Discover Education

Research

Barriers to inclusive education of children with autism: Ghanaian

teachers’ perspective
Eyram Juliet Senoo1 · Mabel Oti‑Boadi2 · Efua Vivian Senoo‑Dogbey3 · Ohenewa Josephine Bampoe1 ·
Luke Laari4

Received: 12 June 2024 / Accepted: 27 August 2024

© The Author(s) 2024  OPEN

Abstract
Background Autism Spectrum Disorder (ASD), a neurodevelopmental condition, has become a major concern for both
developed and underdeveloped countries since the condition is associated with significant caregiver, family, and financial
burdens. Approaches to educating these children, especially in their preschool years, are burdensome and demanding
for both parents and teachers. Although it is recommended that children with ASD receive inclusive, age-appropriate
education in mainstream school settings, there are barriers in Ghana. This study explored barriers faced by preschool
teachers in implementing and adhering to inclusive education for children with ASD.
Methods The study employed an exploratory descriptive qualitative design to sample 17 participants in the Greater Accra
Region using a purposive sampling technique. Data was collected through an in-depth virtual interview and analyzed
using content analysis.
Results The study identified inadequate parental cooperation, poor ASD knowledge of the teachers, socio-cultural and
political issues, and a lack of collaboration with other professionals as major barriers thwarting the success of inclusive
education for children with ASD in Ghana.
Conclusion These barriers affect effective and successful adherence to inclusive education for children with ASD, and as
such, we recommend orientation and special training for teachers, the provision of resources for effective child inclusion,
and the creation of ASD awareness during the training of pre-school teachers.

Keywords Autism spectrum disorder · Barriers · Inclusive education · Pre-school teachers · Ghana

1 Introduction

Autism spectrum disorder (ASD) is a neurodevelopmental spectrum disorder that was first described by Leo Kanner in
1943 [1], as a condition seen in individuals with inadequate language development, social communication, restricted
interests, and repetitive behaviour [2]. It is usually considered a “spectrum” because the disorder has a wide variation
in the type and severity of symptoms. While it is arguably considered a lifelong disorder, the degree of impairment in
functioning varies for everyone on the spectrum [3], and early interventions are helpful [1].

* Luke Laari, llaari@[Link]; Eyram Juliet Senoo, jesenoo@[Link]; Mabel Oti‑Boadi, oti-boadi@[Link]; Efua Vivian
Senoo‑Dogbey, vesenoo-dogbey@[Link]; Ohenewa Josephine Bampoe, obampoe@[Link] | 1Department of Audiology, Speech
and Language Therapy, University of Ghana, Legon, Accra, Ghana. 2Department of Psychology, University of Ghana, Legon, Accra,
Ghana. 3Department of Public Health Nursing, School of Nursing and Midwifery, University of Ghana, Legon, Accra, Ghana. 4School
of Nursing and Midwifery, College of Health Sciences, University of Ghana, [Link] LG 43, Accra, Ghana.

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Over the past decade, estimates of increases between 50% and over 2000% in cases of autistic disorder diagnoses
have been charted, studied, and discussed worldwide [1]. This has made it a major public health concern in developed
and developing countries [4], leading to significant social, caregiver, family, and financial burdens on individuals with
children living with autism [5, 6].
An important social concern associated with ASD is the difficulty in educating children on the autism spectrum,
especially in their preschool years. This has been largely attributed to the high occurrence of ‘problem behaviour’ [7].
Problem behaviour is reported as one of the reasons for excluding these children from educational programs [8]. These
behaviours include frequent outbursts, occasional aggression, and noncompliance, leading to substantially barring
adequate educating of these individuals [9]. Apart from problem behaviours, differences in social interaction ability of
these children with ASD pose a great challenge to educators especially in mainstream school settings [10].
To overcome the problems associated with educating the preschool child with ASD, many international organizations
including UNESCO [11] have recommended that children with ASD and other disabilities receive an inclusive education
in a less restrictive environment with age-appropriate teaching and learning based on country policies and international
guidelines [7, 12]. This would allow peer communication to improve social interaction.
According to Daniels [13] and UNESCO [11] inclusive education is the structuring of the school curriculum to make
it equally accessible to learners with special needs. It ensures that the school community, the school climate, and the
entire school system are adapted to meet the needs of both regular and Special Educational Needs (SEN) pupils. Inclu-
sion, therefore, involves restructuring the regular curriculum and classroom settings to better support children with ASD
and other disabilities. It has the aim of ensuring that all pupils are fully included and have access to equal education,
regardless of their needs [13]. Unfortunately, inclusion does not appear to be working for children with ASD in many
mainstream education settings in many parts of the world [14, 15].
In Ghana, however, even though the policy on the education of children with special needs has been produced and
disseminated in the year 2015 and given recommendations for the inclusion of children with ASD, these children are
overwhelmingly underrepresented in the Ghanaian education system and the special education needs of those who are
enrolled are not being met [16]. There is still no consensus regarding the appropriate educational practices and strategies
for teaching children with ASD in Ghana [17].
Among the various educational policies in Ghana is the Inclusive Education Policy which gave recommendations for
the inclusion of children with disabilities in mainstream educational systems. The Government of Ghana also passed the
disability law (Act 715), which made provisions for inclusive education [18]. Ghana also has a policy on special education
which is based on the key policy objectives of the Education Strategic Plan—2003. All these policies seek to address
the challenges of marginalization, segregation, and inequality that have constituted barriers to the inclusion of persons
with disabilities including ASD in mainstream activities. Despite the tremendous effort the country has put into the
implementation of inclusive education, there are many challenges on the national front [19].
An investigation carried out in Ghana found that teachers and school officials have shown significant commitment
and attention in ensuring the inclusion of children with ASD, despite the challenges of insufficient teaching and learning
resources and a shortage of trained personnel [20]. Another Ghanaian study also reiterated the point that in as much
as inclusive education is profitable for children with disabilities, especially in terms of social development, most often
the opportunity for genuine inclusion is intercepted by challenges and barriers that exist within the education system
[21]. A study that assessed the level of implementation of the child inclusion policy from the perspective of policymak-
ers revealed that there is a need for reconceptualising disability, financial backing, a guideline on teacher recruitment,
and fostering inter-agency collaboration, as the means to achieve the policy goals [22]. No study so far has extensively
explored the perspectives of the teachers on the implementation of the child inclusion policy, hence the need for this
study in Ghana to explore the barriers associated with the inclusion of children with ASD in mainstream classrooms.

2 Methods

2.1 Research design and approach

The current research adopted an exploratory descriptive qualitative design as it allowed in-depth exploration and
detailed descriptions of the teachers’ perspectives on inclusive education in Ghana. Using in-depth interviews data
were gathered about personal experiences of these teachers regarding barriers to including children with ASD in

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mainstream education system in Ghana. Exploratory descriptive is considered the best as it provided the researchers
opportunity to understand the teachers’ perspective of inclusivity with less rigidity in the approaches [23].

2.2 Study setting and population

The study was conducted in the Greater Accra Region of Ghana, the capital, where many private and government
schools accept children with ASD for inclusive education. Participants were recruited conveniently from seven dif-
ferent districts. Professional preschool teachers, their Teaching Assistants, and head teachers who were teaching
in both private and public mainstream pre-schools were considered. This population was selected to ensure the
population is capable of providing insight and clarification of barriers preventing the smooth implementation of
inclusive education for children with ASD in Ghana [24].

2.3 Sampling technique and sample size

The study employed a purposive sampling technique in selecting all the participants. The purposive sampling tech-
nique was used as it served the purpose to appropriately recruit participants with specific characteristics to help
explore the barriers they face with the child inclusion process [25]. Sampling was guided by the data saturation
principle as proposed by Shetty [26], and we reached data saturation after interviewing the 17th participant.
The study included preschool teachers and their assistants who at the time of data collection were teaching in
either public or private mainstream schools in the Greater Accra Region and had at least a child with an official diag-
nosis of ASD in his/her class for at least one year. In addition, head teachers in either public or private schools in the
Greater Accra Region who supervised teachers with an officially diagnosed child with ASD in his/her preschool as
shown in Table 1. Teachers other than those teaching in the preschool without any child with ASD in the class were
excluded.

Table 1  Demographic Teacher # Gender Age (years) Years as a Years taught in Any training in spe- Any train-
information of participants teacher preschool cial need education ing on
ASD

Teacher 1 Female 27 4 2 Yes Yes

Teacher 2 Female 42 15 15 Yes No
Teacher 3 Female 27 4 3 Yes Yes
Teacher 4 Female 41 21 19 Yes No
Teacher 5 Female 30 6 6 Yes No
Teacher 6 Female 35 17 7 Yes No
Teacher 7 Female 41 15 13 No No
Teacher 8 Female 30 5 5 Yes No
Teacher 9 Female 27 4 2 Yes Yes
Teacher 10 Female 46 10 10 No No
Teacher 11 Female 55 30 21 No No
Teacher 12 Female 29 6 4 Yes No
Teacher 13 Female 36 11 8 Yes No
Teacher 14* Female 24 3 3 No No
Teacher 15* Female 21 2 2 No No
Teacher 16** Male 49 28 – Yes Yes
Teacher 17** Male 52 35 – Yes No
*
Assistant teacher
**Head teacher

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2.4 Data collection procedure

An interview guide was developed based on information available in the literature regarding barriers associated with the
inclusion of children with ASD [10, 24]. The interview guide was in two sections: one section with questions on sociodemo-
graphic profiles of the participants and another with questions on the barriers associated with the child inclusion process.
The semi structured interview guide made possible and facilitated probing for details from participants.
The first author, a Ghanaian female with experience raising a child with autism, conducted data collection between August
and September 2020, during the peak period of the COVID-19 pandemic. The other authors are Ghanaians with research
interests in ASD, and because the government imposed social distancing and movement restrictions, interviews were con-
ducted online using one-on-one semi-structured interviews via Microsoft Teams.

2.4.1 Data analysis

The transcripts were analysed by two authors using qualitative content analysis [27]. The authors conducted a comparative
analysis of the interview transcripts and the recorded interviews. To determine the unit of analysis, the first author reread
the interviews multiple times in order to obtain a comprehensive understanding of the entire collection. Meaning units, or
statements that revealed something pertinent to the objective, were highlighted, extracted from the text, and pasted into
an individual Microsoft Word document. After extracting each meaning unit, a code was assigned to it, which contained a
concise explanation of its significance.
Prior to classifying the subthemes into overarching themes, the authors engaged in a back-and-forth discussion of their
variations by navigating between the sections. Following this, the authors analyzed the derived codes’ content, classified them
into overarching themes, and delineated subthemes according to the correlation between their similarities and distinctions.
Based on Graneheim and Lundman [27], approach to the abstraction of subthemes and themes, four overarching themes
were identified with fifteen subthemes.

2.4.2 Ethical considerations

Ethical clearance for this study was obtained from the Ethics & Protocol Review Committee (EPRC) of the School of Biomedical
& Allied Health Sciences (SBAHS), University of Ghana, with clearance number SBAHS/AA/SLT/10015116/2019–2020. Permis-
sion letters were obtained from the school authorities before the recruitment of study participants. All the study participants
received explanations about the study objectives, and those who consented and volunteered to be part of the study were
made to link up with the virtual platform prepared for the meeting. All participants voluntarily accepted, and their rights to
privacy and confidentiality as individual participants were respected. They were also informed about the recording of the
interview. This study was performed in accordance with the consolidated criteria for reporting qualitative research guideline
(COREQ), [28].

2.4.3 Rigour

To ensure the trustworthiness of the study as recommended by Graneheim and Lundman [27], in qualitative content analysis,
credibility, dependability and transferability were considered. Credibility for instance, was ensured by selecting participants
with various experiences and meaning unit during condensation were not too big or small to enhance credibility. Transfer-
ability on the other hand was enhanced by the provision of detailed demographic data and comprehensive presentation
of the findings. To ensure the integrity of the audit trail, we documented the research process’s decisions, and precise data
were diligently preserved and this provided a rationale for the interpretive judgment and methodology employed by the
researchers, potentially contributing to the transferability of the findings. Precise qualitative content analysis and processes
were implemented to ensure dependability. The co-authors, who possess expertise in qualitative content analysis, assessed
and all agreed on the labelling and sorting of themes and subthemes obtained from the data to ensure their confirmability.

2.4.4 Findings

Of the 17 participants, thirteen (13) were preschool teachers, two (2) head teachers, and two (2) teacher assistants. All
the participants were employees of mainstream preschools in both private and public schools. The participants’ ages

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range between 21 and 55, with the majority being female, and their duration of teaching experience ranges from 2 to
35 years. Eight (8) out of the 17 participants had basic knowledge about ASD, whereas three (3) teachers had received
specific training on ASD. In all, 10 of the participants received basic training on special needs education (SNE) during
their teacher training program.
Five main themes were curved out after analysis, including poor parental cooperation, inadequate educator training,
and knowledge, lack of support and policy issues, inadequate professional and specialist collaboration, and demand to
separate ASDs as shown in Table 2.

2.5 Poor parental cooperation

Poor parental cooperation describes the inability of parents to team up with teachers to facilitate the inclusivity of chil-
dren living with autism spectrum disorders in school. Issues that led to this poor cooperation were identified as denial,
community stigma, lack of knowledge, superstitious beliefs, unrealistic parental demands, and poor parental support
from parents.
Denial: Most parents with children with ASD find themselves in a state of denial or grief during the child’s preschool
years since they are unable to cope with the diagnosis of the child living with autism. It, therefore, becomes very difficult
for them to cooperate positively with people who work directly with their children on the spectrum. All participants
revealed that most parents take a while to accept that their child has difficulty, even though the signs are clear, and they
have received an official ASD diagnosis for the child. “…. but most of them are still in denial and will not accept any sugges-
tions. The child’s mother insisted that her child did not have ASD and that he is only having a slight developmental delay” (T3).
“Most parents are in denial; they have simply not come to terms with reality. Most of these parents are not cooperative
at all, and it becomes difficult working with them” (T1).
“The mother of the child I am currently handling says her son does not have that disease; the doctor made a big mistake.
I know in 4 years he will talk. She even said her son could do everything. She asked me to make sure he learns to read
quickly” (T12).
Superstitious beliefs: Some families are very superstitious and consider the child’s condition as spiritual hence it
becomes difficult to engage them or help them modify their thinking. “Most parents are in denial of their child’s condition.
Some pretend nothing is wrong with the child. Most see the situation as being spiritual and want you, the teacher, to accept
their line of thinking and practice” (T13).
“Because the parents see the problem as spiritual, they don’t take your advice……… it’s difficult because they will not
do what you ask for….” (T3).
Unrealistic parental demands: Another area in which participants expressed much frustration with regard to parental
cooperation is that the parents want the class teacher to teach their child to do everything just like their typical peers in
the class. This puts a lot of demand on the class teachers, who are mostly general educators and often lack the professional

Table 2  Barriers to ASD Themes Sub themes

inclusive education
Poor parental cooperation • Denial
• Superstitious beliefs
• Unrealistic parental demands
• Poor parental support
Inadequate educator training, and knowledge • Broad non-specific knowledge
• Scarcity of information on ASD
Lack of support and policy issues • Lack of resources for teaching ASDs
• Financial demand on parents
• Lack of clear policies
• Rigid and unfavourable curricula
Inadequate professional and specialist collaboration • Lack of specialists
• High charges of specialists
• Schools disallowing facilitators visits
Demand to Separate ASDs • Community stigma

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skills to provide interventions for these children. “Parents are overly demanding and comparing the performance of their
children with ASD to that of other typical children. They make you feel like you are not teaching the child well” (T1).
“Most parents pretend they don’t know about the challenges facing their children. They are not cooperative and want
you to do magic with their child” (T7).
Poor parental support: Some teachers are of the view that parents of children with ASD are not cooperative and do
not put in much effort to support the child. “I will teach the child with all the energy I have so the child can improve. He goes
home and they will not help him do his homework” (T3).
“I taught him to use the washroom well, and I was happy. When we returned from vacation, the child was wearing a
diaper. Just imagine! I was furious with the parents. They are too busy to build on what I achieve with the child.” (T4).

2.6 Inadequate educator training, and knowledge

The participants reported a lack of adequate training to warrant their knowledge and ability to assist children with spe-
cial needs in their class. Some of these teachers had broad non-specific knowledge about children with special needs,
while others reported a scarcity of information on how to assist children with ASD in learning in an inclusive classroom.
Broad non-specific knowledge: Ten (10) participants, who were general educators, said they had some basic special
needs education training. Eight (8) of them said their special needs education training did not concentrate on any specific
condition. Only three (3) participants underwent training that was dedicated to ASD. Apart from these three (3) teachers,
the other participants hard a general formal working knowledge about teaching children with disability in a mainstream
setting and not specific to ASD. Most teachers reportedly felt incompetent and expressed an interest in receiving special
training to help them gain specific knowledge to provide the needed support for the children on the spectrum.
“All that I do for these children is purely because I handled a few of them many years ago. I just use my experience as a
teacher; I know it is not enough” (T7).
“The only disability training I had was many years ago in training college. They did not teach any strategies to use, I heard
about autism on a TV programme. That is how I learned about the need to love and have patience for the child” (T11).
“None of the schools where I worked have ever organised training for teachers on disabilities before. All their training is
for normal children, but we need training to work with ASD children too” (T5).
Scarcity of information on ASD: The teachers reported that books and other information on ASD is not readily avail-
able for most of them. As such, the teachers find it difficult to access information about the condition in managing
these children leading to most teachers rejecting them in their classes as supporting them was based on their personal
understanding of the condition. “Because I don’t know much about them at first, I am afraid to accept them in my class. I feel
I cannot teach the boy well. What if he is misbehaving in class? (T4).
The heterogeneous characteristics that children with ASD exhibit create challenges for mainstream preschool teach-
ers. Most of the participants explained the effects of not having access to information about the condition, its manifes-
tations, the possible triggers of unacceptable behaviour as well as modern strategies for managing such a child in the
mainstream classroom.
“These children behave differently, yesterday he was happy and today he is crying without a cause. One time he likes it
when you clap and the next time he will hide under his table when he hears a clap….aba! I get confused. What can I do
again? I wish I knew a little better so I could help him at all times” (T5).
“I don’t have any knowledge about ASD, I cannot teach them well without any training, if only they could train us, it would
be good for the children. Apart from that, they can send them to special schools. It will be better for the children” (T8).
“What works for child A may not work for child B that is why it is difficult if you don’t have training on the different ways
to support these children in the mainstream” (T3).
The receipt of training in the care and support of children with ASD makes the teachers very confident and ready to
support these children to learn in the mainstream classroom. One of the participants expressed her readiness as follows.

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“When I came back from school, (after receiving special training) I wish they could bring ASD cases to my class. The
Applied Behaviour Analysis programme made me confident. I can manage any level of autistic child now and that is
because I was trained” (T1).

2.7 Lack of support and policy issues

Lack of support and policy issues stem from the fact that very little assistance came from both government and institutional
heads towards the implementation of inclusive education for these teachers, who were motivated to accept the children
even though they had no training. These teachers reported a lack of resources for teaching ASDs, financial demands on
parents, lack of clear policies, and rigid and unfavourable curricula from the educational institution. Clear policies, at least,
would have given a clear direction that could harness some support for parents and teachers in handling these children.
Lack of resources for teaching ASDs: The general culture of overlooking the needs of persons with disabilities in the country
is reflected in school practices where mainstream schools rarely make provisions for supporting children with disabilities.
Most mainstream preschool teachers who participated in the study revealed that the non-availability of resources affects
their efforts to properly include children with ASD. They mentioned the inability of the school to procure special toys or
teaching materials for the children. They believe the inability of the school authorities to provide appropriate resources is a
major challenge. Participants reported having to manage with regular toys in the absence of modern devices for teaching.
“We only have to manage with the regular toys. I made the request, but they say the school doesn’t have a budget for special
toys” (T9).
“There are better modern devices that a class teacher can use to support teaching for the child; the question is, will the school
ever buy them? No!” (T3).
“I was told the school cannot spend extra funds on the child alone. What can I do, I bought one pack of special brushes for
him, but I can’t do that always, the school must do that” (T4)
“The resources to use in these special cases are never available. At times, I have to create something myself to help the child
who can learn by seeing clear pictures” (T6)
“The child I have in my class can have a meltdown for up to 4 hours…. I wish the school had a special place like a sensory
room where I could isolate and manage him anytime, he became uncontrollable” (T5).
Financial demand on parents: Most of the time, the schools expect the parents of these children to bear the extra cost of
supporting their children in mainstream preschool. Spending extra on individual needs in the school will affect the finances
of the school hence the parents must provide those resources and facilities for the use of their child with special needs in
class. “Anytime I need a special toy or material to teach the child, I tell his father and he gets it after a few days” (T13).
“But if the parent is poor, there is no way they can pay for all those expensive resources. The child will not benefit” (T3).
Lack of clear policies: Educating children with special needs requires clear policies, guidelines, and supervision that will
guide mainstream educators with the skills to effectively support the teachers. All the participants lamented the lack of clear
policies and guidelines to direct their efforts in supporting children with ASD in mainstream settings. Participants revealed
that most of them do not know much about the government’s policy on inclusive education moreover, no official has ever
come to monitor the implementation of the policy. This leaves a huge gap between the policy and actual practice. “The school
has not given me any documents to guide me about working with the child, I only do what I feel is good” (T2).
“I have taught many children like him but in my 21 years of teaching, no official has ever come to observe what I am doing
and say ooh, this way is better or do it that way rather. So who is supervising the inclusion of ASD?” (T13).
“Stakeholder pro-activeness is important; the policy is just left unsupervised” (T1).
Rigid and unfavourable curricula: Most mainstream schools, especially private schools do not want to take any additional
financial burden. The schools will freely procure resources for mainstream support but will not accept procuring any resources
to support teaching and learning for children with special needs. Also, the education policies of the country are very rigid
and favour only mainstream education. Individual schools find it difficult to manipulate the curricula to favour diversity. “The
school has only one official syllable for the mainstream. The children with disabilities are also here, but there is no syllable for them.
I have to design something myself” (T2).

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2.8 Inadequate professional and specialist collaboration.

Professional and specialist collaboration was inexistent in these schools. Participants reported lack of specialists’ involve-
ment and that where these specialists were involved, their extortionate charges made it unsustainable. Some teachers
also mentioned some schools not allowing facilitators to visit.
Lack of specialists: Successfully managing children with disabilities is a collective responsibility of a Multi-Disciplinary
Team (MDT) [29]. Each child with ASD requires a holistic approach by receiving well-coordinated services within the
critical developmental period. It is very important to have professional input from speech and language therapists
(SLT), psychologists, occupational therapists (OT), behaviour therapists and paediatricians among others, to augment
the efforts of the preschool teacher in educating the child. Some of the participants have never had the opportunity to
collaborate with any of these professionals to support a child with ASD. “I know I have to work with them but where am I
going to get them? They are simply unavailable in this country” (T11).
“Unless the parents bring a report from these professionals, you cannot do anything. Sometimes they tell you what to
do. I wish I had one visiting us at least once a quarter, it can make a huge difference” (T2).
“Frankly speaking; these professionals are hotcakes, and engaging them is difficult and expensive. Some parents do
contact them privately, but the school does not involve itself. But we need their support to be able to work better” (T9).
High charges of specialists: There are just a few of these professionals serving the whole population hence their ser-
vices are very expensive. Again, the schools do not consider it a priority to engage their services to support children
with special needs including ASD. “My school will only advice parents to take their children for further assessment by these
professionals.” (T7).
“Speech therapists and OTs are scarce. I once worked with one at my former school. When I have difficulty with a child’s
behaviour, I call her to help me on a personal level. Her ideas help me manage the child better, but their charges are
exorbitant” (T3).
Schools disallowing facilitator visits: Some teachers reported that their schools do not sanction the presence of Occupa-
tional Therapists and Speech Therapists. Though no reasons were given, some of the teachers believed that the schools
consider the presence of these professionals intrusive, and that they could be used to spy on their operations. “The school
does not allow the presence of facilitators to come in with the child. They will rather ask the parent to withdraw the child from
the school” (T9).
“Anytime the facilitator is around you can see the head teacher walking past the class frequently. He will ask me if your
class is not over, the facilitator needs to leave now” (T1).

2.9 Demand to separate ASDs

The participants reported instances of stigma, where parents demanded the separation of their children from those with
ASD. Some of the teachers expressed frustration when they received this news from those parents. Despite their lack
of justification, these parents insisted on separating their children or removing children with autism spectrum disorder
from the classroom.
Community stigma: The teachers revealed that while most typically developing preschool children do not know
that their mate (a peer with ASD) is different and they need to coexist with them normally, their parents, on the other
hand express reservations. They do not want their children to be in the same class as a child with special needs. Some
of them go to the extent of withdrawing their children from school to prevent them from having contact with the
child with ASD.
“One man warned us to remove the child with ASD from the school or keep him in a separate classroom away from his son.
He forced me to change the sitting position of his son. He later withdrew his ward from the school because of that” (T6).
“One interesting thing is that typical peers don’t care. Most of them are not aware of their friend’s problem, they play
with them and even copy some of the things they do…. But their parents (parents of typical children) ….. hhmm. You
may even feel like crying” (T9).

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3 Discussion

The present study explored the barriers Ghanaian mainstream preschool teachers faced as they endeavour to include
children with ASD into the Ghanaian mainstream education system. The study found inadequate parental cooperation,
lack of knowledge and information on ASD, lack of support and policy issues as well as lack of collaboration with other
professionals as the major challenges affecting the successful inclusion of children with ASD. The findings are consistent
with Okyere, Aldersey and Lysaght [30] on experiences of children with intellectual.
and developmental disabilities in inclusive schools in Ghana and supports findings from a review of stakeholders’
experiences of inclusive education in Sub-Saharan Africa by Genovesi, Jakobsson, Nugent, Hanlon and Hoekstra [31].
Similar findings were also observed by Al Jaffal [24] and Lindsay, Proulx, Thomson and Scott [10] among teachers in the
united States if America and Canada.
This study observed that preschool teachers believe that most parents having children with ASD deny the diagnosis
of ASD for their children at the initial stages. They do not have adequate knowledge and information about the disorder
in terms of presentation and all the functioning difficulties associated with it. Most parents also have the belief that ASD
has a spiritual cause [32, 33]. From the perspectives of the participants, these are the reasons why they (preschool teach-
ers) do not receive the needed collaboration and partnership required from the parents. According to the participants,
whilst some parents are over-demanding, expecting the teachers to rapidly help their children to behave and learn
like their typical peers, some other parents would also not make efforts to support the children at home to sustain or
augment skills acquired in school [10]. However, evidence-based practice showed that a positive partnership between
parents and teachers encourages successful intervention during the inclusion of children with ASD. This collaboration
enhances the generalisation of emotional, social, behavioural, communicative and academic skills acquired in both
home and school settings [34].
The study surprisingly found that parents of typically developing children do not want their children to be in the
same class with a child with ASD and that some of them go to the extent of threatening to and even withdrawing their
children from school to prevent them from having contact with the child with ASD. This observation of lack of accept-
ance and cooperation from the other parents is in agreement with observations made by Gadagbui [35] who reported
that parents of children without disabilities threatened to remove their children from the mainstream classrooms where
a child with ASD and other developmental disabilities is being included. This finding though a challenge for preschool
teachers is worrying and therefore public education and the creation of awareness on ASD is urgently needed to increase
cooperation between teachers and all stakeholders.
One major barrier identified by most of the participants was a lack of knowledge due to inadequate training in han-
dling children with special needs especially those with ASD. This is also reported by Genovesi, Jakobsson, Nugent, Hanlon
and Hoekstra [31] as multiple barriers that prevent teachers from implementing inclusive education in Sub-Saharan Africa.
Participants indicated the training they received on including children with disability was woefully inadequate and could
not equip them for current exigencies. This is congruent with the findings of Agbenyega [17] and Ocloo and Subbey [36]
whose works also found that preschool teachers do not have the appropriate knowledge and skills to effectively handle
inclusive education in mainstream preschools.
Teachers stated they do not have the required knowledge and skills to effectively include and integrate the children
in mainstream preschool settings. This is also consistent with the findings of Lindsay, Proulx, Thomson and Scott [10].
According to Lindsay and her colleagues, teachers had serious difficulty managing behaviour and planning individual
lessons because of a lack of information and training on ASD. The study showed that most teachers knew very little about
ASD in terms of its symptoms, difficulties individuals with ASD have, and the best management strategies. The few-hour
training received by most participants during their pre-service training to support the Ministry of Education’s effort to
enforce inclusive education policy was woefully inadequate [37]. The work of McConkey and Bhlirgri [38] confirmed this
finding as they reported in their study that training received by mainstream educators were very inadequate for the
effective inclusion of children with disability. It is recommended that teachers’ preparation programs must have a com-
ponent of inclusive education courses to enable prospective teachers to acquire the skills of teaching children with ASD.
Another challenge encountered by mainstream preschool teachers in supporting children with ASD in the main-
stream environment is the influence of lack of support and policy issues. According to Reagan [39], inclusive education
will require additional funding and resources to be very successful. In another research, Waddington and Reed [40], also
reported the importance of proper funding for inclusive education. Similarly, Genovesi, Jakobsson, Nugent, Hanlon and
Hoekstra [31] argue that for effective implementation of inclusive education, teachers need access to appropriate training,

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resources, and support. Poor support and a lack of resources are identified as barriers to the successful implementation
of inclusive education.
The inclusive education concept can be successfully built on the willingness and ability to modify the general cur-
riculum and the schools’ environments to accommodate children with special needs [41]. However, participants in this
study revealed their schools do not usually provide additional or special materials to aid teaching and learning for
children with ASD. According to the teachers, most of the schools, as part of their culture do not like to invest in activi-
ties that are peculiar to special needs support. Two head teachers interviewed agreed that their school boards never
allocated funds for the procurement of specialist resources. The findings of the survey showed that mainstream schools
do not like to manipulate or restructure the classroom environments to favour children with disability (including ASD).
This practice is in line with the findings of McAllister and Sloan [42] who also reported in their study that mainstream
school facilities are usually not structured to benefit students with ASD who always experience sensory overloads. The
study lay bare the fact that teachers are left without guidelines, monitoring, and supervision when including children
with disability in mainstream class settings. Participants mentioned that rigid policies and school rules do not comple-
ment their efforts to support children with ASD in the mainstream classroom. This finding confirmed the observations
documented by Lindsay, Proulx, Thomson and Scott [10]. It was also confirmed in earlier research conducted in Ghana
that reported that most supervisors of the special needs education policy do not have much knowledge to support or
guide the mainstream class teachers [36].
The concept of inclusive education identified collaboration among several stakeholders as a key factor for achieving
success [43]. The works of Reagan [39]; Lipsky and Gartner [44], and Kuyini and Desai [45] have revealed that mainstream
teachers need the support of all staff, parents, policy advocates, other professionals, and many others to provide holistic
intervention for the children with special needs in mainstream schools. However, the findings of this study showed a lack
of cooperation between most parents and teachers. Teachers described most parents of the children to be in the “denial
stage or grieving stage” and hence do not cooperate as expected. Teachers stated that most parents complained and
are not satisfied with the efforts of the mainstream preschool teachers handling their children with ASD. This observa-
tion supports the result from [10] who also reported the lack of cooperation by parents who were on different levels of
acceptance of their children’s condition.
All participants indicated that they never had the opportunity of receiving any form of support from other profession-
als such as speech and language therapists, occupational therapists, psychologists, behaviour therapists, or paediatricians
in supporting the children. This confirms the observations made by Majoko [46] where Zimbabwean teachers indicated
the non-availability of other professionals to complement their efforts. The complaint of the teachers was confirmed by
head teachers of two schools who corroborated the fact that their schools do not directly engage the services of a psy-
chologist, occupational therapist, or speech and language therapist to assist in supporting the special needs of children.
Despite all the challenges they faced, almost all the participants agreed that educating children with ASD in a main-
stream setting is very important for their development and the improvement of their difficulty in language development,
social interaction, communication, and behaviour. This finding is supported by the results of Majoko [46], and Engstrand
and Roll‐Pettersson [47] where mainstream teachers believed that the coexistence of children with ASD with typical peers
is beneficial for the improvement of their condition. However, this revelation by teachers in this study contradicts what
was documented by Agbenyega [17], whose study reported that teachers believed it was better to educate children with
disability in an exclusive environment rather than an inclusive environment. Another consistent revelation by the teach-
ers was that the level of severity of the condition will influence their willingness to help the child. Mainstream teachers
were ready to include children who are mild to moderate on the spectrum. They proposed that children who are severe
or profound be rather educated in a special needs environment. This finding is consistent with the observations made
by Engstrand and Roll‐Pettersson [47], Kuyini and Desai [45] who all found that teachers are willing to work with children
with disabilities that are not very profound under inclusive education.
Given the revelations from this present study, the authors are advocating for the teacher training education curricu-
lum to be revised to include comprehensive information on ASD and the different cutting-edge teaching techniques
that can improve the success of child inclusion. The inclusion policy of the Ministry of Education must be implemented
later, and all the implementation gaps must be bridged. There is an urgent need to increase awareness of ASD to help
all stakeholders to be well informed and to adequately support the implementation of the child inclusion policy. There
is also the need to improve the availability of resources for mainstream settings to successfully include children with
ASD. The child inclusion policy needs effective monitoring, and the service providers need continuous supervision and
support. There is a need for the provision of community training programs with professionals such as psychologists,
occupational therapists, paediatricians, behaviour therapists, and speech-language therapists facilitating the processes.

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3.1 Strengths and limitations of the study

Data collection for this study happened at the peak of the coronavirus pandemic and as such virtual means of data
collection were the most appropriate given the restrictions on human movement and gathering by the government of
Ghana. Not having direct face-to-face interaction with the participants could have affected the way they shared their
experiences. The study, however, contributes to the barriers preventing the implementation of inclusive education in
Ghana and may assist policymakers and heads of schools on issues to tackle for a successful inclusive education in Ghana.

4 Conclusion

This study found that a lack of cooperation and partnership between preschool teachers and parents with children
with ASD and even parents of typically developing peers as a drawback to the successful inclusion of children with
ASD. Lack of training and skills for preschool teachers as well as inadequate information on ASD make the teachers
feel less competent and unequipped to successfully include children with ASD in the mainstream preschool setting.
Educational policy issues as well as lack of support influence the availability of resources for the effective inclusion
of children with ASD in preschool settings. A further study in improvisation in the classroom to teach ASDs in low-
income countries may assist teachers to work in resources constrained countries to enhance inclusion.

Acknowledgements The authors wish to acknowledge the teachers, head teachers, and teacher assistants who availed themselves and par-
ticipated voluntarily in this study.

Author contributions Senoo.J, Conceptualization, Methodology, Data collection, Data Analysis. Writing, Original draft preparation. Senoo-
Dogbey V.E, Methodology, Writing, Original draft preparation. Oti-Bodi, M. Supervision, Reviewing and Editing. Bampo J. O. writing, original
draft, Reviewing and Editing, Laari L. writing original draft Reviewing and Editing.

Funding The authors disclosed receipt of no financial support from any internal, or international organization.

Data availability No datasets were generated or analysed during the current study.

Declarations
Ethics approval All authors declare of no financial interest and that this study was approved by the appropriate ethics committee. No funding
was received for conducting this study.

Consent to participate All participants (the teachers) who took part in this study were above 18 years of age and voluntarily consented to
participate in this study.

Competing interests The authors declared no potential competing interests concerning the research, authorship, and/or publication of this
article.

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adapta-
tion, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source,
provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article
are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in
the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will
need to obtain permission directly from the copyright holder. To view a copy of this licence, visit [Link]

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