and control groups had somewhat equal pretest attitude scores. Examination of the findings in Table 3 reveals that the results of the MannWhitney U test for the pretest attitudes scores of teachers in the cognitivebehavior and control groups did not show any statistical difference


9

Hassanein Table 2. Results of the Mann-Whitney U Test to Compare the Groups’ Pretest (Cognitive and Control) Attitude Scores. Variable

Group

Characteristics and value Cognitive Control Social interaction Cognitive Control Education and training Cognitive Control Total score Cognitive Control

N M rank

Sum of ranks

6 6 6 6 6 6 6 6

41.00 37.00 45.00 33.00 37.00 41.00 37.00 41.00

6.83 6.17 7.50 5.50 6.17 6.83 6.17 6.83

U

Z

p

16.000 −0.321 .818 12.000 −0.964 .394 16.000 −0.322 .818 16.000 −0.320 .818

Table 3. Results of the Mann-Whitney U Test to Compare the Groups’ Pretest (Cognitive-Behavior and Control) Attitude Scores. Variable

Group

Characteristics and Cognitive-behavior value Control Social interaction Cognitive-behavior Control Education and Cognitive-behavior training Control Total score Cognitive-behavior Control


7.17 5.83 7.50 5.50 7.17 5.83 6.83 6.17

43.00 35.00 45.00 33.00 43.00 35.00 41.00 37.00

U

Z

p

14.000 −0.646 .589 12.000 −0.969 .394 14.000 −0.647 .589 16.000 −0.320 .818

(characteristics and value Z = −0.321; p = .818 > .05; social interaction Z = −0.964; p = .394 > .05; education and training Z = −0.322; p = .818 > .05; and the total score Z = −0.320; p = .818 > .05). The rank average of the pretest scores of the cognitive-behavior group teachers was (6.83; 7.50; 6.17; 6.17) whereas teachers in the control group had a pretest score rank average of (6.17; 5.50; 6.83; 6.83) for the three subscales and the total score, respectively. The close rank averages of the groups’ pretest attitudes scores indicate that before the experimental application, teachers in the cognitive-behavior and control groups had somewhat equal pretest attitude scores. Furthermore, factors that may affect attitudes toward people with intellectual disabilities were controlled, namely, previous contact experience and gender. Regarding the previous contact experience, all the participants have


10


Table 4. Results of the Mann-Whitney U Test to Compare the Groups’ Pretest (Male and Female) Attitude Scores. Group

N

M rank

Sum of ranks

Male Female Male Female Education and training Male Female Total score Male Female

9 9 9 9 9 9 9 9

7.83 11.17 8.50 10.50 7.22 11.78 7.83 11.17

70.50 100.50 76.50 94.50 65.00 106.00 70.50 100.50

Variable Characteristics and value Social interaction

U

Z

p

25.500

−1.329

31.500

−0.801

20.000

−1.822

25.500

−1.325

.190 .436 .077 .190

no previous contact experience, which indicates broadly that there is no effect for this factor. Regarding gender, a Mann-Whitney test was conducted to investigate differences among the participants according to gender, as explained below. Examination of the findings in Table 4 reveals that the results of the MannWhitney U test for the pretest attitudes scores of the teachers according to gender did not show any statistical difference (characteristics and value Z = −1.329; p = .190 > .05; social interaction Z = −0.801; p = .436 > .05; education and training Z = −1.822; p = .077 > .05; and the total score Z = −1.325; p = .190 > .05). The rank average of the pretest scores of the male teachers was (7.83; 8.50; 7.22; 7.83) whereas female teachers had a pretest score rank average of (11.17; 10.50; 11.78; 11.17) for the three subscales and the total score, respectively. The close rank averages of the groups’ pretest attitudes scores indicate that before the experimental application, male and female teachers had somewhat equal pretest attitude scores.

Results The results will be presented according to the hypotheses: Hypothesis 1: A Wilcoxon signed-ranks test was conducted to evaluate the hypothesis that there are no significant differences between the mean ranks attained by the cognitive group on the posttest and the pretest on attitude scale. Examination of the findings in Table 5 shows that there is a significant difference between the pretest and posttest attitude scores of the teachers in


11

Hassanein Table 5. Results of the Wilcoxon Signed-Ranks Test to Compare the PretestPosttest Attitude Scores of Teachers in the Cognitive Group. Variable

Group

Characteristics and value Negative ranks Positive ranks Ties Total Social interaction Negative ranks Positive ranks Ties Total Education and training Negative ranks Positive ranks Ties Total Total score Negative ranks Positive ranks Ties Total

N M rank

Sum of ranks

0 6 0 6 1 3 2 6 1 5 0 6 0 4 2 6

0.00 21.00 4.00 6.00 3.50 17.50 0.00 10.00

0.00 3.50

4.00 2.00

3.50 3.50

0.00 2.50

Z

p

−2.201 .028**

−0.368 .713

−1.476 .140

−1.826 .068

*p < .01. **p < .05.

the cognitive group in the first dimension of the attitude scale only (characteristics and value Z = −2.201; p = .028 < .05). However, there are no significant differences in the other dimensions (social interaction Z =−0.368; p = .713 > .05; education and training Z = 1.476; p = .140 > .05; and the total score Z = −1.826; p = .068 > .05). The sum of the negative ranks for the cognitive group teachers’ attitudes scores was found to be (0.00; 4.00; 3.50; 0.00) whereas their sum of positive ranks was (21.00; 6.00, 17.50; 10.00) for all the subscales and the total score of attitudes scale, respectively. The observed difference is in favor of positive ranks only for the first dimension. Based on results obtained, it could be argued that the cognitive intervention significantly changed teachers’ knowledge about the characteristics and value of people with intellectual disabilities. In general, comparing the sum of ranks indicates that there is some kind of improvement even it did not reach the statistical significance level for two dimensions of attitude scale. Therefore, the null hypothesis could be cautiously accepted. However, further intensive cognitive training may be effective in changing attitudes.


12


Table 6. Results of the Wilcoxon Signed-Ranks Test to Compare the PretestPosttest Attitude Scores of Teachers in the Control Group. Variable

Group

Characteristics and value

Social interaction

Education and training

Total score

Negative ranks Positive ranks Ties Total Negative ranks Positive ranks Ties Total Negative ranks Positive ranks Ties Total Negative ranks Positive ranks Ties Total

N

M rank

0 2 4 6 0 4 2 6 1 2 3 6 2 3 1 6

0.00 1.50

0.00 2.50

2.00 2.00

3.50 2.67

Sum of ranks 0.00 3.00 0.00 10.00 2.00 4.00 7.00 8.00

Z

p

−1.342

.180

−1.826

.068

−0.577

.564

−0.137

.891

Hypothesis 2: A Wilcoxon signed-ranks test was conducted to evaluate the hypothesis that there are no significant differences between the mean ranks attained by the control group on the posttest and the pretest on attitude scale. Examination of the findings in Table 6 shows that there is no significant difference between the pretest and posttest attitude scores of the teachers in the control group (characteristics and value Z = −1.342; p = .180 > .05; social interaction Z = 1.826; p = .068 > .05; education and training Z = −0.577; p = .564 > .05; and the total score Z = −0.137; p = .891 > .05). The sum of the negative ranks for the control group teachers’ attitudes scores was found to be (7.00) while their sum of positive ranks was (8.00) for the total score of attitudes scale. This indicates that there was no significant improvement in teachers’ attitudes in the control group, which might be because they had not gotten any training. Hypothesis 3: A Mann-Whitney U test was conducted to evaluate the hypothesis that there are no significant differences between the mean ranks attained by the cognitive group and that of the control group on the posttest of attitude scale.


13

Hassanein

Table 7. Results of the Mann-Whitney U Test to Compare the Groups’ Posttest (Cognitive and Control) Attitude Scores. Variable

Group

Characteristics and value Cognitive Control Social interaction Cognitive Control Education and training Cognitive Control Total score Cognitive Control


8.67 4.33 6.33 6.67 7.08 5.92 7.50 5.50

U

Z

p

52.00 5.000 −2.085 .041** 26.00 38.00 17.000 −0.161 .937 40.00 42.50 14.000 −0.562 .589 35.50 45.00 12.000 −0.961 .394 33.00

*p < .01. **p < .05.

Examination of the findings in Table 7 reveals that the results of the MannWhitney U test for the posttest attitudes scores of teachers in the cognitive and control groups showed statistical difference in the first dimension of attitudes scale only: characteristics and value Z = −2.085; p = .041 < .05. However, there were no statistical differences on the other dimensions and the total score (social interaction Z = −0.161; p = .937 > .05; education and training Z = −0.562; p = .589 > .05; and the total score Z = −0.961; p = .394 > .05). The rank average of the posttest scores of the cognitive group teachers was (8.67; 6.33; 7.08; 7.50) whereas teachers in the control group had a posttest score rank average of (4.33; 6.67; 5.92; 5.50) for the three subscales and the total score, respectively. The results indicate that the training was slightly effective in changing teachers’ thoughts and beliefs about the characteristics and value of people with intellectual disabilities. This may be due to the nature of that dimension, which is highly loaded with items related to the participants’ knowledge about people with intellectual disabilities. However, the close rank averages of the groups’ posttest attitudes scores on the other dimensions indicate that the cognitive intervention alone is not highly effective in changing attitudes. Hypothesis 4: A Wilcoxon signed-ranks test was conducted to evaluate the hypothesis that there are no significant differences between the mean ranks attained by the cognitive group on the posttest and that of the same group on the follow-up test on attitude scale. The examination of the findings in Table 8 shows that there are no significant differences between the posttest and follow-up test attitude scores of the teachers in the cognitive group (characteristics and value Z = −0.365; p =


14


Table 8. Results of the Wilcoxon Signed-Ranks Test to Compare the Posttest Follow-Up Test Attitude Scores of Teachers in the Cognitive Group. Variable Characteristics and value

Social interaction

Education and training

Total score

Group

N

M rank

Negative ranks Positive ranks Ties Total Negative ranks Positive ranks Ties Total Negative ranks Positive ranks Ties Total Negative ranks Positive ranks Ties Total

1 3 2 6 2 1 3 6 2 1 3 6 2 2 2 6

4.00 2.00

2.25 1.50

2.50 1.00

3.00 2.00

Sum of ranks 4.00 6.00 4.50 1.50 5.00 1.00 6.00 4.00

Z

p

−0.365

.715

−0.816

.414

1.089

.276

−0.365

.715

.715 > .05; social interaction Z = −0.816; p = .414 > .05; education and training Z = 1.089; p = .276 > .05; and the total score Z = −0.365; p = .715 > .05). The sum of the negative ranks for the cognitive group teachers’ attitudes scores was found to be (4.00; 4.50; 5.00; 6.00) whereas their sum of positive ranks was (6.00, 1.50; 1.00; 4.00) for all the subscales and the total score of attitudes scale, respectively. There is no observed difference between positive and negative ranks. These results showed that there were no differences between teachers’ attitudes on the posttest and the follow-up test, which indicate that the improvement achieved in the posttest lasted in the follow-up test. Hypothesis 5: A Wilcoxon signed-ranks test was conducted to evaluate the hypothesis that there are significant differences between the mean ranks attained by the cognitive-behavior group on the posttest and the pretest on attitude scale in favor of the posttest. The examination of the findings in Table 9 shows that there is a significant difference between the pretest and posttest attitude scores of the teachers in the cognitive-behavior group (characteristics and value Z = −2.207; p = .027 < .05; social interaction Z = −2.201; p = .028 < .05; education and training Z = −2.201; p = .028 < .05; and the total score Z = −2.207; p = .027 < .05).


15

Hassanein Table 9. Results of the Wilcoxon Signed-Ranks Test to Compare the PretestPosttest Attitude Scores of Teachers in the Cognitive-Behavior Group. Variable

Group

Characteristics and Negative ranks value Positive ranks Ties Total Social interaction Negative ranks Positive ranks Ties Total Education and Negative ranks training Positive ranks Ties Total Total score Negative ranks Positive ranks Ties Total

N

M rank

0 6 0 6 0 6 0 6 0 6 0 6 0 6 0 6

0.00 3.50

0.00 3.50

0.00 3.50

0.00 3.50

Sum of ranks 0.00 21.00 0.00 21.00 0.00 21.00 0.00 21.00

Z

p

−2.207 .027**

−2.201 .028**

−2.201 .028**

−2.207 .027**

*p < .01. **p < .05.

The sum of the negative ranks for the cognitive-behavior group teachers’ attitudes scores was found to be (0.00) whereas their sum of positive ranks was (21.00) for all the subscales and the total score of attitudes scale. The observed difference is in favor of positive ranks. On the basis of the results obtained, it could be argued that the cognitive-behavior intervention significantly increased attitudes of teachers in the cognitive-behavior group. Hypothesis 6: A Mann-Whitney U test was conducted to evaluate the hypothesis that there are significant differences between the mean ranks attained by the cognitive-behavior group and that of the cognitive group on the posttest of attitude scale in favor of cognitive-behavior group. Examination of the findings in Table 10 reveals that the results of the Mann-Whitney U test for the posttest attitudes scores of teachers in the cognitive and cognitive-behavior groups show statistical differences (characteristics and value Z = −2.887; p = .002 < .01; social interaction Z = −2.887; p = .002 < .01; education and training Z = −2.898; p = .002 < .01; and the total score Z = −2.882; p = .002 < .01). The rank average of the posttest scores of


16


Table 10. Results of the Mann-Whitney U Test to Compare the Groups’ Posttest (Cognitive and Cognitive-Behavior) Attitude Scores. Variable

Group

Characteristics and value Social interaction

Cognitive Cognitive-behavior Cognitive Cognitive-behavior Education and training Cognitive Cognitive-behavior Total score Cognitive Cognitive-behavior


3.50 9.50 3.50 9.50 3.50 9.50 3.50 9.50

21.00 57.00 21.00 57.00 21.00 57.00 21.00 57.00

U

Z

p

.000 −2.887 .002* .000 −2.887 .002* .000 −2.898 .002* .000 −2.882 .002*

*p < .01. **p < .05.

the cognitive group teachers was (3.50) whereas teachers in the cognitivebehavior group had a posttest score rank average of (9.50) for the three subscales and the total score. Examination of the rank average of posttest scores for attitudes scores demonstrates that the teachers in the cognitive-behavior group had higher attitudes scores than those in the cognitive group, which indicates that the cognitive-behavioral intervention is more effective than the cognitive intervention alone in changing attitudes. Hypothesis 7: A Mann-Whitney U test was conducted to evaluate the hypothesis that there are significant differences between the mean ranks attained by the cognitive-behavior group and that of the control group on the posttest of attitude scale in favor of cognitive-behavior group. Examination of the findings in Table 11 reveals that the results of the MannWhitney U test for the posttest attitudes scores of teachers in the cognitivebehavior and control groups show statistical difference (characteristics and value Z = −2.882; p = .002 < .01; social interaction Z = −2.887; p = 002 < .01; education and training Z = −2.892; p = 002 < .01; and the total score Z = −2.882; p = 002 < .01). The rank average of the posttest scores of the cognitive-behavior group teachers was (9.50) whereas teachers in the control group had a posttest score rank average of (3.50) for the three subscales and the total score. The different rank averages of the groups’ posttest attitudes scores indicates that the cognitive-behavior intervention is effective in changing attitudes. Hypothesis 8: A Wilcoxon signed-ranks test was conducted to evaluate the hypothesis that there are no significant differences between the mean ranks attained by the cognitive-behavior group on the posttest and that of the same group on the follow-up test on attitude scale.


17

Hassanein

Table 11. Results of the Mann-Whitney U Test to Compare the Groups’ Posttest (Cognitive-Behavior and Control) Attitude Scores. Variable

Group

Characteristics Cognitive-behavior and value Control Social interaction Cognitive-behavior Control Education and Cognitive-behavior training Control Total score Cognitive-behavior Control

N

M rank

Sum of ranks

6 6 6 6 6 6 6 6

9.50 3.50 9.50 3.50 9.50 3.50 9.50 3.50

57.00 21.00 57.00 21.00 57.00 21.00 57.00 21.00

U

Z

p

.000 −2.882 .002* .000 −2.887 .002* .000 −2.892 .002* .000 −2.882 .002*

*p < .01. **p < .05.

Table 12. Results of the Wilcoxon Signed-Ranks Test to Compare the Posttest Follow-Up Test Attitude Scores of Teachers in the Cognitive-Behavior Group. Variable

Group

Characteristics and value Negative ranks Positive ranks Ties Total Social interaction Negative ranks Positive ranks Ties Total Education and training Negative ranks Positive ranks Ties Total Total score Negative ranks Positive ranks Ties Total

N M rank

Sum of ranks

1 2 3 6 4 1 1 6 2 2 2 6 3 2 1 6

1.00 5.00 12.50 2.50 6.00 4.00 9.00 6.00

1.00 2.50

3.12 2.50

3.00 2.00

3.00 3.00

Z

p

−1.069 .285

−1.414 .157

−0.378 .705

−0.412 .680

Examination of the findings in Table 12 shows that there are no significant differences between the posttest and follow-up test attitude scores of the teachers in the cognitive-behavior group (characteristics and value Z = 1.069; p = .285 > .05; social interaction Z = −1.414; p = .157 > .05; education and


18


training Z = −0.378; p = .705 > .05; and the total score Z = −0.412; p = .680 > .05). The sum of the negative ranks for the cognitive-behavior group teachers’ attitudes scores was found to be (1.00; 12.50; 6.00; 9.00) whereas their sum of positive ranks was (5.00; 2.50; 4.00; 6.00) for all the subscales and the total score of attitudes scale. The close rank averages of the groups’ posttest and follow-up test attitudes scores indicates that the cognitive-behavior training was effective as its effect continued at the follow-up test after 12 weeks.

Discussion The study investigated the possibility of changing attitudes toward people with intellectual disabilities by comparing the effectiveness of a purely cognitive training program and a combined cognitive and behavioral approach and tested both against a no-intervention control group. The findings supported the hypothesis that a combined cognitive and behavioral intervention can reduce negative attitudes toward people with intellectual disabilities. However, the results also indicated that there was change in teachers’ attitudes toward people with intellectual disabilities in the cognitive group in the dimension related to the characteristics and the value of people with intellectual disabilities. This could be explained by the nature of that dimension, which is loaded with items related to the participants’ knowledge and beliefs about the intellectual disability. However, in the other domains of the scale that require some kind of interaction between people with disabilities and people without disabilities, the results indicated that there were no significant differences among the participants. This is not surprising, based on Fishbein and Ajzen’s framework of attitude formation and change (Ajzen & Fishbein, 1980; Fishbein & Ajzen, 1975). Some researchers adopted this framework and argued that “negative attitudes toward people with disabilities appear to stem from faulty information in the belief system about disability and about people who have disabilities” (Lee & Rodda, 1994, p. 232). Therefore, it could be concluded that one way to change attitudes is to change beliefs, for example, through educational interventions and sensitivity training (e.g., Hunt & Hunt, 2004; Lee & Rodda, 1994). In addition, some previous studies indicated that information-based courses led to changes in knowledge and beliefs (Forlin et al., 1999; Hastings et al., 1996; Tait & Purdie, 2000). Yet, Hastings et al. (1996) argued that information-based courses do little to modify attitudes. It is, therefore, the changes in attitudes, found in the current study, that provide the most interesting result. The study illustrated the value of combining information-based training programs with structured fieldwork or real contact experiences in changing attitudes toward disability. The contact experience adopted in this study had


19

Hassanein

an effect on more general attitudes toward people with intellectual disabilities. Consequently, it appears that the specific behavioral experience had the potential to change more general attitudes about people with intellectual disabilities. The findings can be interpreted in the context of Allport’s (1954) contact hypothesis. According to Allport, negative attitudes toward an out group can be changed through personal contact with members of the out group, provided the contact is cooperative and on an equal status level. These conditions were met by the present behavioral intervention to a great extent. Personal contact through the joint activities with students with disabilities led to less negative attitudes toward people with intellectual disabilities than the cognitive intervention alone. These findings concur with the results of Campbell et al. (2003), Krahe and Altwasser (2006), Pernice and Lys (1996), and Rees et al. (1991), which showed that information-based training programs combined with experiential contact have significant impact on teachers’ attitudes toward individuals with disabilities. It is also important at this point to highlight the critical components of the cognitive-behavioral intervention. The fundamental point here is the critical combination between cognition and experience. Teachers’ epistemological assumptions and conceptions about disability and inclusion were synthesized through theorizing and experience. In this, teachers’ assumptions were reviewed through contact experience, and this experience itself was reviewed through cognition. This approach represents a reflective practice model (Bayliss, 1998) that allows experience to be synthesized through theorizing. It is not cognition + experience; it is cognition reviewed through experience/ experience reviewed through cognition as a dynamic process of reflective practice. Such results have practical implications for developing training programs for teachers. These programs should have a practical experience of meaningful contact with people with disabilities, in addition to the theoretical components of the curriculum. Teachers also should be trained in how to acquire the “generic” teaching skills that allow them to modify their practice in ways that meet the needs of all learners within “inclusive frameworks” (Bayliss, 1998). Such training should be continuous, practical, and appealing. This is in line with the argument of many authors (e.g., Fullan, 1991; Fullan & Hargreaves, 1992) that simply supporting the practitioners in the early stages of the implementation of an educational reform is not enough; continued support, real contact experience, and technical assistance must be provided. In addition, teachers should be educated in ways that promote and sustain understanding and acceptance of a range of disabilities, and provide them with the skills to support children with special needs in inclusive classroom settings.


20


Furthermore, teachers’ positive attitudes toward persons with disability and toward inclusion were addressed because teachers will have an essential role to play in the implementation of the inclusive education policy, as they are responsible for implementing many of the changes necessary to put this policy into practice. Supporting this argument, Bailey (1995) stated that “unless teachers are enjoying positive, health-enhancing and productive emotional states and high motivation and commitment, and unless they have the skills and the drive to implement change programs, inclusive education approaches will not be implemented wholeheartedly or effectively” (p. 16). It has also been suggested that one of the greatest barriers to the development of inclusion is that most teachers do not have the necessary knowledge, skills, and attitudes to carry out this work (Forlin, 2001). It is especially important, therefore, that we prepare teachers who have both the confidence and the skills to teach in inclusive settings, and who are equipped to provide appropriate instruction for all pupils. Nonetheless, the limitations of the present study suggest caution in interpreting the results. The first is that, through the training program, teachers may have become more aware of the social desirability of affirming positive attitudes toward persons with intellectual disabilities based on the argument that disability surveys tend to elicit responses biased toward socially or politically correct views (Campbell et al., 2003). Yet, the participants in the current study were motivated to describe themselves accurately and honestly. In addition, it could not be ascertained whether the superior effectiveness of the combined cognitive and behavioral intervention was due to the fact that both elements were included or attributable exclusively to the behavioral element. To address this question, a further condition using a “behavioral only” group would have been required. This possibility was discussed in the planning stage of the study but eventually rejected due to some contextual barriers in the training context. Future studies should try to address this issue. The limited sample size in this study calls for replications using a larger number of participants, but the fact that substantive effects emerged with such a limited sample points to the robustness of the findings. It is also worth mentioning that it was possible that the cognitive intervention had a greater effect, but the very small sample size did not yield sufficient power to detect that effect. This is a limitation, but it does not negate the fact that the cognitive-behavioral condition had a much larger effect regardless. In general, the study shows that it is possible to change negative attitudes toward people with intellectual disabilities. The results provide preliminary evidence that information-based training programs combined with experiential contact training could be an effective intervention tool for enhancing more favorable attitudes toward persons with intellectual disabilities.


21

Hassanein Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding The author(s) received no financial support for the research, authorship, and/or publication of this article.

References Ajzen, I., & Fishbein, M. (1980). Understanding attitudes and predicting social behavior. Englewood Cliffs, NJ: Prentice-Hall. Alkoreity, A. (1992). Attitudes towards people with disabilities scale. Cairo, Egypt: Al-Anglo Almesria. Allport, G. W. (1954). The nature of prejudice. Cambridge, MA: Addison-Wesley. Avramidis, E., Bayliss, P., & Burden, R. (2000). A survey into mainstream teachers’ attitudes towards the inclusion of children with special educational needs in the ordinary school in one local education authority. Educational Psychology, 20, 191-211. Bailey, J. (1995). Stress, morale and acceptance of change by special educators. In C. Clark, A. Dyson, & A. Millward (Eds.), Towards inclusive schools? (pp. 15-29). London, England: David Fulton. Barnes, C., Mercer, G., & Shakespeare, T. (1999). Exploring disability: A sociological introduction. Cambridge, UK: Blackwell. Bayliss, P. (1998). Models of complexity: Theory driven intervention practices. In C. Clark, A. Dyson, & A. Millward (Eds.), Theorizing special education (pp. 6179). London, England: Routledge. Buell, M. J., Hallam, R., Gamel-McCormick, M., & Scheer, S. (1999). A survey of general and special education teachers’ perceptions and in-service needs concerning inclusion. International Journal of Disability, Development and Education, 46, 143-156. Campbell, J., Gilmore, L., & Cuskelly, M. (2003). Changing student teachers’ attitudes towards disability and inclusion. Journal of Intellectual & Developmental Disability, 28, 369-379. Center, Y., & Ward, J. (1987). Teachers’ attitudes towards the integration of disabled children into regular schools. The Exceptional Child, 34, 41-56. Dupoux, E., Wolman, C., & Estrada, E. (2005). Teachers’ attitudes toward integration of students with disabilities in Haiti and the United States. International Journal of Disability, Development and Education, 52, 45-60. Eagly, A. H., & Chaiken, S. (1993). The psychology of attitudes. Fort Worth, TX: Harcourt Brace Jovanovich. Fishbein, M., & Ajzen, I. (1975). Belief, attitude, intention, and behavior: An introduction to theory and research. Reading, MA: Addison-Wesley.


22


Ford, A., Pugach, M. A., & Otis-Wilborn, A. (2001). Preparing general educators to work well with students who have disabilities: What’s reasonable at the preservice level? Learning Disability Quarterly, 24, 275-285. Forlin, C. (1995). Educators’ beliefs about inclusive practices in Western Australia. British Journal of Special Education, 22, 179-185. Forlin, C. (2001). Inclusion: Identifying potential stressors for regular class teachers. Educational Research, 43, 235-245. Forlin, C., Douglas, G., & Hattie, J. (1996). Inclusive practices: How accepting are teachers? International Journal of Disability, Development and Education, 43, 119-133. Forlin, C., Tait, K., Carroll, A., & Jobling, A. (1999). Teacher education for diversity. Queensland Journal of Educational Research, 15, 207-225. Fullan, M. (1991). The new meaning of educational change. New York, NY: Teachers College Press. Fullan, M., & Hargreaves, A. (1992). Teacher development and educational change. London, England: Falmer Press. Hassanein, E. (2010). The inclusion of children with special educational needs in mainstream schools in Egypt (Doctoral thesis). Exeter University, UK. Hastings, R. P., Hewes, A., Lock, S., & Witting, A. (1996). Do special educational needs courses have any impact on student teachers’ perceptions of children with severe learning difficulties? British Journal of Special Education, 23, 139-144. Hastings, R. P., & Oakford, S. (2003). Student teachers’ attitudes towards the inclusion of children with special needs. Educational Psychology, 23, 87-94. Heflin, L. J., & Bullock, L. M. (1999). Inclusion of students with emotional/behavioral disorders: A survey of teachers in general and special education. Preventing School Failure, 43, 103-112. Hunt, C., & Hunt, B. (2004). Changing attitudes toward people with disabilities: Experimenting with an educational intervention. Journal of Managerial Issues, 16, 266-280. Kalyva, E., Gojkovic, D., & Tsakiris, V. (2007). Serbian teachers’ attitudes towards inclusion. International Journal of Special Education, 22, 30-35. Krahe, B., & Altwasser, C. (2006). Changing negative attitudes towards the physically disabled. Journal of Community & Applied Social Psychology, 16, 59-69. Lee, T., & Rodda, M. (1994). Modification of attitudes toward people with disabilities. Canadian Journal of Rehabilitation, 7, 229-238. Linton, S. (1998). Claiming disability: Knowledge and identity. New York: New York University Press. Myklebust, J. (2006). Class placement and competence attainment among students with special educational needs. British Journal of Special Education, 33, 76-81. Oliver, M. (1990). The politics of disablement. London, England: Macmillan Press. Olson, J. M., & Zanna, M. P. (1993). Attitudes and attitude change. Annual Review of Psychology, 44, 117-154. Pernice, R., & Lys, K. (1996). Interventions for attitude change towards people with disabilities: How successful are they? International Journal of Rehabilitation Research, 19, 171-174.


23

Hassanein

Pruett, S., Lee, E., Chan, F., Wang, M., & Lane, F. (2008). Dimensionality of the contact with disabled persons scale: Results from exploratory and confirmatory factor analyses. Rehabilitation Counseling Bulletin, 51, 210-220. Rees, L. M., Spreen, O., & Harnadek, M. (1991). Do attitudes towards persons with handicaps really shift over time? Comparison between 1975 and 1988. Mental Retardation, 29, 81-86. Scruggs, T. E., & Mastropieri, M. A. (1996). Teacher perceptions of mainstreaming/ inclusion, 1958-1995: A research synthesis. Exceptional Children, 63, 59-74. Seccombe, J. (2007). Attitudes towards disability in an undergraduate nursing curriculum: The effects of curriculum change. Nurse Education Today, 27, 445-451. Semmel, M. I., Abernathy, T. V., Butera, G., & Lesar, S. (1991). Teacher perceptions of the regular education initiative. Exceptional Children, 58, 9-24. Tait, K., & Purdie, N. (2000). Attitudes toward disability: Teacher education for inclusive environments in an Australian university. International Journal of Disability, Development and Education, 47, 25-38.

Author Biography Elsayed Elshabrawy Ahmed Hassanein, PhD, is an assistant professor at the Faculty of Education, Al-Azhar University, Cairo, Egypt. His current research interests include inclusive education, disability studies, and the design and delivery of services to people with intellectual and developmental disabilities.


Changing attitudes toward disabilities through unified sports.

developmental disabilities: an initial prospective analysis.

Public attitudes toward people with intellectual disabilities after viewing Olympic or Paralympic performance.

Attitudes Toward Male and Female Sexuality Among Men and Women With Intellectual Disabilities.

Attitudes toward the sexuality of persons with physical versus psychiatric disabilities.

Factor analysis of the Spanish Multidimensional Attitudes Scale Toward Persons with Disabilities.

Healthcare providers' attitudes toward persons with schizophrenia.

Factors affecting attitudes toward persons with AIDS.

[Obsessive Compulsive Symptoms in Persons with Intellectual Disabilities].

Public attitudes toward persons with mental illness.

Changing attitudes toward orofacial tattoos.

Taiwanese attitudes and affective reactions toward individuals and coworkers who have intellectual disabilities.

Situational and dispositional components of reactions toward persons with disabilities.

Attitudes toward people with disabilities and judgments of employment potential.

Development of a measure of attitudes toward persons with AIDS.

Changing attitudes of medical teachers towards medical education.

Strategies for changing negative public attitudes toward organ donation in the People's Republic of China.

Teachers' and parents' views on the Internet and social media usage by pupils with intellectual disabilities.

Modifying attitudes of Arab school teachers toward stuttering.

Factors Associated with Primary School Teachers' Attitudes Towards the Inclusion of Students with Disabilities.

The structure of informal social networks of persons with profound intellectual and multiple disabilities.

Supported decision-making and personal autonomy for persons with intellectual disabilities: article 12 of the UN convention on the rights of persons with disabilities.

Norms of the Attitudes Toward Intellectual Disability Questionnaire.

Systematic review of restraint interventions for challenging behaviour among persons with intellectual disabilities: focus on experiences.