versão On-line ISSN 2179-6491
J. Soc. Bras. Fonoaudiol. vol.24 no.1 São Paulo 2012
EVIDENCE-BASED SPEECH-LANGUAGE PATHOLOGY AND AUDIOLOGY FONOAUDIOLOGIA BASEADA EM EVIDÊNCIAS
Fabiana Trevisani SilvaI; Eduardo Augusto Vella GonçalvesII; Kátia de Freitas AlvarengaIII
ILaw School, Fundação Educacional do Município de Assis FEMA Assis (SP), Brazil
IIFundação Educacional do Município de Assis FEMA Assis (SP), Brazil
IIIDepartment of Speech-Language Pathology and Audiology, Universidade de São Paulo USP Bauru (SP), Brazil
PURPOSE: To critically analyze the inclusion of individuals with special needs in regular education in Brazil, considering social and legal aspects, through literature review.
RESEARCH STRATEGY: The literature search was conducted in open access databases: LILACS, SciELO, Portal Cochrane and IUSDATA, the latter belonging to the Library of the Law School of the University of São Paulo, considering all articles published until December 2010. The search strategy used the following keywords: inclusive education; special education; inclusive proposal; individuals with special needs.
SELECTION CRITERIA: In the search, only studies in which the summary or the body of the article were related to the purpose of the study were evaluated and selected.
DATA ANALYSIS: The potentially relevant articles for review were presented in a protocol form containing the eligibility criteria of the study, methods used, characteristics of the analyzed group or manuscripts, type of intervention used in the study, and results obtained. Articles classified as expert opinions, despite their low level of scientific evidence, were considered in this work, since they are often found in the literature on the issue.
RESULTS: A total of 1,399 articles was found and 120 potentially relevant articles were selected after reading their abstracts. From these, 67 articles were cited in more than one database, which resulted in 53 articles to be fully read. Fifteen of these articles were excluded after reading because they did not meet the inclusion criteria. Thus, 38 studies were included and analyzed.
CONCLUSION: Following a critical analysis of the literature in the field, it was concluded that, so far, in general, the school receives individuals with special needs; however, there is a long way to go to actually include these individuals, although Brazil has the scope of inclusion. Therefore, it is necessary to establish public policies and guidelines aimed at effective inclusion.
Keywords: Education, special; Disabled persons/education; Mainstreaming (Education); Teaching; Evidence-based practice
The social aspect and the need to reduce inequalities is one of the most controversial and intriguing subjects of present time. It is not conceivable that in a modern, technological and globalized world we cannot transpose the barrier of the differences.
The State abandons its position of abstinence in social matters and starts to intervene, promoting public policies to stimulate the process of a more just and egalitarian society.
The Federal Government has invested gradually in the Brazilian Education. However, the results continue to be unsatisfactory, once the decrease of 29,1% in the illiteracy rate between 1996 and 2006 was not enough to take Brazil off the place before last in the literacy ranking in South America, according to data from IBGE (Brazilian Institute of Geography and Statistics) (http://noticias.uol.com.br/educacao, available access in May of 2010). There are still other indicators that the Brazilian educational system presents misguided public politics that do not guarantee satisfactory results. An example of this is the continued progression that has generated serious deficits in learning, as the students pass to the following grade, many times presenting significant deficiencies in learning. Also, the teachers' level of education and the absence of a policy of merit, where the good ones would be valued and consequently stimulated for a constant qualification have been focus of concern and discussion.
It is in this context that the inclusive education is being discussed. During the 1950's, the creation of independent Secretary of Health and Education promoted discussions about education, what would have to start happening in a pedagogical instead of medical view, that is, in which the exception was seen as illness(1,2).
Considering the historical perspective of the legislation(3), the inclusive education in Brazil has already had advances and draw backs ; this happened because the laws were created in accordance with the conceptions of the governing people and the political moment of each time. Thus, there were periods in which the education was aimed only at a certain social class, generally the wealthiest one, and in others, it aimed to also take care of the less favored population. This situation changed with the Federal Constitution of 1998, which guaranteed:
Art 1. The Federative Republic of Brazil, formed by the indissoluble union of the States and Cities and the Federal District, consists of a Democratic State of Right and has as bedding:
II - the dignity of the human being;
Art. 3. Basic objective of the Federative Republic of Brazil:
I - to constitute a free, just, and solidary society;
III to eradicate poverty and substandard living conditions and to reduce social and regional inequalities
Art. 208. "The duty of the State towards education shall be fulfilled by ensuring the following:
I mandatory basic education, free of charge, including the assurance of its free offer to all those who did not have access to it at the proper age;
III specialized schooling for the handicapped, preferably in the regular school system.
Thus, the Federal Constitution of 1998 contemplates the international parameters when prioritizing the individual inserted in the legal system, fundamental rights such as health, education, among others. In such a way, a drastic modification in education was observed, which had to adjust to new universal principles(4). The Law of Directives and Bases (1996) created in previous paradigms had to be reformulated (1988), with prominence for the administrative decentralization of the education that was transferred from the union to the city, the quantitative increase in the number of openings, and the new vision of the inclusive education.
Currently, the inclusive education is guided by resolutions nº 95 of 11/21/2000 and nº 02 of September 11, 2001 and by Law nº 10.845, of March 5, 2004. They discuss about access and permanence of the handicapped students (SNS's, special needs students) in regular education, and actions that make this new educational reality possible.
In this context, the inclusion of handicapped students in regular education propels a new social reality. Inserting all the students in a regular school, not discriminating those that historically had been segregated and to involve the family in the educational process proves be the most effective way to change society. These yearnings meet the current debate of the Law, in regards to dignity, equality of opportunities and prohibition of discrimination.
It is important to highlight that we defined to analyze only the national literature aimed at inclusion, once the objective of this study is to critically analyze the inclusion of handicapped people in the Brazilian regular education, that is, how this process is being developed, considering the available resources in our reality.
Based on what has been discussed, the objective of this study was to critically analyze the inclusion of handicapped students in Brazilian regular education, considering social and legal aspects.
The question of investigation that subsidized the review was: "Does the Brazilian legislation ensure the inclusion of people with special needs in regular education, from the teacher's and the educational coordinator's perspective?"
The bibliographical research was conducted in databases of public access: LILACS, SciELO, Cochrane portal and IUSDATA, being this last one of the Library of the Law School of the University of São Paulo. We analyzed studies published until December 2010.
Initially a survey in the Cochrane portal of the Virtual Library in Health (VLH) was conducted, available in the address:http://cochane.bvsalud.org/portal/php/indexphp?lang=pt. The lack of studies of systematic review that had analyzed the inclusion of the SNS's (Special Needs Students) in regular education was established.
Starting at the planning of the investigative question, we tried to do the bibliographical research on the main subjects of this work using the following free terms in isolated form, without the combination of them: inclusive education, special education, inclusive proposal and people with special needs.
The exclusion criteria adopted were: studies developed outside the national context and isolate studies developed in special schools. Articles of systematic review, descriptive studies and opinion of specialists were selected, being that the last two, although present low level of scientific evidence, were included in this research, as they are frequently found in the literature of the area.
Only those studies whose summary or body were related to the objective of the present study were evaluated and selected, for posterior attainment of articles in complete text.
The potentially relevant articles for the review were presented in a protocol form containing eligibility criteria of the study, methods used, characteristic of the analyzed group, type of intervention carried through, and results obtained in the study.
The records obtained and selected in the different databases, are presented in Chart 1.
From the 120 selected articles, 67 were excluded for being concomitantly in more than one base, resulting in 53 articles to be read in full.
After reading 53 articles, 15 were excluded, as they did not meet the inclusion criteria. The summary of the process to obtain the 38 articles selected for the literature review is represented in Figure 1. The content discussed in each of the articles is described in Chart 2.
After the process of bibliographical research and analysis of potentially relevant articles for the review, it was evidenced that to make the inclusive education possible with the involvement of the federal, state and municipal governments, the State created a Program called "Inclusive Education: the right to diversity" and the Secretary of Special Education of the Federal Government (MEC/SEESP, 2007) established to multiply its actions in the area of Special Education(5). However, in spite of these actions, the monitoring of the process of implantation of the proposal has been insufficient, what possibly reflects in the results obtained until the present moment(6). Studies that had as methodology the analysis of official documents and records showed that the information directed to the inclusive education proceeded from isolated actions on the part of principals and teachers and not of the public administration, what made any longitudinal analysis of the results obtained in the school that had special needs students difficult(7,8). It is important to highlight that official data are essential so that a public policy is kept and improved. Assuming that they are true, these results will reflect the real situation of the problem, preventing an empirical analysis from being made.
Brazilian legislation defined clearly the target population to which the inclusive education is meant for. However, there are no precise official data on the number of existing SNS's in each region of Brazil, fundamental information to implement any public policies(9). The IBGE could be the source of information, but the criteria used by it make it difficult to apply the data to the legal device that defines who are the students with special educational needs (Article 5º of the Resolution nº 2 of 9/11/2010). The classification of deficiency used by IBGE (2000) in six categories (visual, auditory, motor, physical, mental, and multiple deficiencies) encompasses all the aspects that reflect the global development of the individual: motor, linguistic, sensorial, cognitive, socialization and self care, and meet the national and international definitions of deficiency. However, the criterion of degree of severity (incapable, some or great permanent difficulty) make it difficult to identify with clarity which individuals really need and benefit with the policy of inclusive education.
In the literature of the area, it is observed that the majority of the experiences with inclusion did not happen in favorable conditions(10,11), what would allow for a substantiated and correct analysis. Another important aspect is related to the understanding of the inclusion concept(12,13), in which the existing reality was described as the adaptation of the SNS's. Thus, education is seen as a socio-educational model that selects and excludes users; as a parallel process, in face of necessity of individualized works and adequate methods and techniques(14,15), and finally, as a process of homogenization of opportunities as the so called normal people(16).
In presenting an inclusive proposal, the least that is expected is the qualification of the professionals involved in the education of the student with special needs(17-19), from the professor to the administrative employee(20). As a starting point we have a shift in posture going from fear, repulsion, violence, and authoritarianism to patience and courage(21,22). However, this is the aspect that the studies consider as presenting the most deficit, and points to the desires of those involved in the process, as the teacher was not prepared at a graduation level (considering the Course of Education). Moreover, there isn't an effective proposal of qualification courses that aim at continuous and permanent education, mainly for those that are working in the field. In spite of experiences demonstrating promising results in regards to teacher-student relationship(23), what it is observed is teachers educating the SNS's keeping the same curriculum, pedagogical methodology and the performance assessment is done in a traditional way(24-29), just as the schools without project of inclusion with definite guidelines(30).
In addition to the aspects mentioned above, there aren't always resource rooms with assisted technology, demanded by law, that meet the plurality of these new students promoting self-esteem, autonomy, and creativity. This happens due to the difficulty to implement them and to keep them, considering the number of SNS enrolled in the units(31).
The issues in educating teachers becomes much more complex when we consider that, generally, the only criterion for formation of the classrooms is the age group, what can make the teacher face a diversity of pathologies that present different clinical situations, what demands a differentiated and specific treatment(32,33). This fact justifies having a team of professionals in education at the school , but also professionals in health, to assist the professionals of the institution, creating conditions of permanence and insertion of the student with special needs in regular education. Successful outcomes described in the literature were achieved due to the existence of a multidisciplinary team in the school(34,35).
Many times, the SENS is not accepted by the so called "normal" students, inside the school itself, what causes the exclusion, that is, the opposite of what it is proposed. Thus, on family education, working the concept of deficiency becomes important even if there are no SENS's in the family. This will contribute so that the child does not establish prejudice and learn to coexist with the differences. From then on we can propose that the interaction among the students is a facilitator for the learning of the SNSs.
The impression we get from the current situation is that the student with special needs was introduced to, but not included in regular education(36). Kafrouni(30) considered a discussion around two terms apparently similar, but surrounded of many antinomy, what makes it necessary to distinguish them: to integrate and to include. To center the deficiency in the person who possesses it, demanding their habilitation so that they can enter society is a position that defines the integration. The inclusion starts at another paradigm where the deficiency is not exclusive responsibility of the person who has it, being the society's responsibility to modify itself to propitiate a total insertion of the individual, independently of their deficits or necessities(30,37,38).
In the legal context there is also antinomy, because the same legislation that praises the access to education in an indiscriminate way opposes guiding principles of the whole legal system, as the principle of isonomy and of the dignity of the human being which consists of "dealing with equals equally and with different ones differently". This happens because when inserting the student without creating physical, pedagogical and humane conditions, we are treating all the students as equal without respecting the individual differences and necessities. The dignity of these SNS's is disrespected from the moment that the conditions offered make the student a mere spectator and not subject of the learning process.
Currently, numerous challenges need to be conquered so that inclusive education can be attained, but its formal legality cannot be ignored. The existence of the law guarantees the right of SNS's to regular education, with all the necessary conditions so that learning occurs effectively, and mainly, keeps society conscientious and active so that the inclusive education can be brought into a material legality, that is, to become a reality in the Brazilian educational system.
It is important to take into consideration the fact that the inclusion of the students with special needs cannot be analyzed only as an educational aspect, but as social phenomenon. The change in paradigm that transforms segregation into inclusion will not be provided only for the fact that laws and public policies exist, but for the change of social behavior that will only happen through education. Thus, education is the drive of social changes, but society also makes new educational possibilities a reality.
After the critical analysis of the literature it can be concluded that, up to this point, in general, the school receives, but there's a long way to go to include SENS's, although the country possesses the scope of inclusion. Thus, it becomes necessary to establish guidelines and political actions aiming at the effective inclusion of the SNS's in regular classrooms, what demands beyond boldness and courage, some prudence and good sense so that an inclusive reality is built indeed.
The the São Paulo Research Foundation (Fundação de Amparo à Pesquisa do Estado de São Paulo FAPESP) for the research grant provided for the accomplishment of the study, under process number 09/50403-9.
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Correspondence address: Received: 10/26/2010 Study conducted at the Law School, Fundação Educacional do Município de Assis FEMA Assis (SP), Brazil.
Kátia de Freitas Alvarenga
Departamento de Fonoaudiologia da Faculdade de Odontologia de Bauru USP
Al. Dr. Octávio Pinheiro Brisola, 9/75, Bauru (SP), Brasil, CEP: 17012001.
Conflict of interests: None
Study conducted at the Law School, Fundação Educacional do Município de Assis FEMA Assis (SP), Brazil.