Inclusive Education for Students with Intellectual Disabilities in Saudi Arabia: A Systematic Review
Abstract
Inclusive education in Saudi Arabia for students with intellectual disabilities is still progressing. This systematic review examined peer-reviewed studies that have been published from 2008 through 2023 in English and Arabic to gain a broad perspective on the status of inclusive education for students with intellectual disabilities in Saudi Arabia. This search yielded 11 studies according to defined criteria. Three thematic categories were identified throughout this review: teachers’ varying perspectives about inclusive education for students with ID, insufficient studies on student outcomes, and limited studies on the quality of the programs and assessments. Recommendations for improving future research and the practice of inclusive education have been outlined.
Research consistently has found that for students with intellectual disabilities (ID) inclusive education has resulted in better outcomes than services in self-contained special education classes (Gee et al., 2020; Ryndak et al., 2012). Research also has found that classmates who do not have disabilities and are in classes with students with disabilities have improved academic, social, and emotional outcomes (Hehir et al., 2016; Jorgensen et al., 2007; Kurth et al., 2015; Ryndak et al., 2013; Shogren et al., 2015; Wehmeyer et al., 2021).
These findings support inclusive education initiatives for students with disabilities in both international agreements and initiatives, and country-specific laws and regulations (Chitiyo et al., in press). For instance, internationally, groups of countries have declared the rights of people with disabilities (United Nations Convention on the Rights of People with Disabilities, 2006), as well as the rights of children with disabilities to inclusive education (Salamanca Statement and Framework for Action on Special Needs Education, 1994). As an individual country, the United States of America legally mandated that students with disabilities must be served in each state’s education system through the Education of All Handicapped Children Act (Public Law 94-142, 1975), currently reauthorized as the Individuals with Disabilities Education Act (2004).
Over decades these international and country-specific efforts increasingly have focused on providing educational services for students with disabilities in general education classes with the same-age classmates who do not have disabilities, with the accommodations they need to benefit from educational services (UNESCO, 1994). In addition, these efforts increasingly have focused on providing these services within the school they would attend if they did not have a disability (UNESCO, 1994). This type of service delivery has been labeled inclusive education and comprises the context, content/curriculum, effective use of evidence-based instructional practices, and demonstration of student progress (Ryndak et al., 2013).
In Saudi Arabia, the Ministry of Education started to provide educational services for students with disabilities in self-contained special education classes serving only students with disabilities in general education schools in the late 1990s. These settings were labeled as inclusive schools even though students with disabilities are placed in self-contained classrooms that serve only students with disabilities (Aldabas, 2015; Alkhattabi, 2022; Alnahdi 2014; Alshuayl et al., 2024). These self-contained classes are included within general education schools, although the students in those classes are not included in classes with same-age classmates who do not have disabilities. In addition, the self-contained classes in these inclusive schools have teachers, supervisors, curriculum, and instruction that are separate and different from those for students without disabilities. For example, students with moderate intellectual disabilities are served only in self-contained classes, by different teachers, on a different curriculum, and with different instruction, all supervised through a different administration system than that for students without disabilities (Alkhattabi, 2022). Thus, in Saudi Arabia students with ID are still segregated from their peers without disabilities, even if they receive educational services in the same inclusive school building.
Three literature reviews of research related to inclusive education in Saudi Arabia have been published. Alkhateeb et al. (2016) analyzed studies on the inclusion of children with developmental disabilities in Arab countries which were published in English from 1990 to 2014. Their review included eight studies in Saudi Arabia, with six of these studies focused on teachers’ or/and parents’ perspectives and attitudes about inclusion for students with various types of disabilities (i.e., disabilities in general [n = 1], learning disabilities [n = 2], Autism [n = 1], severe disabilities [n = 1], and hearing impairments [n = 1]). In addition, one study (n = 1) evaluated programs of students with disabilities in inclusive schools, and one study (n = 1) focused on the effects of inclusive education on the language development of students with hearing impairment.
The second and third literature reviews (Alqahtani et al., 2021; Altamimi et al., 2015) analyzed peer-reviewed research related to services for students with disabilities only in Saudi Arabia. Altamimi et al. (2015) reviewed peer-reviewed research, dissertation, and conference proceedings published in English from 1970 to 2014, and Alqhatani et al. (2021) reviewed peer-reviewed research published in either English or Arabic from 2008 and 2016. Both literature reviews summarized information about the type of publication, topic, participants, methodology, and findings, and Alqahtani et al. (2021) found that 82% of the special education research written in either Arabic or English were written between the years 2008 and 2016.
The purpose of this review of research was to describe what peer-reviewed research tells us about the current state of services specifically for students with ID in Saudi Arabia. To do so, we reviewed special education peer-reviewed studies written in either Arabic or English that were related to inclusive education for students with ID in Saudi Arabia. Because the vast majority of publications on special education in Saudi Arabia were found to be published starting in 2008, one inclusion criterion for the current review was publication from 2008-2023. Because Altamimi et al. (2015) focused only on studies published in English, a second inclusion criterion was having been written in either English or Arabic. The following research questions guided our review: (a) what are the characteristics of participants, methodologies, and findings in studies related to inclusive education for students with ID in Saudi Arabia, and (b) what themes emerged from the analysis of these topics?
Method
A systematic literature review examines a specified topic using “explicit methods to identify, select, and critically appraise relevant research, and extract and analyze data (as appropriate) from studies” (Talbott et al., 2018, p. 250). We specifically sought to review the literature on inclusive education for students with ID in Saudi Arabia to determine both the state of inclusive education in the country and to summarize that body of research. We conducted a systematic literature review using the following procedures.
Search Procedures
First, we searched both English online databases (i.e., ERIC, Academic Search Complete, EBSCO, PsycINFO, Scopus, JSTOR, Proquest, and Proquest Education) and Arabic online databases (i.e., Saudi Digital Library, Almandumah, and AskZad) for studies on inclusive education for students with ID in Saudi Arabie published from 2008 to 2023. We used the following search terms in both English and Arabic: (inclusive education OR inclusion OR mainstreaming OR integration), AND intellectual disabilities, AND Saudi Arabia. This search yielded 2,148 studies through the following results: (a) Education Source, ERIC, Academic Search Complete (n = 31); (b) PsycInfo (n = 30); (c) Scopus (n = 694); (d) Education Database (n = 293); (e) Saudi Digital Library (n = 1,068); (f) Almandumah (n = 25); and (g) AskZad (n = 7) (see Figure 1 for PRISMA flow diagram; Moher et al., 2009).
Citation: Journal of International Special Needs Education 28, 2; 10.9782/2331-4001-28.2.47
Five parameters were required for a study to be included in this review. Those included being: (a) published in either English or Arabic, (b) published in a peer-reviewed journal, (c) between 2008-2023, (d) conducted in Saudi Arabia, and (e) focused on inclusive educational services for students with intellectual disabilities. Studies were limited to those published in peer-reviewed journals to ensure the highest level of rigor and international accessibility. Of the studies found using the search terms listed above, 1,048 were studies published in English and 1,100 were published in Arabic. We then screened the titles and abstracts of these studies to (a) identify duplicates, excluding 15 studies published in English and 10 studies published in Arabic; and (b) identify studies that did meet the inclusion criteria, excluding 1,027 published in English and 1,057 published in Arabic. This resulted in 39 studies remaining. We then conducted a full text review to identify studies that met all the inclusion criterion, excluding zero studies published in English and 38 studies published in Arabic. This resulted in 11 studies meeting the inclusion criterion for this literature review, with six published in English and five published in Arabic.
Coding Procedures
The first two authors coded the content of the 11 studies using a shared Microsoft Excel data sheet. We coded content for (a) author, (b) year, (c) language, (d) title, (e) affiliation, (f) topic, (g) severity of ID of students served, (h) aim of the study, (i) method, (j) gender, (k) participants, (l) grade settings, (m) intervention, and (n) findings. Each author independently coded 30% (n = 4) of the studies independently, and then the two authors compared their codes, reached consensus on any discrepancies when possible and, when they could not reach consensus, they discussed the discrepancy with the third author until consensus was reached. They determined the level of intercoder agreement by dividing the number of variables on which they agreed, by the number of variables on which they agreed plus the number of variables on which they disagreed, and then multiplying by 100. This resulted in an inter-coder agreement of 97.5%.
Findings
In this section we describe the main characteristics of the 11 studies included in this review and the themes that emerged from the analysis (see Table 1).
Main Characteristics of the Studies
Of the 11 studies, five were published in Arabic and six were published in English. Five of these studies used survey methodology; one validated a scale; one used a scale to determine whether differences in scores were evident for students in different educational settings; one used a scale to examine the attitudes of students without disabilities toward their peers with disabilities; one used a scale to determine any relationship between exposure to bullying and withdrawal behavior among students with ID; and one used non-experimental mixed methods (i.e., teacher interviews, observations) to describe programs serving students with ID. Only one study used an experimental design with pre- and post- measures on the effectiveness of an intervention (i.e., training program) focused on psychological and social skills of students with ID.
Of these 11 studies, participants for four studies included general and special education teachers, two included only special education teachers, four included students with ID, and one included students without disabilities who were classmates of students with ID. Five studies had only female participants, four had male and female participants, one study had only male participants, and one did not report the gender of their participants.
Seven studies were conducted in inclusive schools; one was conducted in both inclusive schools and general education schools with no students with disabilities; one was conducted across multiple segregated settings that included institutions and schools for students with severe ID; one was conducted in schools, institutions and centers that had programs for students with severe disabilities; and one did not include the exact setting.
Five studies did not report the severity of ID of students for whom educational services were provided in these settings; two reported serving students with mild ID; one reported serving students with severe ID; one reported serving students with mild and moderate ID; one reported serving students with moderate to severe ID; and one reported serving students with mild, moderate, and severe ID.
Four studies did not report the grades in which the participating teachers worked; one reported participating teachers in elementary schools; and one reported participating teachers in pre-kindergarten, elementary, middle, and high schools. Three studies reported participating students in elementary schools; one reported participating students in middle schools; and one reported participating students across all levels except pre-kindergarten.
Themes
Three themes associated with the current state of inclusive education specifically for students with ID in Saudi Arabia emerged from the 11 identified studies. The first theme related to the varying perceptions teachers had about SA inclusive schools for students with ID. The second theme related to the limited research about either interventions, instructional practices, or the impact of services on student outcomes. The third theme related to the limited research on the quality of services provided for, and the assessment of the performance of, students with ID.
Teachers’ varying perceptions about inclusive education for students with ID.
Five (45.5%) of the 11 studies (see Table 1) researched teachers’ perceptions about inclusive education for students with ID in SA in three main areas. First, in three studies researchers found that teachers had varying perceptions related to both including students with ID with grade-level peers without disabilities in inclusive schools, and their own preparedness to support students with ID in inclusive schools. Alkhattabi et al. (2020) found differences in the educational background, roles, and responsibilities between special and general education teachers, leading to varying perceptions about teaching students with ID in inclusive schools. For instance, special education teachers considered it their responsibility to teach students with ID in inclusive schools, while general education teachers did not consider it their responsibility to teach students with ID in any setting. In addition, both sets of teachers believed that students with ID, especially students with more severe disabilities, should be taught in segregated schools (Alkhattabi et al., 2020). This result was consistent with a second study which found that special and general education teachers had slightly negative attitudes toward including students with severe ID with their peers who did not have disabilities (Alquraini, 2012). The study provided no information, however, on what led the teachers to hold these negative perceptions about serving students with ID in SA inclusive schools. Aldabas (2020) focused on special education teachers’ perceptions toward their preparedness to teach students with severe ID with peers who did not have disabilities in inclusive general education classrooms. The researchers found that most of the teachers felt confident because their teacher preparation programs and teaching experiences taught them how to teach in inclusive schools (Aldabas, 2020).
Second, in one study researchers investigated attitudes toward the use of assistive technology with students with ID. Almalki and Alharthi (2020) found that general and special education teachers’ considered students’ use of assistive technology to be important. The study did not, however, address whether assistive technology was being used by students with ID, the type of assistive technology being used, or how assistive technology was being used in instruction.
Finally, one study examined general and special education teachers’ perceptions about their principals’ role in facilitating inclusive education. Alshamari and Alhazani (2021) found that both sets of teachers agreed on the importance of their principals’ role in assisting in discovering the talents (i.e., mental ability, ability to distinguish between sounds, verbal ability, mathematical ability based on abstract thinking, and spatial abilities) of their students with ID. The teachers discussed several manners in which principals could support them, including facilitating collaboration among teachers, provision of support and assistive technology materials, and increasing awareness of the importance of assistive technology among all teachers in the school. All five of the studies from which this theme emerged used survey methodology. In addition, none of these studies provided insight about the reasons underlying these varying perceptions of the teachers, or teachers’ perceptions of how to improve services for students with ID.
Limited research on interventions, instructional practices, or the impact of services on students outcomes.
A second theme that emerged from the findings was the limited research addressing the actual effectiveness of interventions or instructional practices for students with ID in any educational settings, as well as the impact of any type of service on students with ID. Only four of the 11 studies (36.4%) addressed any aspect of student assessment, attitudes, behaviors, or instruction (see Table 1). First, Al-Sulaiman (2014) aimed to assess the validity of a scale developed to measure the talents and abilities of female students with mild and moderate ID in five areas (i.e., verbal, numerical, spatial, kinesthetic, rhythmic skills). The researcher found statistically significant differences between the mean scores of students with mild ID and students with moderate ID, supporting the validity of the scale. Second, Alnahdi (2019) used a scale to investigate the attitudes toward students with ID of students without disabilities in schools that did not serve any students with ID, and in schools that served students with ID in self-contained classes. The researcher found students held positive attitudes toward students with ID, although the attitudes of the students in schools that served students with ID were more positive than the attitudes of the students in schools that did not serve students with ID. Third, Elsayed (2021) used a scale to examine the relationship between exposure to bullying and withdrawal behavior among students with ID. The researcher found (a) a positive relationship between a student’s exposure to bullying and their withdrawal from the bullying context, and (b) male students experienced more incidents of bullying than female students. Finally, in an experimental study, Abd El Kawi (2017) taught psychological skills (e.g., self-care, self-confidence., collaboration with others, problem-solving) and social skills (e.g., personal relationship, building friendship, positive communication with others) to one group of students with ID, while not teaching these skills to a control group. The researcher found significant differences in skill levels between the experimental and control groups.
Three of these four studies used scales to describe the students, attitudes toward the students, and the impact of a context on students with ID. Only one study researched the effectiveness of an intervention on the acquisition of skills by students with ID.
Limited research on the quality of services, and assessment of progress, for students.
A third theme that emerged from the findings was the existence of limited research on the quality of programs and the validity of assessment of progress for students with ID. Two of the 11 identified studies (18.2%) focused on program evaluation and validation of an assessment scale (see Appendix 1) . Alnahdi (2014) evaluated programs for students with ID and found four systemic issues that need to be addressed to improve their services, including the (a) segregation of students with ID from their peers, (b) incorrect implementation of students’ individualized educational programs, (c) lack of multi-disciplinary teams conducting assessments and diagnoses, and (d) use of a mandated academic curriculum for student with ID in lieu of content identified on their individualized educational programs.
In a second study, Alnahdi and Schwab (2020) validated an Arabic version of an assessment scale (i.e., Behavioral Intention to Interact with Peers with Intellectual Disability Scale). They found that the internal consistency of items was good, and that the scale was reliable for use to assess students' behavioral intentions toward interacting with peers who have intellectual disabilities.
Research on the quality of services provided for students with ID in SA, and the progress of students with ID attributed to those services, were addressed in only two of the 11 studies. This is a limited set of extant research related to the intent or impact of educational services for students with ID.
Discussion
The purpose of this review was to understand the state of inclusive education for students with ID in Saudi Arabia as represented in the extant literature over the past 15 years. Based on the three themes that emerged from this literature review, four overarching issues warrant discussion. First, with only 11 studies meeting the inclusion criteria for this review, it is clear there is scant research related to inclusive education for students with ID in Saudi Arabia. While research related to students with ID in SA has begun, that research has been limited in a number of ways.
Second, the scope of this scant research is limited in what is studied, including perceptions of inclusive education; scale development, validation, and use; teaching psychological skills; and program evaluation. While four studies addressed some form of outcomes for students with ID in Saudi Arabia, none of these studied the impact of placement (e.g., self-contained special education classes in inclusive schools or separate schools), the impact of curriculum content or inclusive instructional practices on student outcomes, or the impact of opportunities to interact with general education classmates who do not have disabilities. The research also was limited in the sources of information sought; none of the research studied information about or from students with ID, the parents or siblings of students with ID, special education supervisors, administrators, student teachers, or university faculty/researchers.
Third, the 11 studies reflect the use of a limited set of methodologies, including survey methodology, scales for assessment purposes, mixed methods, and experimental design. This is consistent with other reviews that reflect a: (a) heavy reliance on survey methodology, instead of intervention methods; and (b) a lack of intervention studies in the field (Alkhateeb et al., 2016; Alqahtani et al., 2021; Altamimi et al., 2015). This calls to question whether researchers in SA are focused on adding to the extant international intervention research on evidence-based practices for teaching students with ID in inclusive general education classes (Agran et al., 2020), the impact of those practices on student outcomes (Alshuayl et al., 2024; Gee et al., 2020), or efforts to change educational services on a systematic basis (Burnette, 2022; Ryndak et al., 2007).
Fourth, this literature review informs the field about the current state of inclusive education for students with ID in Saudi Arabia. Most concerning is the confirmation that students with ID are segregated from their peers without disabilities for all or most of the day in SA schools. Even in inclusive schools, students with ID receive their educational services in self-contained classrooms (Aldabas, 2015; Alkhattabi, 2022; Alnahdi, 2014; Alshuayl et al., 2024), while having the potential to interact with schoolmates without disabilities only during morning assembly, lunch, and extracurricular activities (Alkhattabi, 2022). Despite the law in the late 1990s that allows students with disabilities to receive educational services with peers who do not have disabilities, schools in SA have not made sufficient progress toward providing services in inclusive general education classes. There are many barriers to such inclusive education in the SA context, including lack of (a) policies for early identification and intervention, (b) parent involvement, (c) transition services and related support (Alshuayl, 2021), (d) financial support, (e) guidance, and (f) supervision (Aldabas, 2015; Alharbi & Madhesh, 2018; Alkhattabi, 2022). In addition, other barriers to inclusive education potentially could limit the current implementation of inclusive education for students with ID in SA, such as teachers' preparation and experience, biases against students with ID, perceptions of competency, lack of research, and lack of the capacity of schools (Agran et al., 2020). Moreover, it is not clear from the findings of the included studies what type of support is being provided in schools either for students (e.g., personnel, such as related service providers or teaching assistants; location of service, such as resource rooms; accommodations or modifications of instruction or instructional materials) or personnel (e.g., teacher preparation, professional development) to support inclusive education. It would assist schools if the Saudi education system could develop “clear guidelines and expectations that move beyond integration towards inclusion” (Alharbi & Madhesh, 2018, p. 954).
The scant available research is insufficient for analyzing and improving educational services for students with ID in SA, so that adults with ID are valued and contributing members of society. Much more research is needed. The limited parameters of that research suggest a truncated view of what comprises high quality peer-reviewed research on inclusive education, as well as a lack of focus on intervention research, that should inform practice. This is disappointing; much more research is needed related to the impact of educational services on students with ID, how to improve student outcomes, and how to provide inclusive education services in SA.
It would be helpful to the field if more research was conducted in SA on identification and use of evidence-based inclusive instruction practices, as well as on the extent to which the overall education system ensures teachers and school leaders have knowledge of and implement these practices. To do so, future research should reflect a high level of rigor using diverse intervention methodologies, as well as include all the stakeholders to inform school leaders, practitioners, policymakers, and parents about how to improve the field of inclusive education for students with ID in SA (Talbott et al., 2018).
Limitations
This literature review of research published between 2008 through 2023 related to inclusive education for students with ID in SA has two main limitations that need to be acknowledged. First, only peer-reviewed studies were included in the search, leaving out other types of publications (e.g., doctoral dissertations, master theses, reports, and book chapters) that also create valid contributions to the field. Second, the search might have missed some relevant studies that we did not locate, although we included all peer-reviewed studies that were found online and were accessible.
Recommendations for Future Research
This literature review provides an overview of the current state of research on inclusive education for students with ID in SA. However, it is necessary to say there are challenges and barriers to inclusive education in SA to be studied and addressed. First, having only one intervention study is alarming; therefore, the field needs to focus more on intervention studies to determine what evidence-based practices are applicable to and effective in the Saudi context. Second, future studies need to include all the stakeholders engaged in inclusive education for students with ID (e.g., parents, siblings, supervisors, student teachers, principals, and other school personnel). Third, future research should study both teacher preparation programs and ongoing professional development for current teachers in SA, the content addressed in those efforts, and the best strategies to embed knowledge and skills related to inclusive education for students with ID within these efforts.
Conclusions
This is the first literature review that focuses on inclusive education for students with ID in SA for the past 15 years. This review provides an overview of the scant research on the state of inclusive education for students with ID, highlights emerging issues, discusses the existing gap in research, and provides recommendations for future research. If the trend in research on inclusive education in SA mirrors the trends in other countries, future research will begin to shift from descriptive studies on perceptions in several ways. For instance, research could study services actually provided for students and the quality of those services (e.g., reflecting evidence-based practices, determining additional effective interventions, impact of various types of services on student short- and long-term outcomes; Gee et al., 2020). Future research also could study strategies for changing the education system to improve use of evidence-based practices and student outcomes (Burnette, 2022; Ryndak et al., 2007).
It is hoped that this review provides the basic information for other researchers who endeavor to make further advances in our knowledge about inclusive education for students with ID in SA. The field has a lot of work to do if we are to increase the extent to which inclusive education is provided for students with ID in SA based on research findings.
Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) Flow Diagram for Search Procedures, Adapted from Moher et al. (2009)
Contributor Notes