Abstract
This study explored access to inclusive environments for students with Complex Chronic Conditions (CCC) in secondary settings, identified barriers to access, and examined Evidence-Based Practices (EBPs) that support inclusion. This mixed-methods investigation utilized inductive thematic analysis and single-subject research design (SSRD) to examine existing barriers to inclusion within the education system. As a small minority, students with CCC faced significant challenges in achieving meaningful inclusion, which contributed to their ongoing marginalization. Despite the efforts of parents, teachers, and other stakeholders, the progress of educational inclusion for this group remained limited, reflecting the evolving societal perceptions of disability over time. The study’s conceptual framework was grounded in social constructivism and supported by social learning theories, emphasizing the importance of social interactions and environmental factors in the learning process. Drawing on learning theories, the historical roots of ableism, and existing research, this study identified a concerning trend of limited access to inclusive environments for students with CCC.The study employed a combination of qualitative and single-subject research designs, focusing on two key participant groups: students with CCC and teachers who instruct these students. The qualitative portion utilized a semi-structured interview protocol to gain a nuanced understanding of teachers' perspectives. Teacher participants represented various regions across the United States. Interview topics included placement, behavior, communication, barriers to inclusive environments, and successful strategies that increased participation and positive behaviors in these settings. Interview transcripts underwent rigorous analysis, coding, and thematic identification. For the SSRD component, participants with CCC were observed in a general education classroom, where the researcher collected frequency data on disruptive behaviors. A multiple probe and multiple baseline design was employed to determine if a functional relationship existed between the independent variables and target behaviors in the general education setting. Visual analysis and descriptive statistics were used to analyze the SSRD data.
Following the analysis of both data sets, the data were systematically converged to produce robust results and findings. The qualitative data produced five key themes related to barriers from other educators, logistics, systemic challenges, student characteristics, and effective strategies. The SSRD data revealed a functional relationship between EBPs and a decrease in disruptive behaviors in general education settings among both participants. The convergence of data from both studies and literature was compared, matched, and triangulated. This convergent study's strengths and contributions included the triangulation of research and practice, insights from primary researcher data, and personal accounts from practitioners. Ultimately, this study provided valuable insights from teachers on existing barriers within the education system and effective strategies for students with CCC. The findings aimed to inform educators about inclusive practices for students with high complex needs in secondary general education settings, thereby contributing to broader discussions on enhancing educational inclusivity.