Disability and Rehabilitation

ISSN: (Print) (Online) Journal homepage: https://www.tandfonline.com/loi/idre20

The potential impact of experiencing social

inclusion in recreation for children with and
without disabilities

Brydne Edwards, Debra Cameron, Gillian King & Amy C. McPherson

To cite this article: Brydne Edwards, Debra Cameron, Gillian King & Amy C. McPherson (2021):
The potential impact of experiencing social inclusion in recreation for children with and without
disabilities, Disability and Rehabilitation, DOI: 10.1080/09638288.2020.1865465

To link to this article: https://doi.org/10.1080/09638288.2020.1865465

Published online: 06 Jan 2021.

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DISABILITY AND REHABILITATION
https://doi.org/10.1080/09638288.2020.1865465

ORIGINAL ARTICLE

The potential impact of experiencing social inclusion in recreation for children

with and without disabilities
Brydne Edwardsa,b, Debra Camerona,c, Gillian Kinga,b,c and Amy C. McPhersona,b,d
a
Rehabilitation Science Institute, University of Toronto, Toronto, Canada; bBloorview Research Institute, Holland Bloorview Kids Rehabilitation
Hospital, Toronto, Canada; cDepartment of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada; dDalla
Lana School of Public Health, University of Toronto, Toronto, Canada

ABSTRACT ARTICLE HISTORY

Purpose: Inclusive recreation programs can have individual and community impacts for children with Received 10 January 2020
and without disabilities. However, studies that explore the impact of such programs on children’s atti- Revised 11 November 2020
tudes are mixed. The purpose of this study was to explore the perspectives of children with and without Accepted 14 December 2020
disabilities on the individual impact of an inclusive recreation program.
KEYWORDS
Material and Method: This study adopted a generic qualitative methodology. Interviews were con- Rehabilitation; involvement;
ducted with participants between the ages of eight and 18 enrolled in the same program and each par- leisure; integration;
ticipant was interviewed twice. Inductive thematic analysis was used to analyze results. qualitative research
Results: 17 participants were recruited for this study, which included nine children without disabilities
(CWODs) and eight children with disabilities (CWDs). This study revealed five themes: a) CWODs have lim-
ited exposure to people with disabilities; b) CWODs and CWDs’ hopes of change; c) CWODs learned how
to interact with people with disabilities; d) CWODs reported greater perceived similarity in functional abil-
ity and hobbies/interests between themselves and CWDs, and; e) CWODs become more comfortable
being around people with disabilities.
Conclusions: This study helps broaden understandings of how inclusive experiences in recreation set-
tings impact children with and without disability.

ä IMPLICATIONS FOR REHABILITATION

Children without disabilities can develop more positive attitudes toward children with disabilities in
affective and cognitive domains after participating in an inclusive recreation program.

Incorporating inclusive language into program design and implementation may promote positive atti-
tudes toward diversity in recreation settings.

Children without disabilities would benefit from more opportunities to interact with children with dis-
abilities in unstructured, inclusive or integrated recreation settings.

Introduction prejudices toward an out-group (e.g., children with disabilities)

Social inclusion and involvement in recreational activities are
essential for healthy child development and can have many psy-
chosocial benefits for children with and without disabilities [1,2].
Experiencing social inclusion, facilitates social skill development,
broadens social networks, and increases self-efficacy [3–5]. Studies
show that recreation programs that encompass children with and
without disabilities have many individual and community benefits.
For example, these programs have been shown to foster individ-
ual psychosocial outcomes such as improved self-concept and
social skills children with and without disabilities [6,7]. For chil-
dren with disabilities (CWDs), their social skills and self-confidence
has been shown to improve [6,7]. These recreation programs can
support social inclusion across the lifespan and reduce negative
societal stigma toward people with disabilities [4,8,9].
To explain this positive impact of individual attitudes on soci-
etal stigma, contact theory, later called inter-group contact theory
[10,11], explains how members of an in-group (e.g., children with-
out disabilities) can develop more positive attitudes and reduce
when they have opportunities to directly interact (e.g., participate
in the same activity together) [12]. Impact is defined in this study
as any direct or indirect, intended or unintended, positive or
negative influence of such opportunities [13]. Individual attitudinal
changes can be expressed cognitively (e.g., what they learned
about the out-group), behaviorally (e.g., changing one’s behavior
toward members of the out-group), and affectively (e.g., reduced
negative emotions toward out-group) [12]. Applying the theory to
recreation programs that include children with and without dis-
abilities, studies have shown that children without disabilities
(CWODs) can develop more positive attitudes toward CWDs,
which subsequently generalize to other people with disabilities
people and helps reduce societal stigma over time [3,14–17].
Although inter-group contact theory seems to offer a reason-
able explanation for attitudinal generalization across different
groups, such as children and adults with disabilities, studies show
mixed results regarding the attitudinal impact of “direct contact”
opportunities in recreation and school settings for CWODs
[11,12,17–19]. Interacting with CWDs can have a positive impact

CONTACT Brydne Edwards brydne.edwards@mail.utoronto.ca, brydne.ot@gmail.com

ß 2021 Informa UK Limited, trading as Taylor & Francis Group
2 B. EDWARDS ET AL.
on attitudes, such as believing CWDs are capable of completing
tasks [20], or a negative impact on attitudes, such as reinforcing
negative stereotypes of CWDs as incapable [12,17]. These mixed
findings raise the question of whether certain factors hinder or
promote positive attitudes toward people with disabilities in
childhood [11,12,17].
There are multiple explanations for these mixed findings,
which could be related to research design. Most studies exploring
the impact of such contact opportunities for CWODs and CWDs
on aspects of social inclusion (e.g., attitudes toward disability)
used qualitative designs with objective outcome measures
[11,18,21]. In addition, the perspectives of CWODs and CWDs are
rarely explored together in the same program. A deeper under-
standing of the potential impact of inclusive programs directly
from CWDs and CWODs’ perspectives may help to understand
whether such programs impact attitudes and in what manner.
Finally, studies do not consistently distinguish and integrated and
inclusive recreation programs. Integrated recreation programs are
programs where children with and without disabilities engage in
recreation together, which encompass formal and informal activ-
ities outside of mandated school activities [4,6,22]. In these pro-
grams, children have the opportunity to participate in activities in
the same setting without the adoption of specific strategies to
support inclusion of all children. Inclusive recreation programs dif-
fer in that they adopt an explicit inclusion strategies to support
inclusion for all children [1,23]. In these programs, the program is
designed and implemented strategically to promote social inclu-
sion, such as adopting a child-driven approach, having a small
child-to-staff ratio and having high-quality staff training [1,9,23]. It
is not consistently clear in the literature whether recreation pro-
grams under study are integrated or inclusive [4,9]. Without a
clear understanding of the research setting, it can be difficult to
interpret results.
The objective of the present study was to explore the individ-
ual impact of participating in an inclusive recreation program on
children’s perspectives related to social inclusion (e.g., thoughts,
beliefs, attitudes). In the context of the present study, impact
does not imply a causal relationship between factors [13], as this
study adopted the interpretive paradigm and the authors acknow-
ledge that any number of factors could influence a change in par-
ticipants’ perspectives.
Materials and methods
A generic qualitative methodology was used because it allowed
the authors to investigate multiple, related objectives simultan-
eously without compromising methodological coherence [24].
Researchers in the present study were required to be intentionally
non-committal to a traditional methodology (e.g., grounded the-
ory, phenomenogology), as this study adopted multiple methods
of inquiry to address multiple objectives [25,26]. This study was
part of a larger study that explored meaningful aspects of social
inclusion from the perspectives of CWDs and CWODs in the same
recreation program, and explored strategies used to facilitate
social inclusion in recreation programs where CWDs and CWODs
are together [23,25].
Theoretical approach
This study implemented an inductive analysis, and thus drew on
theory at a paradigmatic level rather than substantive level [27].
The authors drew on the interpretive paradigm (interpretivism),
relativist ontology and subjectivist epistemology to guide the
selection of particular methods of inquiry. Interpretivism, com-
bined with relativism, is useful when conducting research that
aims to explore participants’ collective perspectives and under-
stand how they attribute meaning to experiences [28–30]. The
subjectivist epistemology involves a hermeneutical process of
interpreting participants’ subjective perspectives of social phe-
nomena through language or behavior [31,32]. Thus, such an
approach was suitable to address the present study’s objective of
exploring participants’ perspectives.
The authors made a number of assumptions based on this the-
oretical approach, which impacted the selection of specific meth-
ods of inquiry. First, the authors assumed that language and
behavior can be used to understand participants’ experiences and
perceptions, as well as interpret social phenomena, such as social
inclusion [33]. Second, the authors assumed that there were mul-
tiple realities that are contextual and co-constructed between par-
ticipants and researchers [30,34–36]. Since researchers are
involved in this co-construction, the authors assumed that their
beliefs and experiences may influence data interpretation [35,37].
The first author maintained a reflexive journal before and during
data collection to reflect on positionality (e.g., values, beliefs, etc.),
and consider how gender, age, academic and professional experi-
ence might influence interpretation. In addition, the involvement
of multiple researchers in the later stages of analysis enriched
data interpretation, as multiple perspectives guided analysis.
These reflexivity and triangulation processes facilitated transpar-
ency and overall study credibility [38].
Research setting
This study was conducted in an arts-based outdoor recreation
program at a hospital in Toronto, Ontario, called Spiral Garden.
Spiral Garden was selected as the ideal environment to explore
the potential impact of inclusive recreation programs, because of
the evidence supporting its inclusive design and implementation
[23,25,39,40]. The program adopts an inclusive design and there
are strategies in place to support inclusion for all children
[24,25,39,40]. Thus, Spiral Garden is considered an inclusive recre-
ation program because it evidence shows it is intentionally
designed to promote inclusion [1].
Spiral Garden adopts a unique philosophy, where overall well-
ing is promoted by being in a natural environment and having
shared creative experiences [41]. The program has four sessions
annually with approximately 50 to 60 children. Each session is
two weeks in duration and occurs in July and August.
Approximately half of the children have disabilities, which range
from mild to severe, and include children with intellectual, devel-
opmental and/or physical disabilities. The program is facilitated
by a combination of professionals and volunteers, including
artists, educators and medical staff. All staff and volunteers are
trained to inclusion by encouraging interactions, challenging
negative stereotypes about disabilities and facilitating shared
experiences amongst all children [40]. The program offers multiple
art activities simultaneously including theatre, puppetry, music,
wood-working, cooking, gardening, clay and painting [41].
Participants have the choice of which activities they participate in
and for how long. For more detailed information about the pro-
gram, please see Edwards and colleagues [26], Smart and col-
leagues [40)] and King and colleagues [39].
 THE IMPACT OF INCLUSION EXPERIENCES IN CHILDHOOD 3

Participant recruitment whether to conduct the interview in an interview room at

the hospital or outside where the program took place (but before
To capture a range of perspectives about social inclusion, this
or after the program started for privacy). Finally, parents/guardi-
study recruited participants of different ages, genders, and abil-
ans could join interviews for emotional support and/or to serve as
ities (verbal, cognitive, physical capacities). This study did not
communication assistants.
recruit participants under eight years of age since previous studies
suggest that typically developing children under the age of eight
may not have the cognitive ability to communicate rich and/or Analysis
valuable insights about social phenomena [42].
Inductive thematic analysis was used to analyze interview tran-
To be eligible to participate in the present study, potential par-
scripts [46]. This approach was selected to highlight participants’
ticipants must have been: a) enrolled in Spiral Garden; b) able to
perspectives [27]. The first author conducted each of the six
comprehend and communicate in English verbally or with an aug-
stages of data analysis outlined by Braun and Clark [46]. Stages
mentative and alternative communication (AAC) device; c) able to
one to three involved becoming familiar with the entire data set,
communicate more than yes/no responses exclusively, either ver-
coding all data, and assigning initial themes. The remaining
bally or with a communication assistant (parent or AAC); d) cogni-
authors participated in stages four to six, which involved generat-
tively functioning at a minimum grade three level according to
ing clear theme definitions and integrating findings with the cur-
staff and/or parents, and; e) eight to 18 years of age.
rent substantive and theoretical literature.
Several recruitment strategies were employed, including
To support methodological rigor, the researchers drew on
recruitment flyers, online advertisements on the organization’s
Tracy’s [38] criteria. For example, to ensure trustworthiness and
internal website, and information letters sent to all children
credibility, the first author maintained a reflexive journal through-
enrolled in Spiral Garden. Families expressing interest were then
out all stages of analysis to document and reflect how their posi-
screened for eligibility. If the child/youth was not able to provide
tionality and assumptions may impact data interpretation.
informed consent, but was willing to participate, the child
Trustworthiness can also be enhanced through triangulation.
assented to participate, and the parent/guardian provided
Triangulation was achieved during data collection (stage 1), by
informed consent.
allowing the researchers to follow-up on emerging themes follow-
ing interview #1. Triangulation was also achieved during stages
Data collection three to five, as the research team worked together to
refine themes.
Two semi-structured interviews were conducted with each partici-
pant. Interview #1 was completed at the beginning of the pro-
gram and explored participants’ thoughts and beliefs about social Results
inclusion and their experiences of inclusion in different settings
A total of 17 children with and without disabilities were recruited
(e.g., school, recreation). Questions included: What does it mean
for this study. Nine participants were CWODs and eight were
to be included in an activity? Is Spiral Garden the same or differ-
CWDs. Eleven participants were between eight and 12 years of
ent from school? Can you tell me about why you think they
age, and six were 13 years of age or older. Two participants in the
[other recreation programs] are the same/different from Spiral
eight-12 age group were a CWD, and six were CWODs. Eight par-
Garden? Interview #1 responses were used to contextualize
ticipants were male and nine were female. See Table 1 for partici-
responses to interview #2.
pant demographics. Of the eight participants whom were CWDs,
Four to six weeks after participants finished the first interview,
four participants were male and four participants were female.
interview #2 was conducted to explore the impact of participating
Based on the authors’ analysis, the findings were not different
in the program as well as follow-up on key themes that emerged
based on age or gender. The nature of the impairments repre-
from interview #1. Questions for each participant included: What
sented included cognitive (n ¼ 1), physical (n ¼ 3) and a combin-
is the same or different about how you treat people with different
ation of sensory, cognitive and physical (n ¼ 4). Of the eight
abilities now compared to before? Do you think you treat people
participants who were CWDs, two of the participants were inde-
the same or different; how? Would you want to participate in
pendently verbal and six used a communication assistant during
other programs like Spiral Garden, where there are equal numbers
of people with and without disabilities; why? These questions
Table 1. Participant demographics.
were selected based on the study’s objective and were informed
by previous empirical research about social inclusion [43,44]. Pseudonym Age range Age range Participant had a
name 8–12 13–18 Gender disability (Y/N)
A total of four guides were developed; a different guide for
each interview and a separate guide for younger (12 and Sophie X F N
Sam X M N
younger) and older participants (13 and older). Consistent with Walid X M Y
the semi-structured approach, the interviewer modified questions Patrick X M Y
from the guide slightly according to the participants’ responses Olivia X F N
and emerging themes to illicit meaningful responses related to Toby X M N
Charlie X M Y
the study objective [45]. Several strategies were used to support Abigail X F Y
participant engagement and facilitate meaningful responses. For Zoe X F Y
example, the guide for younger participants included sentence Isaac X M N
starters, such as “I know I am included when … .” The guide for Francis X M Y
Ellie X F N
older participants included more complex questions about the
Lily X F Y
same topic, such as “Can you tell me about a time when you did Claudia X F N
not feel included? What could have been different to change this Anne X F N
experience?” In addition, participants were able to choose the Logan X M N
location and time of the interview. Participants could choose Bianca X F Y
4 B. EDWARDS ET AL.
the interviews. Three of these six used an AAC device in conjunc-
tion with their parents/guardians. All but two of the participants
had participated in Spiral Garden at least one previous year.
The main themes were not intended to be categorized by
whether participants did or did not have a disability, however, the
themes emerged in this way. The main themes were: a) CWODs
have limited exposure to people with disabilities; b) CWODs and
CWDs’ hopes of change; c) CWODs learned how to interact with
people with disabilities; d) CWODs reported greater perceived
similarity in functional ability and hobbies/interests between
themselves and CWDs, and; e) CWODs become more comfortable
being around people with disabilities.
Interview excerpts from interview #1 are identified in brackets
as I-1 and interview excerpts from interview #2 are identified as I-
2 to show potential differences in attitudes and perceptions.
Some excerpts include a dialogue between the interviewer and
the participant. In these cases, the interviewer is represented as
“I” and the participant is represented as “R”. If the participant had
a parent/guardian present to facilitate communication, they are
represented as “R2”.
CWODs and CWDs have limited exposure to one another
An interesting – albeit disappointing – finding was that CWODs
commented that the Spiral Garden program was the only place
they saw or interacted with CWDs. Data included in this theme
represented statements or comments that alluded to the limited
time CWODs and CWDs spend together. Similarly, CWDs
explained that they did not have a lot of opportunity outside of
Spiral Garden (e.g., school) to interact with CWODs and/or chil-
dren with different types of disabilities (e.g., cognitive, phys-
ical, etc.).
Patrick explained that there were not any students with phys-
ical disabilities at his school: “I don’t know … there’s no peo-
ple … there’s no people in wheelchairs at school.” (Patrick-CWD,
I-2). Spiral Garden was the first time he had seen people in wheel-
chairs. Charlie, a boy in a wheelchair who used an AAC device,
explained with the help of his parent/guardian that he is often
segregated from the rest of the school:
R2: No, how many people in your class, how many students? Five?
Four? Six?
R: Uh-huh.
R2: Six.
I: Six, okay. And you only … at … when you’re at school, you’re only
spending time with those six people in your class?
R: Yeah.” (Charlie-CWD, I-1)
Patrick and Charlie’s comments speak to the limited exposure
CWDs have with CWODs.
This limited exposure was also reported by CWODs. Isaac
explained in detail his limited exposure to CWDs:
“Throughout my day I don’t really see disabled people, and then when
I came to this camp I’ve seen them a lot. And so … um, and so now
I’m … well, being more used to seeing them is … um … the effect …
the effect it has on me is … um … I get a better understanding if …
um … well, I already understand people that are in wheelchairs, but I
get a better understanding of um things, for example, these are … this
is surprisingly the first time I’d actually seen … I’ve actually met a
mentally disabled kid.” (Isaac-CWOD, I-2)
The interviewer asked participants whether they had interac-
tions with other children who had disabilities in any other setting.
Anne explained that, “there’s no people with disabilities [at school
or other programs] … ” (Anne-CWOD, I-1). Similarly, when the
interviewer asked Olivia about her experiences in other programs
where there are CWDs present, she said “I’ve never been to one”
(Olivia-CWOD, I-2).
This theme highlights the limited exposure CWODs have with
to CWDs. CWODs in the present study said that they had limited
interaction with CWDs in school and did not attend other inclu-
sive programs.
CWODs and CWDs’ hopes of change
Data were categorized in this theme if participants reported feel-
ings, thoughts, or behaviors they hoped would change as a result
of participating in a recreation program where CWDs and CWODs
participate in activities together.
Participants discussed how CWODs might learn helpful behav-
iors and/or empathy. Francis (CWD) reported that he hoped
CWODs learned to “respect [CWDs]” having participated in Spiral
Garden. Logan (CWOD) also spoke about how he hoped CWODs
would respect CWDs more after being in the program together:
“I think they [CWODs] gain respect and helpfulness.” (Logan-
CWOD, I-2).
Abigail stated that she hoped CWODs would become
more empathetic:
Actually, yeah, I do feel like that’s a good thing ’cause then they can,
like … I know that most people that are able-bodied usually don’t
really care about the people you see that have disabilities, but like
there’s still a way to know that, like, they … that you have to care for
everyone (Abigail-CWD, I-2).
Abigail continued stating: “They [CWODs] … like, they might
actually care for the people that they see that are in wheelchairs
or have walkers. And that they know that they’re people too.”
(Abigail-CWD, I-2). Anne (CWOD), was the only participant who
commented on how she feels when she sees people with disabil-
ities being treated differently in public:
R: Yeah, ’cause I see somebody walking by in a wheelchair, like, and
they need, like, somebody to push them, or if they’re not, like, moving
in a wheelchair, then I see people looking at them, like, little kids and
sometimes even like adults just staring at them and it kinda makes me
feel bad …
I: mmhmm.
R: For the person ’cause I wouldn’t like to walk down the street and
just see half the people just staring at me … looking at me.” (Anne-
CWOD, I-1)
Abigail’s comments reflect hope that CWODs’ changed atti-
tudes and perspectives would generalize toward all people with
disabilities, and Anne’s comment suggests that such experiences
might have a positive impact on CWODs’ empathy for CWDs.
CWODs learned how to interact with people with disabilities
As the previous theme showed, CWDs spoke of how they hoped
that CWODs would learn about people with disabilities. Data fit
under this theme if they were related to something CWODs
learned about people with disabilities more generally. As Zoe
stated, "I think children without disabilities learn other ways to do
things.” (Zoe-CWD, I-2). Furthermore:
Well I understand more of, like, how they go around and, like … I don’t
really know, well I have one friend with a minor disability, but … but
like I’ll understand more about, like, if someone sees someone with a
disability where they’re in a wheelchair. I’ll understand more how hard
it is … how much harder it is to be in a wheelchair than just on
legs … like … you can’t go over, like a bump or something. (Sam-
CWOD, I-2)

CWODs reported learning about different ways to communi-
cate and interact. Ellie said that she enjoyed learning about how
different people communicate: “I think it’s fun to have them just
to, like, see how they communicate and stuff.” (Ellie-CWOD, I-1).
Toby also mentioned that he feels more confident in how to
speak to people with disabilities:
R: Well because now I’ve like interact with people with disabilities,
I know how to cope with them, I guess.
I: mmhmm. And when you say cope, what do you mean?
R: Like I know how to handle them, talk to them.” (Toby-CWOD, I-2)
CWODs learned different ways to do different everyday activities,
such as communicate. They also learned to appreciate the different
environmental barriers impeding simple, taken-for-granted actions/
activities, such as going over a curb.
CWODs reported greater perceived similarity in functional
ability and hobbies/interests between themselves and CWDs
CWODs reported that they perceived to have more in common
with CWDs after interacting with CWDs. Data fit with this theme if
CWODs reported similarity between CWDs and themselves in
terms of functional ability and/or interests/hobbies.
CWODs reported that they perceived CWDs to be more cap-
able and more similar to themselves after they participated in
Spiral Garden. Logan (CWOD) explained that the perceived differ-
ences between himself and CWDs were mitigated after he partici-
pated in the program: “ … just because they have a disability it
doesn’t mean that it doesn’t … they’re not that different from
everybody else.” (Logan-CWOD, I-1). Ellie’s comment mirrored
these perspectives: “Although they have disabilities, they’re,
like … they’re the exact same and they’re … and … [pause
8  9 s] That’s about it.” (Ellie-CWOD, I-1).
Sam (CWOD), talked about activities he and a CWD have in
common. In the following quote, Sam is referring to a child who
wore a piece of clothing to prevent himself from scratching his
arms and legs during involuntary muscle movements:
“I don’t know I also like soccer and he … he likes soccer too and
maybe we could talk about soccer ’cause he … he might like [soccer
player name], I saw he was wearing a [soccer play name] shirt and …
I also scratch myself ’cause at the cottage they have a lot of mosquitos,
and I have to resist from scratching them, so it was a cool idea to wear
the [article of clothing] on your hand” (Sam-CWOD, I-1)
Olivia also spoke about how CWDs seemed less different from
CWODs after attending the program: “It [inclusive recreation pro-
gram] kinda lets you get to know people with disabilities and
don’t think that they’re weird.” (Olivia-CWOD, I-1).
Recognizing similarity was accompanied by CWODs believing
that CWDs were more capable than they thought before entering
the program. Sophie compared her expectations before and after
participating in the program: “It’s not as hard as I thought it was
to interact with people with disabilities.” (Sophie-CWOD, I-2).
Similarly, Ellie compared her perspective about CWDs before and
after participating in Spiral Garden: “Like I … when I would see
people with disabilities before, I wouldn’t really, like, know them,
or what they do or something. But at Spiral Garden I can see that
the people actually, like, they’re included in things” (Ellie-CWOD,
I-2). Ellie further explained:
“I would, like, treat them, like not … like they were in a wheelchair,
like, just a person normally because I went to Spiral Garden and I, like,
saw that they can do things. Um, but if I were one of my friends who
have not seen them, I would probably … um, like, not know what they
THE IMPACT OF INCLUSION EXPERIENCES IN CHILDHOOD 5
were capable of, so it would change my … like, opinion then.” (Ellie-
CWOD, I-2)
Perceived similarity was an important theme in the present
study, as CWODs were able to identify hobbies, interests, activities
and/or general behaviors that they have in common with CWDs.
CWODs became more comfortable being around people with
disabilities
CWODs spoke about how their limited exposure to people with
disabilities before the program made them uncomfortable around
people with disabilities. In her first interview, Claudia (a CWOD)
explained how her behavior is different from her peers who have
not interacted with children who have disabilities:
Um … well, I would just treat them [CWDs] as I treat everyone else. But
classmates, if they haven’t, like, been around them as much, I would
say they probably, like, maybe just not talk to them [CWDs] as much
and feel uncomfortable around them. (Claudia-CWOD, I-1).
Similarly, in Anne’s first interview, she compared her uncer-
tainty about how to interact with people who have disabilities:
“When I was younger I didn’t know what it [nature of children’s
impairment] was and I was confused I didn’t know what to do.”
(Anne-CWOD, I-1). These comments highlight how behaviors (e.g.,
talking to CWDs) might be different depending on respective
comfort levels around people with disabilities.
Once participants had the opportunity to interact with people
with disabilities, they felt more comfortable. As Sophie’s com-
ment highlights:
No. Not really. I can’t really think of any reason that make me … that
would make me not want to be friends with them, but it … maybe
when I was littler, I might have felt, like uncomfortable around people
who have disability.
I: Why is that?
R: I don’t know. I just thought maybe they weren’t normal. And I didn’t
know. (Sophie-CWOD, I-1)
Anne also commented about how CWDs seemed “more nor-
mal” after having the opportunity to participate in activities with
children who have disabilities:
R: And so when I come it’s a chance to interact with them and I …
before I came I was kind of scared of them ’cause I didn’t know what
they would do.
I: Hmm.
R: But now that I know that they’re not going to do anything to me
and they’re just trying to live a normal life. (Anne-CWOD, I-1)
Claudia also had a similar comment: “Yeah. I … well I feel more
comfortable around them and I also think of them more as, like,
just normal people now. That just, like, have a bit of a disability,
but they’re like normal people.” (Claudia-CWOD, I-2).
Having the opportunity to interact with children who have dis-
abilities provided a normalization experience, where CWODs
seemed “more normal” compared to their perceptions before
CWODs participated in the same program.
Discussion
This study aimed to explore the individual impact of an inclusive
recreation program from the perspectives of children with and
without disabilities on the individual impact of an inclusive recre-
ation program. Two themes incorporated the perspectives of both
6 B. EDWARDS ET AL.
CWDs and CWODs: CWODs have limited exposure to CWDs and
hopes of change. The remaining three themes generated exclu-
sively from the perspectives of CWODs were: CWODs learned how
to interact with people with disabilities; CWODs reported greater
similarity in functional ability and hobbies/interests between
themselves and CWDs, and CWODs become more comfortable
being around people with disabilities. This discussion considers
these results in relation to current literature, beginning with a
potential rationale for the over-representation of the perspectives
of CWODs’ in the findings. This is followed by how inter-group
contact theory is useful to understand the impact of inclusive and
integrated recreation programs. This discussion will conclude with
a critique of normalizing language used by CWODs and will offer
recommendations for future research.
Over-representation of CWODs’ voices
The voices of CWODs may be over-represented in the findings, in
that more themes incorporate their perspectives exclusively. Most
of the evidence provided is from CWODs because CWDs did not
report any change in aspects of social inclusion (e.g., thoughts,
beliefs, behaviors, emotions, social skills) after participating in the
program. Three CWDs (given the pseudonyms Francis, Zoe and
Abigail) explicitly stated in their interviews that nothing changed
for them after participating in the program, but they did hope
that the program impacted the attitudes and behaviors of CWODs
toward CWDs (theme #2). Other CWDs, including Lily, Patrick,
Charlie, Walid and Bianca (pseudonyms) did not report an impact
of Spiral Garden on their perspectives, attitudes, and/or
social skills.
The authors hypothesize that this over-representation could be
due to CWDs having more participating in activities with peers
with different abilities. Thus, participating in activities with CWDs
is a more novel experience for CWODs compared to CWDs.
CWODs in the present study reported that they rarely – if ever –
saw or interacted with anyone with a visible disability in their
school, neighborhood or other recreation programs. Integrated
and/or inclusive recreation may be their first opportunity to inter-
act with children who are similar in age, but potentially different
in functional ability and skill. Recent studies suggest that interac-
tions between CWDs and CWODs may be rare, despite CWDs and
CWODs being mandated to attend the same schools [18,47,48].
According to inter-group contact theory, this over-representation
may be expected, as inter-group contact is presumed to have a
greater influence on the in-group’s prejudices than the out-group’s
[49]. Although some studies suggested that integrated recreation
programs can have a positive impact on self-esteem and social skills
for both CWDs and CWODs [6,7], CWDs in this study explained that
nothing changed after leaving the program, in terms of social skills
or any self-construct (e.g., self-efficacy, self-esteem, etc.). Instead,
CWDs in this study reported on what they hoped CWODs would
gain from attending the program. CWDs are frequently exposed to
situations where they interact with people who have different com-
munication, physical and/or intellectual ability, so interacting with
people who are different from them in a recreation setting is not a
novel experience. As previous studies show, CWODs, generally, do
not have the same opportunities to interact with other children
who are different from them [50]. Therefore, being involved in an
integrated or inclusive program may be a more novel experience
for CWODs compared to CWDs.
Perspectives of CWODs and inter-group contact theory
As the results show, for CWODs inclusive recreation may have posi-
tive impacts on attitudes and beliefs about people with disabilities,
which provides some additional evidence to support inter- contact
theory. The findings in this study suggest that contact opportunities
in the context of an inclusive recreation program may have a posi-
tive impact on attitudes and beliefs about people with disabilities.
According to inter-group contact theory, changes in attitudes can
occur in cognitive, behavioral and affective domains after having
the opportunity to interact with the out-group [12]. However, after
a two-week inclusive recreation program, the impact on attitudes
for CWODs may be more cognitive (e.g., CWODs believe that they
have more in common with CWDs) and affective (e.g., feel more
comfortable interacting with children who have disabilities) in
nature, rather than behavioral.
In the cognitive domain, CWODs in the present study reported
learning how to interact with people who have disabilities and
believing that they have more in common with CWDs after partic-
ipating in the Sprial Garden program. Previous studies show that
when CWODs have an opportunity to learn about CWDs and their
communication needs, the frequency of socially-related interac-
tions increases [51]. Additionally, previous research has demon-
strated that CWODs tend to interact more with children they
perceive to be similar to them in terms of intellectual, physical
and overall developmental functioning [18,52]. Similarly, CWODs
typically develop greater peer acceptance and develop friendships
with children who have disabilities when they are able to identify
similar interests/hobbies [18,53]. The opportunity for CWODs and
CWDs to interact in an unstructured inclusive recreation setting,
as opposed to a structured school setting, may be more condu-
cive to discovering shared interests and hobbies.
In the affective domain, CWODs spoke about how they had
reduced fear and greater comfort when interacting with people
with disabilities. Keith and colleagues [12] suggested that reducing
intergroup anxiety is a powerful mediating mechanism to produce
changes in beliefs, thoughts and behaviors for the out-group
(CWODs). Intergroup anxiety is defined as an “uncomfortable feeling
that in-group members might have interacting with a person from
the out-group” [12,p. 15]. After being in the Spiral Garden program,
CWODs in the present study described being more comfortable
interacting with people who had disabilities and reported being less
“afraid” of people with disabilities. This has two important implica-
tions. First, it suggests that feeling “uncomfortable” or “afraid” of
people (adults and children) with disabilities could be how CWODs
express intergroup anxiety. Second, the findings of the present
study could be interpreted as participants overcoming inter-group
contact anxiety by participating in an inclusive recreation program.
A potential critique of inter-group contact theory is that it
over-simplifies inclusion processes by assuming that inter-group
contact will lead to positive attitudinal change. First, it assumes
that everyone has the same tolerance level for the out-group [49].
As Pettigrew and colleagues [49] explain, members of the in-
group who choose inter-group contact may already have positive
attitudes toward diversity. Thus, the inter-group contact may not
always be the sole explanation for positive attitudes following inter-
group contact. Second, inter-group contact theory over-simplifies
who are members of the in-group and members of the out-group.
For example, the “majority” (in-group) does not account for people
who might experience marginalization for different reasons in differ-
ent settings and/or who may have multiple qualities of different
out-groups. For example, an individual may be a member of an eth-
nic minority but not have a disability. Thus, they might experience
prejudice in one setting but not another. It is also possible that an

individual may identifies as an ethnic minority in addition to having
a disability, which may potentially add to the prejudices against
them from the “majority” (in-group). Thus, it is important to con-
sider the limitations of exploring/interpreting the findings of this
study using inter-group contact theory.
Theoretical alternative: normalization/social role valorization
Given the limitations of inter-group contact theory, normalization
may be an alternative theory to interpret the findings of the pre-
sent study. Having the opportunity to experience inclusion with
CWDs made CWODs believe that their peers with disabilities were
“more normal.” The notion of normality was especially prevalent
in the fifth theme, where CWODs seemed to describe becoming
more comfortable around people with disabilities after participat-
ing in the program because CWDs were perceived to be “more
normal.” This language is reminiscent of Wolfensberger’s normal-
ization principle [54], later called social role valorization [55]. The
goal of normalization/social role valorization is the “creation, sup-
port, and defense of valued social roles for people who are at
risk of social devaluation” [55,p. 435]. People with disabilities,
including CWDs, are a group at risk of social devaluation [56].
Integrating children with and without disabilities in the same
environment is a way to engage CWDs in socially valued activities
(e.g., inclusive recreation, mainstream school) to boost the CWDs’
social image and expectations, which presumably enhances
CWDs’ capabilities [56]. Therefore, it is possible that Spiral Garden
has a positive impact because CWODs and CWDs participated in
the same activities together, leading to improved social image of
CWDs in Spiral Garden.
An improvement in social image could be extrapolated by
CWODs stating that CWDs seemed “more normal” after having
the opportunity to interact directly with them. Such findings are
reflective of a critique of normalization/social role valorization,
which is that it idealizes normality. Normalization/social role valor-
ization suggests that being “normal” is better than being
“different,” and it reinforces harmful social dichotomies (e.g., nor-
mal/abnormal) that privilege able bodies [57]. CWODs said they
became more comfortable with people with disabilities because
they seem “more normal,” suggesting that participants previously
believed people that people with disabilities were abnormal.
Language can be a powerful tool in perpetuating negative stereo-
types [58]. The way children speak about disability may reinforce
dominant normality discourses, devaluing those who do not fit
dominant perceptions of normality [59]. Integrating children with
and without disabilities in recreation intends to promote diversity,
not assimilate CWDs to social conceptions of normality.
Communication can be a tool healthcare providers and
researchers can use to better promote diversity. Such professio-
nals have been encouraged to adopt more inclusive language
and to acknowledge disability as a socially constructed experience
[60]. Strategies to promote inclusion may include focusing on
blurring the distinction between normality and impairment rather
than reifying such distinctions [60]. It appears that such inclusive
language may need to be taught and adopted by the general
public to produce societal change. Without inclusive language
being used and adopted by the general public, it may be difficult
to promote attitudinal change at a community or societal level.
Future research
There are three recommendations for future research. First, it
would be beneficial to conduct more studies that explore the
THE IMPACT OF INCLUSION EXPERIENCES IN CHILDHOOD 7
perspectives of CWDs and CWODs in other inclusive and/or inte-
grated recreation programs. Although previous studies show the
impact of contact opportunities on cognitions, behavior and feel-
ings about disability are mixed [11,17,18,61], CWODs in the pre-
sent study did not indicate that such opportunities in Spiral
Garden had a negative impact. It would be useful to compare
inclusive recreation programs (programs that intentionally pro-
mote inclusion) to integrated recreation programs (programs
where children with and without disabilities are welcome, but
there are not strategies in place to specifically promote inclusion)
to further understand whether an intentional inclusive design is
be required for contact opportunities to have a positive impact.
This could help researchers understand whether explicit strategies
are necessary to promote inclusion or whether inclusion will
spontaneously emerge due to direct contact.
Second, inter-group contact theory would suggest that direct
contact between CWODs and CWDs would have some impact on
behavior. CWDs reported that they hoped behaviors would
change (e.g., CWODs would stare less), but CWODs did not report
that their behavior actually did change. Some studies have sug-
gested that there is a positive association between time spent
with the out-group and positive change [62]. Thus, it is possible
that a two-week inclusive program did not provide enough inte-
gration opportunities to produce behavioral changes. Conducting
larger, longitudinal studies may be useful to identify potential
behavioral impacts in different program environments.
Furthermore, given the present study’s methodological approach,
it is important to exercise caution when speculating on the rele-
vance of these findings with regards to behaviors. Future research
may consider adopting multiple methods of inquiry to further
understand what factors might contribute to behavior change
specifically. Exploring the influence of behavior within and outside
the program may require slightly different research questions and
the integration of covert observation methods of inquiry.
Third, it would be useful to compare children’s perspectives
across settings to gain a deeper understanding of how integration
opportunities can influence the perspectives of those who might
be more reluctant to interact with children who have disabilities
(e.g., compare inclusive recreation and mainstream educational
settings). The people that would benefit most from integration
opportunities are often those who will not seek out such opportu-
nities and try to avoid them altogether [63]. Exploring perspec-
tives in settings where children with and without disabilities are
mandated to be in the same physical space (e.g., mainstream
school) versus choosing (or their parents/guardians choosing) to
be in the same space (e.g., inclusive recreation) could inform strat-
egies to overcome such avoidance. This could address barriers to
reaching people with strong prejudice and further contribute to
reducing social stigma against people with disabilities.
Limitations
This study may have encompassed participants who were already
more accepting of diversity compared to those who would avoid
integrated/inclusive recreation altogether. Additionally, it is pos-
sible that parents/guardians with more accepting attitudes are
more likely to enroll their children in integrated/inclusive recre-
ation programs. Those who are willing to challenge their assump-
tions and learn about different abilities are likely to have more
positive attitudes and less prejudice to begin with compared to
those who avoid such opportunities [63]. Studies exploring the
impact of integration opportunities tend to capture the perspec-
tives of participants who are willing to put themselves in a
8 B. EDWARDS ET AL.
situation where they might experience inter-group contact anxiety
and are willing to learn about diversity [49].
Furthermore, it is possible that CWODs responded favorably
to questions about acceptance to present themselves in a non-
discriminatory fashion. This is a consideration for future research.
This limitation could be mitigated by adopting additional meth-
ods of inquiry that might capture children’s attitudes in other
ways, such as using covert observation methods to observe and
interpret behavior to better understand behavioral change.
Conclusion
Enrolling CWDs and CWODs in the same recreation programs may
provide meaningful integration opportunities for CWODs. Results
from this study suggest that CWODs may perceive greater similar-
ity between themselves and CWDs as well as experience increased
comfort interacting with people with disabilities in their commun-
ities when they have the opportunity to take part in recreation
together. On the other hand, CWDs did not report changes in
beliefs, behaviors or thoughts affiliated with social inclusion.
Instead, CWDs discussed what they hoped would change for
CWODs as a result of having integration opportunities in a recre-
ation program. This differential impact of recreation programs on
CWODs compared to CWDs may be due to the novelty of experi-
ence and a reduction in inter-group anxiety for CWODs. Despite
having exposure to CWDs, CWODs to describe CWDs in terms of
normality, which may be contradictory to the intention of inclu-
sive and integrated recreation. It is important that the professio-
nals designing such programs consider strategies to promote
inclusive language. Although the individual impact of inclusive
programs on CWDs may be minimal, inclusive and integrated
recreation programs have the potential to impact the attitudes
and perceptions of CWODs and may influence societal stereotypes
of future generations.
Acknowledgements
The authors would like to thank the participants and their families
for their transparency and candor during our interviews.
Disclosure statement
The authors report no conflicts of interest.
Funding
This project was funded by the Holland Bloorview Foundation
Graduate Student Scholarship to this scholarship.
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