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Journal of Intellectual Disability Research doi: 10.1111/jir.12060


625
volume 58 part 7 pp 625–636 july 2014

A quantitative assessment of educational integration of


students with Down syndrome in the Netherlands
G. De Graaf,1 G. Van Hove2 & M. Haveman3
1 Dutch Down Syndrome Foundation, Meppel, the Netherlands
2 Department of Orthopedagogy, Ghent University, Ghent, Belgium
3 Faculty Rehabilitation Sciences, University of Dortmund, Dortmund, Germany

Abstract (about 140 children) in 1991–1992, to 25% (about


400) in 1996–1997, to 35% (about 650) in 2001–
Background In the Netherlands, as in many other
2002 and to 37% (about 800) since 2005–2006.
countries, there are indications of an inclusive
The proportional increase stopped in recent years.
school policy for children with Down syndrome.
Conclusion During the 1980s and 1990s, clearly
However, there is a lack of studies that evaluate to
more and more children with Down syndrome were
what extent this policy has actually succeeded in
in regular education, being supported by the then
supporting the mainstreaming of these students.
existing ad hoc regulations aimed at providing extra
Method For the period 1984–2011, the number of
support in regular education. In the Netherlands, in
children with Down syndrome entering regular edu-
2003, these temporary regulations were transformed
cation and the percentage of children still in regular
into structural legislation for children with disabili-
education after 1–7 years were estimated on basis of
ties. With regard to the mainstreaming of students
samples from the database of the Dutch Down
with Down syndrome, the 2003 legislation has con-
Syndrome Foundation. These estimations were
solidated the situation. However, as percentages in
combined with historical demographic data on the
regular education stayed fairly constant after 2000,
total number of children with Down syndrome in
it has failed to boost the mainstreaming of children
primary school age. Validity of the model was
with Down syndrome. The results of this study are
examined by comparison of the model-based esti-
discussed in the context of national and interna-
mations of numbers and percentages in regular edu-
tional legislation and educational policy.
cation with relevant available empirical data from
the Dutch Ministry of Education and from Dutch Keywords Down syndrome, inclusion, inclusive
special schools. education, intellectual disability, prevalence
Results The percentage of all children with Down
syndrome in the age range 4–13 in regular primary
education has risen from 1% or 2% (at the very Introduction
most about 20 children) in 1986–1987, to 10%
Since the mid-1980s in many countries, including
the UK (Cuckle 1997), Australia (Bochner &
Pieterse 1996) and the Netherlands (Scheepstra
Correspondence: Mr Gert De Graaf, Dutch Down Syndrome
Foundation, Hoogeveenseweg 38, gebouw U, Meppel, 7943KA, the
et al. 1996; Scheepstra 1998; de Graaf 2007), more
Netherlands (e-mail: Graaf.Bosch@ziggo.nl; gertdegraaf@ and more children with Down syndrome are enter-
downsyndroom.nl). ing regular classrooms. For children with Down

© 2013 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and
John Wiley & Sons Ltd
Journal of Intellectual Disability Research volume 58 part 7 july 2014
626
G. De Graaf et al. • Dutch Down syndrome educational integration

syndrome, their parents’ choice for inclusion has regular education of children with Down syndrome
been and still is the driving force for changes in and other children with ID traditionally placed in
educational placements. SLD schools (IQ under 55–60) is largely due to the
Although research shows clear educational advan- activities of parent organisations and was not the
tages of regular placement for children with Down result of deliberate governmental policy. However,
syndrome (Lorenz et al. 1985; Casey et al. 1988; starting from the mid-1980s, the Dutch Govern-
Sloper et al. 1990; Philps 1992; Laws et al. 1995, ment has followed this parent-initiated trend by cre-
2000; Yadarola 1996, 1998; Buckley et al. 2006; ating ad hoc regulations aimed at providing extra
Turner et al. 2008; de Graaf et al. 2012a; de Graaf support in regular education. In 2003, these tempo-
et al. 2013), still many parents of children with rary regulations were transformed into structural
Down syndrome or similar intellectual disabilities legislation for children with disabilities (Besluit
(ID) have to invest extraordinary levels of time, Leerlinggebonden Financiering 2003; Wet op de
energy and resources in their struggle to get their Expertisecentra 2003). Under this legislation, paren-
children into mainstream school and to support tal choice is important. Parents of children admissi-
their educational progress, once there (Cuckle 1999; ble to the more expensive forms of special schools
van Hove 1999; Lorenz 1999; Ghesquière et al. may opt for special or regular education. However,
2002; Kenny et al. 2005). there is no clearly stated right to attend a regular
Cunningham et al. (1998) and Cuckle (1997) school. Regular schools may refuse placement of a
demonstrate that in the 1990s in the UK, huge child with a disability, if they can argue why it
local differences existed in the extent to which stu- would not be in the best interest of the child or
dents with Down syndrome started their school classmates, making integration highly selective. As
career in regular schools and in the extent to regards students with ID (those eligible for admis-
which they stayed in regular education until at sion to a SLD school), counsellors from special
least the end of primary education. These differ- education advise the regular schools about teaching
ences in support of mainstreamed children with methods and materials. In addition, regular schools
Down syndrome must be the result of varying receive an extra budget sufficient for hiring qualified
local educational policies. teaching staff for about half a day each week in
The Netherlands has a dual system of integrated grade 1 and 2 (in the Dutch context, these grades
and segregated special education. However, the usually are for 4- to 5-year-olds), and twice this
majority of children with ID are still educated in budget in grades 3 through 8 (in the Dutch context,
special schools. In 2009, according to counts by the these grades usually are for 6- to 12-year-olds).
Dutch special schools, only approximately 14% of Sometimes this is supplemented by money from the
all students (age range 4–20 years) who, on basis of Dutch care system. However, governmental policy is
their cognitive functioning, were admissible to now planning to replace the financial open-ended
schools for students with Severe Learning Difficul- system of personal educational budgets with a
ties (SLD schools: in the Netherlands schools for regional fixed budget for all students in the nearby
students with an IQ under 55–60) were in regular future (Eerste Kamer, vergaderjaar 2011–2012,
schools [Landelijke Vereniging Cluster 3 (LVC3) 33 106, B). We may conclude that in the Nether-
2009]. In Dutch educational policy, special schools lands, even now, the amount of assistance for inte-
are divided into two broad categories: there are grated children with Down syndrome that can be
special schools for children with mild developmental purchased by means of the personal educational
disabilities and specific learning disorders, and there budget is rather low. In contrast to the Dutch situa-
are more expensive forms of special schools catering tion, in the UK half- to full-time personal assistance
for students with physical and/or sensory disabili- is quite common for mainstreamed children with
ties, and/or SLD and/or severe behavioural prob- Down syndrome.
lems. Dutch educational policy since the 1980s aims On the basis of data from the Dutch Ministry of
to reduce the number of children with mild devel- Education, Scheepstra (1998) and Scheepstra et al.
opmental disabilities and specific learning disorders (1996) made an assessment of the number of stu-
in special schools. In contrast, the integration into dents with Down syndrome in Dutch primary

© 2013 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and
John Wiley & Sons Ltd
Journal of Intellectual Disability Research volume 58 part 7 july 2014
627
G. De Graaf et al. • Dutch Down syndrome educational integration

regular education in the school years 1993/1994 to basis of samples from the database of the Dutch
1996/1997. Numbers progressively rose from an esti- Down Syndrome Foundation. The relevant demo-
mated 221 students in 1993/1994, to 303 in 1994/ graphic information was derived from a study of de
1995, to 339 in 1995/1996 and to 398 in 1996/1997. Graaf et al. (2010). Validity of the model was exam-
Combining this information with the relevant ined by comparison of the model-based estimations
Dutch Down syndrome birth prevalence data of of numbers and percentages in regular education
EUROCAT, and information on the survival of with relevant available empirical data from the
young children with Down syndrome in the 1980s Dutch Ministry of Education and from Dutch
(de Walle et al. 1995), Scheepstra estimated that of special schools.
all children with Down syndrome in the primary
school age (4–12 years) in 1993/1994, 15% was edu-
Operationalising the model
cated in regular education, rising to 27% in 1996/
1997. However, more recent information on the The database of the Dutch Down Syndrome
extent to which children with Down syndrome are Foundation is highly representative for all children
educated in regular schools in the Netherlands is with Down syndrome from the year of birth 1986
lacking. Thus, it is unknown to what extent Dutch onwards (de Graaf et al. 2010, 2011). In 2006,
educational policy has succeeded in supporting the approximately 80% of all children with Down syn-
mainstreaming of students with Down syndrome. drome in the age range 5–12 years were represented
This article aims to fill in this gap of information in the Foundation’s database (de Graaf et al. 2010,
and tries to answer the following questions: How 2011). For the age range 17–18 years, the corre-
many children with Down syndrome in the last sponding percentage was approximately 73%.
three decades were placed in regular primary For a study in 2006, two random samples of
schools? How many children with Down syndrome parents from this database were addressed by tel-
are in regular education? What percentage of the ephone. The first sample consisted of 259 parents
total Down syndrome primary school age popula- with children from the years of birth 1993–2000
tion is in regular education? What is the historical (age range 5–12 years). The second sample con-
development in these aspects? sisted of 92 parents with children from the years of
birth 1987–1988 (17–18 years). The response rate
was respectively 98% and 100%. In addition, from
the first sample, a smaller at random sample of 160
Method
children was selected to be followed up in 2007 and
If, for each year of birth, one would know how 2010 (all attending a school; children in special day-
many children with Down syndrome entered regular care centre (9%) were excluded). In 2010, 142 of
education in grade 1 (4-year-olds in the Dutch these respondents were still in the study.
context), and if in addition one would know what The Foundation’s database might contain a selec-
percentage of these children would still be in tion of cases in favour of inclusive education, as the
regular school in the following 7 years, one could Foundation is a strong proponent of inclusion.
estimate the total number of children with Down There is no direct information available on children
syndrome in regular primary education for each of parents who never made any contact with the
school year. Subsequently, in order to assess the Foundation. As we have seen, this concerns approxi-
percentage of children in regular education, this mately 20% of the 1993–2000 cohort and 27% of
information could be combined with historical the 1987–1988 cohort. In analysing the Founda-
demographic data on the total number of children tion’s database, de Graaf (2010) concludes that, in
with Down syndrome in primary school age. Fol- the primary school age range, only 5% consisted of
lowing this line of reasoning, a simulation model parents from non-Western ethnic minority groups.
was developed. In building this model, the number Weijerman et al. (2008), studying children with
of children with Down syndrome entering regular Down syndrome registered by the Dutch Paediatric
education and the percentage of children still in Surveillance Unit in 2003, reports 20% from ethnic
regular education after 1–7 years, were estimated on (non-Western) minority groups. Thus, the group of

© 2013 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and
John Wiley & Sons Ltd
Journal of Intellectual Disability Research volume 58 part 7 july 2014
628
G. De Graaf et al. • Dutch Down syndrome educational integration

parents unknown by the Foundation consists for a education. From the year of birth 2000, this was
large part of parents from non-Western ethnic around 150. From the years of birth 1987 and 1988,
minority groups. It is unlikely that these children this was respectively 65 and 71. The number of chil-
are in regular education, as in the Netherlands dren entering regular education for the years of
parents have to negotiate such a placement entirely birth 1989, 1990, 1991 and 1992 were extrapolated.
by themselves. On basis of information from parent’s organisations,
The hypothesis that children not in the Founda- we know that regular school placement for children
tion’s database never were in regular education with Down syndrome started in the early eighties
leads to the most conservative estimation of the with only very few children. We assumed it
numbers in regular education – a minimum variant. started with two children from the year of birth
Alternatively, in a maximum variant, there would be 1979 going up to 65 as estimated for the year of
no difference between children not in and those in birth 1987 in the minimum variant. Data for inter-
the database. In an intermediate variant, the per- mediary years were extrapolated. Finally, we
centage of children not in the database entering assumed that of children from the years of birth
regular schools is half the corresponding percentage after 2000 the same proportion entered regular edu-
of those in the database. Estimations were made for cation as for the years 1993–2000. This assumption
all three variants (see Figs 1, 3). However, the is corroborated by figures from a 2009 online parent
minimum variant clearly showed the best fit with questionnaire by the Dutch Down Syndrome Foun-
available empirical data from other sources (see the dation (de Graaf 2010). Out of a total of 109
section on validating the model). For that reason, respondents with children from the years of birth
we will present detailed information on the 2001–2005, 72% had entered a regular school. For
minimum model only. these years of birth, the database of the Dutch
Down Syndrome Foundation covered approximately
78% of all children with Down syndrome. Thus,
Results of the model
again assuming that children not in the database
The procedures used in building the model are probably never were in regular schools (minimum
visually depicted in Fig. A1 in Appendix 1. Compar- variant), it could be estimated that indeed approxi-
ing the children 5–8 years of age with the children mately 56% (72% ¥ 78%) of these children started
9–12 years of age in the 2006 study, there were no off in a regular school. Figure 1 presents the esti-
significant differences in the percentage entering mated numbers of children with Down syndrome
regular education. In the total sample from the entering regular education per year of birth.
years of birth 1993–2000, approximately 70% of the
children had started in regular education. In the
Estimating percentages still in regular education
minimum variant, it was estimated that approxi-
after 1–7 years
mately 56% (70% ¥ 80%) of all children with Down
syndrome from the years of birth 1993–2000 started The second building block of the model is estimat-
off in a regular school, 35% started their school ing the percentages still in regular education after
career in special schools (almost always SLD 1–7 years.
schools) and another 9% stayed in special day-care In the 2006 sample, 182 children from the years
centres during primary school age. of birth 1993–2000 started in regular education.
The absolute numbers entering regular education Of these children, 16 were in their first school
for the years of birth 1993–2000 and 1987–1988 year. The other 166 children had already been in
were estimated on basis of these percentages, in school more than one year. Of these children, 153
combination with estimations (per year of birth) of (92%) had also been in regular education more
the total number of children with Down syndrome than 1 year at that moment. The other 13 children
still alive at age 5 as these can be derived from the (8%) were already transferred to special school
study of de Graaf et al. (2010). In the minimum after 1 year. Subsequently, of the 142 children who
variant, from the year of birth 1993 an estimated started in regular education and were more than
130 children with Down syndrome entered regular 2 years in school, 121 (85%) had also been in

© 2013 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and
John Wiley & Sons Ltd
Journal of Intellectual Disability Research volume 58 part 7 july 2014
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G. De Graaf et al. • Dutch Down syndrome educational integration

Figure 1 Estimated numbers of children


with Down syndrome entering regular
education per year of birth.

Figure 2 Estimated percentages of


mainstreamed children with Down
syndrome still in regular school after 1–7
years.

regular education more than 2 years. This implies of the 2006 sample of 160 parents, this yields the
that, if we take 100% as the starting point, after same percentages as using the initial 2006 data, sug-
2 years 78% (92% ¥ 85%) were still in regular gesting that in this respect there has been no major
school. This procedure was repeated, in this way change since the school year 2005/2006.
constructing the percentages still in regular educa- Using the same procedure, we also estimated a
tion after 1–7 years. curve for the years of birth 1987–1988. Figure 2
If we alternatively would base the curve for the presents the estimations for both samples of years
years of birth 1993–2000 upon the 2010 follow-up of birth.

© 2013 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and
John Wiley & Sons Ltd
Journal of Intellectual Disability Research volume 58 part 7 july 2014
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G. De Graaf et al. • Dutch Down syndrome educational integration

The curves in Fig. 2 are slightly different. Dutch Ministry of Education, available for the
Although more children from the years of birth school years 1993/1994 to 1996/1997 in Scheepstra
1993–2000 started in regular school, the percentage (1998), and, on request of the first author, directly
allowed to stay there was somewhat less favourable. provided by the Ministry for the period 1998/1999
to 2003/2004. Both older and more recent data
were not available. Figure 3 shows that the
Estimating the number of children with Down
minimum model clearly has the best fit.
syndrome in regular education
Yet another comparison could be made with data
In estimating how many children were in regular derived from 21 out of 121 Dutch SLD schools for
school, we used the 1987–1988 curve for all years of the school year 2005/2006 (De Graaf 2006). Results
birth from 1979 to 1991 and the 1993–2000 curve revealed that 121 of their 300 pupils with Down
for all years of birth from 1992 onwards (the first syndrome in the primary age range were in regular
year an estimated more than 100 children with education (40.3%). Because around 9% of children
Down syndrome – in the minimum variant – started with Down syndrome in this age range are in special
their school career in regular education). day-care centres, and these were not counted in, the
Furthermore, because in the Netherlands most real proportion in regular education will be around
children with Down syndrome start their school 37% (91% ¥ 40.3%), which equals the percentage of
career slightly later than other children, often 37% as predicted by the minimum model (Fig. 4)
between 4.5 and 5 years of age instead of immedi- for this school year. For the school year 2010/2011,
ately after their fourth birthday, we assumed that in the first author repeated this request to 20 SLD
any given school year (for instance 2005/2006) only schools. The proportion in regular education (cor-
25% of the 4-year-olds (year of birth 2001) had rected for children in special day care) was 36%,
already entered regular school. In addition, because almost equalling the minimum model prediction of
a small part of children with Down syndrome leave 37% for this school year. In Fig. 4 the data from the
primary education somewhat later than most other minimum model on the percentages in regular edu-
children, at age 13–14 instead of age 12, we assumed cation are presented.
that in any given school year (for instance 2005/ On basis of the minimum model, it can be con-
2006) 33% of the 13 years olds (year of birth 1992) cluded that the percentage of all children with
were still in primary school. Down syndrome in the age range 4–13 in regular
By combining the modelled numbers of children primary education has risen from 1% or 2% (at the
with Down syndrome entering regular school per very most about 20 children) in 1986–1987, to 10%
year of birth (Fig. 1) with the constructed curves for (about 140 children) in 1991–1992, to 25% (about
staying in regular education (Fig. 2), the number of 400) in 1996–1997, to 35% (about 650) in 2001–
children with Down syndrome in regular education 2002 and to 37% (about 800) since 2005–2006
for each school year from 1984/1985 onwards could (Fig. 4). The proportional increase stopped in
be computed. Subsequently, by combining these last recent years. There has been, however, a slight
numbers with an estimation of the total numbers of increase in absolute numbers in regular education
children with Down syndrome in the primary until 2011 (Fig. 3). This increase is a result of the
school age range per school year, based upon the growing size of birth cohorts of children with Down
demographic model of de Graaf et al. (2010), the syndrome in the 1990s till 2002. After the year
percentage of all children with Down syndrome in 2002, a slight decrease in birth rates of children
regular school could be computed for each school with Down syndrome started (de Graaf et al. 2010,
year from 1984/1985 onwards. 2011).
On basis of the minimum model, it can be esti-
mated that of the approximately 800 regularly
Validating the model
placed children with Down syndrome (the esti-
The model can be validated using external data. mated number since 2005/2006) around 44% were
First, the estimated number in regular school per in kindergarten (which in the Dutch school system
school year can be compared with data from the is grade 1 and 2 of the school, usually for 4- to

© 2013 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and
John Wiley & Sons Ltd
Journal of Intellectual Disability Research volume 58 part 7 july 2014
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G. De Graaf et al. • Dutch Down syndrome educational integration

Figure 3 Estimated numbers of children


with Down syndrome in regular education
per school year.

Figure 4 Estimated percentages in regular


education of the total primary school aged
population of children with Down
syndrome per school year, using the
minimum model (this model has the best
fit with available empirical data).

5-year-olds). According to the model, the number school period in this same 15 years has risen from
of students who reached the end of the primary about 33 to 85 every year. Taken together, around
school period still in regular education has risen 2600 students with Down syndrome since the
from about 6 in 1996–1997, to 29 in 2001–2002, early 1980s until 2011–2012 have been in a regular
to about 50 in 2006–2007 and about 60 in 2011/ school at least during part of their school career.
2012. The number of pupils that are transferred to However, both the 2009 online questionnaire and
special schools before the end of the primary the 2010 follow-up of the 2006 study (see the

© 2013 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and
John Wiley & Sons Ltd
Journal of Intellectual Disability Research volume 58 part 7 july 2014
632
G. De Graaf et al. • Dutch Down syndrome educational integration

section on method) indicate that the number of schools counselling from special education and pro-
students with Down syndrome that start off in viding a system of personal educational budgets for
regular secondary education is still very low, prob- mainstreamed students, has not brought much
ably less than 10 students per year nowadays. In change towards inclusion for students with Down
the Dutch context, as in many other countries, all syndrome. During the 1980s and 1990s, clearly
students are streamed by ability in different types more and more children with Down syndrome were
of secondary school, making the inclusion of stu- in regular education, being supported by the then
dents with ID at odds with the educational system existing ad hoc regulations aimed at providing extra
logic. For that reason, inclusion of students with support in regular education. The 2003 legislation
Down syndrome in Dutch secondary schools is has consolidated this situation. However, it has
extremely rare. However, there are a few secondary failed to boost the mainstreaming of children with
schools that report successful inclusion of these Down syndrome.
students. The situation might be different for other sub-
groups of students with ID. Already since the mid-
1980s, parents of children with Down syndrome
are actively informed by their parent organisation
Discussion
about inclusive placement. The 2003 legislation,
In several countries, there are indications of an the media coverage, and being actively informed
inclusive school policy for children with Down syn- by the government about the inclusive option
drome. However, the effect of this policy on actual during individual trajectories of school placement
numbers of students with Down syndrome in since 2003 might have been a stimulus for the
regular education has only been studied in the inclusion of also non-DS children with ID. Some
Netherlands and in the UK. Cunningham et al. figures appear to support this notion. Between
(1998) showed that in Leeds, a region with an active 2002 and 2009, according to the LVC3 (National
inclusive education policy, at 5 years of age 80% of Association of special schools, including the SLD
the students with Down syndrome were in regular schools), the number of students in regular educa-
education. Of all children with Down syndrome tion admissible to schools for students with SLD
born between 1985 and 1988, 68% were still in rose from 750 to 3008. However, in the same
regular school at age 11. In the Netherlands, as our period, the total number of students admissible to
model reveals, the current situation is less favour- SLD schools (being in either special or regular
able, with this first percentage around 56% and the school) rose from 16 950 to 22 137 (LVC3 2009),
latter around 26%. suggesting that the growth of the number of SLD-
Article 24 of the UN Convention on the Rights admissible students in regular schools is also the
of Persons with Disabilities states that States Parties result of an increase in labelling students as such,
shall ensure an inclusive education system (UN instead of the result of more inclusion. In line
2006). Article 31 demands States Parties to collect with this conclusion, Minne et al. (2009) argue
appropriate information, including statistical and that the 2003 legislation has led to a shift to more
research data, in order to assess the implementation expensive forms of special school placement. If a
of States Parties’ obligations under the Convention. child functions in the overlapping zone of less
In this article, we have presented statistical informa- expensive and more expensive forms of special
tion on the extent to which Dutch educational educational provision, parents and schools will
policy is effective in supporting one specific well- more likely try to get a statement for the more
defined subgroup of people with ID, that is, primary expensive form, especially in the case of regularly
school aged students with Down syndrome, to be in placed children, as only a statement for the more
inclusive educational environments. expensive forms entitles the child to a personal
On basis of our study, it can be concluded that educational budget in regular school. As a side-
the Dutch 2003 legislation that was meant to make effect, this mechanism also increases referrals to
it easier for parents of children with a disability to the more expensive forms of special schools, later
opt for a regular school, providing the regular on in the child’s school career. Interestingly, our

© 2013 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and
John Wiley & Sons Ltd
Journal of Intellectual Disability Research volume 58 part 7 july 2014
633
G. De Graaf et al. • Dutch Down syndrome educational integration

study appears to give some indirect support for tional legislative context the shift has been made to
this notion of strategic behaviour. In the case of a social model of disability (UN 2006). In order to
Down syndrome, strategic behaviour was clearly ratify, the Netherlands will have to align their
not invited, as in the Netherlands the diagnosis national policy with the Convention’s demands.
Down syndrome automatically entitles the child In March 2012, the Dutch Lower Chamber has
to a statement for the more expensive forms of accorded a new educational policy, so-called
special education. If the percentage of students ‘Passend Onderwijs’ (Fitting Education), replacing
with Down syndrome in regular education had the financial open-ended system of personal educa-
increased after 2003, this would not have been tional budgets with a regional fixed budget for all
the result of strategic behaviour of parents and students. The expectation is that this new legislation
schools. In contrast, there would have been a (Eerste Kamer, vergaderjaar 2011–2012, 33 106, B)
genuine inclusion-enhancing effect of the 2003 leg- will soon be adopted by the Dutch Upper Chamber
islation. However, in the last decade actually this too. This new legislation appears to be more in line
percentage stayed fairly constant. with a social model of disability. It starts off with
We feel that it is important to have some under- pointing at the schools. Within each region, school
standing why the 2003 legislation might have failed boards working together in a co-operative must
to boost the mainstreaming of children with Down define what support every regular school minimally
syndrome. De Graaf et al. (2012b) identified 12 can offer. In addition, each separate regular school
factors associated with successful inclusion of stu- is required to clarify what extra support they can
dents with Down syndrome. In this context, two provide on top of this. Furthermore, if a school
of these appear to be highly relevant. First, the deems a certain child to need extra support, the
national educational legislation will have a direct school must describe long-term developmental goals
influence on the amount of classroom assistance and explain what supports are needed to get to
and/or personal assistance regular schools can these goals. Thus, the focus of assessment is on
organise for an included child. For students with defining the environmental supports more than on
Down syndrome (or other students with ID and the disability/defect itself. Financially the system
an IQ under 55–60), the 2003 legislation implied might work out to be more flexible, as money for
the same amount of extra money for every regu- regularly placed students is not automatically linked
larly placed student, irrespective of the children’s to certain disabilities/defects, but is linked to the
differences in abilities and irrespective of local supports needed. Finally, an advantage of a regional
circumstances in the school. One can say that fixed budget is that it does not encourage strategic
the educational budgets were personal, but not behaviour of schools.
personalised. Second, the legislative context might However, like the 2003 legislation, the new legis-
have an influence on the way schools will tend to lation shows no preference for inclusive schooling.
look at disability. The focus of assessment under In this respect, the Government entirely relies on
the 2003 legislation was on determining whether the financial incentives of the new system, as special
the child was admissible to a certain type of schools are a relatively expensive option. Second,
special school. This assessment procedure is likely regular schools are not obliged to admit every
to reinforce schools (and possible parents too) to student with a disability. Yet, parents who wish
think along lines of the medical model, focusing inclusive education can challenge transfer to a
on the defects of the child rather than focusing special school. The Dutch Law on Equal Treatment
on the way schools can accommodate for differ- on basis of Disability or Chronic Illness (Wet gelijke
ences. Of course, individual schools can and behandeling op grond van handicap of chronische
do challenge this medical point of view, but ziekte 2012) demands that regular schools on an
perhaps more would do so if the legislation had individual basis assess what accommodations are
been more strongly based on a social model of needed. In line with article 24 of the UN Conven-
disability. tion, schools are obliged to provide appropriate and
The UN Convention on the Rights of Persons reasonable accommodations, if not imposing a dis-
with Disabilities demonstrates that in the interna- proportionate or undue burden on the school. Juris-

© 2013 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and
John Wiley & Sons Ltd
Journal of Intellectual Disability Research volume 58 part 7 july 2014
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G. De Graaf et al. • Dutch Down syndrome educational integration

prudence in coming years will have to define these and academic attainments. The British Journal of Educa-
broad terms in more detail. Finally, the positive fact tional Psychology 58, 279–86.
that financially the new system might work out to Cuckle P. (1997) The school placement of pupils with
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extent to which students with Down syndrome are van leerlingen in het basisonderwijs, speciaal en
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© 2013 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and
John Wiley & Sons Ltd
Journal of Intellectual Disability Research volume 58 part 7 july 2014
636
G. De Graaf et al. • Dutch Down syndrome educational integration

con síndrome de Down escolarizados en escuelas Appendix 1: Constructing the model


comunes y en escuelas especiales (in Spanish). Boletín de
la Asociación Síndrome de Down de la República Argentina The procedures used in building the model are
10, 1–12. visually depicted in Fig. A1, using the sample of the
years of birth 1993–2000 as the example.
Accepted 29 May 2013

Figure A1 Steps in building the model.

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