The Problem of Attitude Normally Developing Adolescents to Inclusive Health Improvement



Objectives. Health improvement in an inclusive environment allows adolescents with special needs not only to improve their health, but also promotes their socialization and integration. Normally developing adolescents have another opportunity to make new friends and to develop the most important quality — tolerance. The attitude of normally developing adolescents to inclusive health improvement in the conditions of summer country camps in the Republic of Belarus was studied in order to determine the characteristics of the formation of an inclusive culture. 

Methods. The empirical study involved adolescent children (N=412), a total of 263 girls and 149 boys, who underwent health improvement in nine summer camps in the Republic of Belarus. Age of respondents: 13—16 years. We used the author’s questionnaire, which includes the following content blocks: understanding the importance of inclusive health improvement, readiness for health improvement, experience of interaction with children with special needs, problems of joint health improvement.

Results. Half of the adolescents surveyed recognize the importance of inclusive health improvement, but only 20% expressed their willingness to participate in it. The respondents identified non-acceptance and negative attitudes from peers, problems in communication and interaction as the main difficulties for the child with special needs. The majority of participants (90%) do not have regular experience of communicating with children with special needs, and 27% of adolescents identify the expected difficulties in communication as the main obstacle. None of the adolescents who participated in the study wrote about their negative attitude towards children with special needs, but 44% assume that others will offend such peers.

Conclusions. Participants in children’s health camps of adolescence generally have a positive attitude towards the idea of inclusive shifts, while their personal unpreparedness for inclusive health can be explained by the lack of experience interacting with children with special needs. 44% of adolescents have an unclear attitude towards inclusion and children with special needs, and competent educational work on the part of teachers will help change this attitude to a positive one, increasing an inclusive culture.

General Information

Keywords: adolescents with special needs, normally developing adolescents, inclusive health improvement, inclusive culture, inclusive shifts, summer country camps

Journal rubric: Sociocultural Integration & Sports

Article type: scientific article


Acknowledgements. The author are grateful for assistance in data collection PhD in Psychology Lemekh E.A.

Received: 31.07.2023


For citation: The Problem of Attitude Normally Developing Adolescents to Inclusive Health Improvement. Autizm i narusheniya razvitiya = Autism and Developmental Disorders, 2023. Vol. 21, no. 3, pp. 48–53. DOI: 10.17759/autdd.2023210305.

Full text


Implementation of inclusive education concepts is a priority direction in development of general and special education in Belarus. Children with special developmental needs should be provided with the same educational opportunities as their typically developing peers, including recreation in summer camps. The formation of an inclusive culture in the subjects is the key direction of creating an inclusive educational environment in a health camp [13]. The peculiarities of the implementation of the educational process in the conditions of a stationary health camp with a roundthe-clock stay are caused by the following factors: the absence of the educational process, children’s living apart from the family in educational institutions with unfamiliar teachers and children, short-term functioning of children’s collectives [3]. The practice of inclusive health improvement in the Republic of Belarus is currently going through a formative stage. Teachers and children are not always prepared for interaction with children with special needs. The inclusion of a child with special developmental needs in the health improvement process can be hindered by negative attitudes, stereotypes and prejudices of peers and teachers, as well as parents of normally developing children [13]. Identification of the peculiarities of the formation of inclusive culture in all participants of inclusive health improvement will help to determine the content, methods and techniques of work in this area.

The UN Convention on the Rights of Persons with Disabilities defines disability as the result of “the interaction that occurs between people with disabilities and attitudinal and environmental barriers, which prevents their full and effective participation in society on an equal basis with others” [4, p. 3]. Formation of stereotypes and prejudices in people’s minds, stigmatisation and discrimination are not the result of a person’s disability or peculiarities in development, but a consequence of the lack of adequate attitudes and low level of inclusive culture in society.

The analysis of modern publications shows that most studies are aimed at substantiating the importance of inclusive education, studying the peculiarities of social attitudes to the idea of inclusive education and to children with disabilities, determining teachers’ readiness to work in inclusive environments [1; 2; 5, etc.]. Significantly fewer works present data on children’s attitudes towards inclusive education [6; 7]. In E.V. Shengaltz’s work, on the one hand, a positive attitude of high school students towards inclusive education was revealed (85% of respondents have a positive attitude towards the fact that a child with disabilities will study in their school, 54% believe that children with disabilities should study together with healthy children). On the other hand, there are doubts about the success of inclusive education implementation (only 31% of respondents assess inclusive education as pleasant for children with disabilities and 35% — for normally developing peers) [6].

The problem of implementing inclusive recreation and health improvement in modern research is considered in two aspects: creating inclusive space in children’s camps [9; 10] and characteristics of inclusion of children with various developmental disorders in inclusive camps [8; 11; 12; 14].

However, I have not found any empirical studies aimed at studying the peculiarities of the attitudes of typically developing children towards inclusive health improvement.


The proposed study involved 412 adolescent children who were on holiday in a summer health camp. The age of the respondents: from 13 to 16 years, average age — 15 years; a total of 263 girls and 149 boys. The difference in the ratio of the number of respondents of different sexes is explained by the fact that the questionnaire was conducted at will and, taking into account psychological characteristics, adolescent girls more often agree to fulfil the requests of adults, show greater interest in communication, self-discovery and self-analysis.

The survey was conducted in 2018—2019 in the following educational and recreational institutions: National Children’s Educational and Recreational Centre “Zubrenok”, 8 recreational camps in Grodno, Minsk and Mogilev regions of the Republic of Belarus. To study children’s willingness to participate in integrative health improvement, we chose such a questionnaire method as a verbal-communicative method that allows us to draw conclusions about the characteristics of their perceptions and attitudes to the studied phenomena based on respondents’ answers.

Four questions of the questionnaire were closed and assumed the choice of a preferred option from the proposed ones. Five questions were open-ended and assumed independent answer formulation by the respondent.

All questions were divided into several content blocks.
  1. Understanding the significance of inclusive health improvement.
  2. Readiness for joint health
  3. Experience of interaction with children with
  4. Challenges of joint health


Understanding the significance of inclusive health improvement.

The first block included a closed question: “Do you think there is a need for camp shifts where both normal children and children with developmental disabilities, children with disabilities (e.g., blind, hearing impaired, cerebral palsy, autism, etc.) would be present at the same time? Half of the teenagers who took part in the survey answered positively, 26 per cent gave a negative answer and 24 per cent of the respondents found it difficult to answer.

Next, they were asked to explain their choice. Proponents of joint health improvement explained their position: all children have the same rights; it is necessary for communication, development of communication skills of all; it is necessary for inclusion of children with special needs in society; it is interesting for all; all will become kinder, more tolerant to each other.

Teenagers who think that inclusive shifts are not necessary, give the following arguments: negative attitude to children with special needs by other children is possible; there will be difficulties in understanding and communication; children with special needs will be uncomfortable; children with disabilities need special conditions.

A closed question “If you think that joint shifts are necessary, in your opinion, what would be the best way to organise them?” was used to explore teenagers’ perceptions of the possibilities of organising joint shifts. The following answers were received:

  • separate detachment for children with developmental disabilities — 48% of respondents;
  • children with disabilities are in groups together with normal children — 28% of the surveyed teenagers;
  • 24% of those who took part in the questionnaire found it difficult to answer.

Readiness for joint health improvement.

This block included a question assessing the readiness of normally developing adolescents for health improvement in the conditions of inclusive camp shifts: “Would you like to have children with developmental disabilities in your group? The following data were obtained: only 20 per cent of teens surveyed agreed, 36 per cent answered negatively, and 44 per cent found it difficult to answer.

Then they were asked to explain their choice. It should be noted that 44 per cent of the surveyed teenagers found it difficult to explain their position. Adolescents who expressed readiness for joint health improvement indicated the following arguments: everyone has equal rights; I want to learn to understand such children; I want to help such children; it is interesting; it will teach tolerance to all children.

Teenagers, who expressed their unwillingness to undergo recuperation in the summer camp together with children with SDN, explained their choice in the following way: I do not know how to communicate, I will not find an approach; other children will hurt them; they will be uncomfortable; all children will be uncomfortable.

Analysis of first and second block data revealed that while half of children had positive attitudes towards inclusive change, only 20% of young people were prepared to engage in such dialogue. Difficulties in communication and the risk of negative attitudes from other peers are cited as the main concerns. A significant proportion of young people (between a quarter to 44 per cent depending on the question) are characterised by uncertain attitudes towards integration and children with disabilities, and competent educational work by teachers will help to change these attitudes to positive ones. It is also interesting to note that none of the young people who responded to the questionnaire wrote about their negative attitudes towards children with disabilities, while at the same time pointing out that “others” might offend and insult such children.

Experience of interaction with children with SDN.

The questions in the third block allowed us to assess the experience of interaction with children with SDN. Only 10% of respondents indicated that they had regular experience of interacting with them, 36% had interacted with such children only once; 37% of respondents noted that they had no experience of interacting with children with SDN, and 17% found it difficult to answer.

Interactions with children with SDN took place in the following settings: casual acquaintance, at school, in the playground, neighbours.

Next, respondents indicated children with which developmental disabilities they communicated with (it was possible to choose several options for answering the question, some children did not indicate an answer, so the sum of the total number of choices does not add up to 100%): with locomotor disorders (16%); with hearing impairment (12%); with mental development disorders (learning difficulties) (6%); with visual impairment (6%); with speech impairment (5%); with intellectual disability (4%); with autism (11%); with Down’s syndrome (3%); don’t know what kind of impairment (6%).

Challenges of joint health improvement.

The questions in this block revealed adolescents’ perceptions of the problems that may be encountered by children with SDN and normally developing children in inclusive settings.

As the main difficulties that a child with SDN may face, respondents indicated (it was possible to choose several options for answering the question, so the sum of the total number of choices does not amount to 100%):

  • negative attitude, disrespect, will be offended — 44%;
  • difficulties in communication and interaction with children — 23%;
  • misunderstanding — 7%;
  • difficulties in adaptation — 9%;
  • lack of special conditions — 6%;
  • find it difficult to answer — 12%.
Adolescents see the main difficulties that respondents themselves may face:
  • difficulties in communication — 27%;
  • misunderstanding — 11%;
  • excessive emotional reaction (pity, embarrassment, fear) — 7%;
  • it will be uncomfortable — 4%;
  • I don’t know how to help, how to communicate — 2%;
  • find it difficult to answer — 20%;
  • do not see difficulties — 20%.
Adolescents’ perceptions of possible difficulties are largely related to their lack of experience in interaction and are based on traditional stereotypes and prejudices.


The empirical study showed that normally developing adolescent children, who generally understand the importance of inclusive health improvement, have a positive attitude towards the idea of inclusive shifts, but have no experience of interacting with children with SDN and are not yet ready for inclusive health improvement. The tendency of some adolescents to have a negative attitude towards the idea of inclusive shifts can be explained by the immaturity and subjectivity of their personal position and limited experience of interacting with children with SDN. Therefore, it is necessary to work systematically with children to develop a tolerant attitude towards children with SDN. In this case, the situation of a health camp, where children are not engaged in educational activities, but are constantly in a group of peers and reference adults for them, creates favourable conditions for working in this direction. It is also important to note that the concerns are not about discomfort for the adolescent, but about discomfort for the child with SDN, possible negative peer attitudes and difficulties in communication. This can be explained by the fact that the need to belong, to be included in a peer group, is one of the most important needs of adolescence. Fearing isolation and negative peer attitudes, the adolescent imagines a peer with SDN who is even more vulnerable than he or she is, and projects his or her fears and concerns onto that peer. At the same time, an important resource is the absence of negative attitudes towards children with disabilities among modern adolescents, interest and desire to establish contact with them, which should be taken into account when organizing inclusive health improvement.

If the teachers are ready to work in inclusive conditions, if the inclusive health improvement is practically implemented and if the institution has a suitable educational environment, the children can have the experience of shared leisure time and the anxiety of the children can be alleviated. However, it is important to remember that including children with disabilities in recreational activities with typically developing children does not automatically mean creating an atmosphere of acceptance and tolerance. There is a need for constant and purposeful work of the whole teaching staff to create an inclusive culture: to identify and destroy stereotypes, to form positive attitudes towards children with disabilities and inclusive health improvement, communication skills, to create a favourable psychological climate in the children’s collective.


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