Life at the intersections of disability with ethnicity, class,
gender, sexual orientation and gender identity is more
than the sum of each vulnerability (Connor, 2014).
From a statistical point of view, sample size is a challenge
for analysis of intersecting disadvantage. Standard
household surveys suffer from rapidly shrinking samples
and larger estimation errors as the focus shifts to
individuals with multiple specific characteristics. But it is
important not to underestimate the risk that, for instance,
poor people with disabilities may be twice excluded: from
society generally and also within the disability movement.
Intersecting vulnerabilities may mean some go
unaddressed. Language difficulties and behavioural, social
and emotional difficulties often coincide (Hartas, 2011).
Yet bilingual students with disabilities, for instance, are
likely to be in classrooms that address their academic or
linguistic needs but not both (Cioè-Peña, 2017).
In studies of children and adolescents with epilepsy,
one-quarter met criteria for depression (Ettinger et al.,
1998) and half for learning difficulties (Fastenau et al., 2008).
Children identified as gifted and talented often experience
emotional difficulties coping with their exceptionality
and social distance from peers. Giftedness may not be
recognized in children with autistic spectrum disorders.
Assessment criteria to identify special education
needs can be arbitrary and contentious
Not all children with disabilities have special education
needs, nor do all children with special education needs
have a disability (Keil et al., 2006; Porter et al., 2011).
While a consensus approach on defining disability
in surveys improves cross-national comparisons of
population-level estimates, countries focus on special
education needs for their national policy discussions:
Who has special education needs, where are they
educated and what is the quality of that education?
Special needs identification is distinct from disability
measurement and entails less consensus.
The share of students identified as having special
education needs varies widely. In Europe, it ranges from
1% in Sweden to 21% in Scotland (United Kingdom); in
Central and Eastern Europe, it varies from 3.3% in Poland
to 13% in Lithuania (European Agency for Special Needs
and Inclusive Education, 2018) (
Figure 3.10
). Such variation
is mainly explained by differences in how countries define
special education needs, a political decision linked to
history. Institution, funding and training requirements
vary, as do policy implications. The variation in approaches
also presents measurement and data challenges.
Comparing the prevalence of disability, difficulties and
disadvantage across education systems and over time is
problematic, even for clinical diagnoses. For example, in
the case of autism spectrum disorder neither medical nor
education considerations give unambiguous guidance on
the point at which a behaviour becomes a disorder.
The determination partly depends on context. Whatever
the underlying biochemistry of attention deficit
hyperactivity disorder (ADHD), in some settings the
boundary of orderly behaviour determines the diagnosis.
Pre-primary and even early childhood education settings
have become more academic. Moreover, measurement
difficulties compromise the comparability of global data
or limit their availability. For instance, the mean prevalence
rate of autism spectrum disorder is 0.6% in EU countries
among children aged 2 to 17, but among the 16 countries
reporting data, the average treatment rate was 0.08%.
Likewise, with an estimated ADHD prevalence rate of
5% for children aged 6 to 17, the average treatment rate
was 1.6% (Wittchen et al., 2011; Aleman-Diaz et al., 2018).
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