# The Factors Important in Inclusive Education of the Pupil with Traumatic Brain Injury Identified on the Basis of the Lived Experience of His Mother

Authors: Dagmar Sedláčková; Jiří Kantor
Journal: Education Research International
 (2022)

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## Abstract

Changes in Czech legislation in 2016 created more favorable conditions for learners with special educational needs (SEN) and their involvement in mainstream schools. However, we do not have enough information about the educational experiences of pupils with SEN/their parents, and some types of SEN, for example, traumatic brain injury (TBI), are under-researched worldwide. A qualitative design was chosen to explore the lived experiences of a mother (52) of a learner with traumatic brain injury (14), educated in a typical elementary school. Semistructured interviews based on the biographical narration of the mother together with studying the pupil’s documentation and using a brief questionnaire with the pupil and three members of the school staff were all used for data collection. Data analyses carried out according to van Manen’s approach that revealed seven themes: (1) what helps, (2) barriers, (3) active life and well-being of the pupil, (4) decision-making, (5) social environment approach, (6) participation, and (7) the future. The results of this study point to a number of obstacles that the pupil and his mother faced in education and also represent the ways how to cope with them. The study depicts the school life of the pupil with TBI and his family and helps us perceive disability and what it brings to life from their perspective.


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## Body

## 1. Introduction

The Czech educational system has undergone the process of transformation from school integration (from 1992) to inclusive education since 2016 when the Educational Act was amended. The changes have affected the work of stakeholders, teachers, and other school staff and, in particular, have brought different approaches to learners with special educational needs (SEN). The new legislative framework enables them to be educated on the basis of equal opportunities with schoolmates without SEN [1]. Pupils with SEN have higher chances to build social relationships [2], to achieve academic results leading to building a career based on their abilities without social restrictions or prejudices, and to become independent and equal members of society [3, 4]. On the other hand, the new system also faces some difficulties associated with nonsupportive individual attitudes, lack of services, professional school staff qualified in special pedagogy, and also a lack of fully barrier-free schools [5].Because of the many changes in the educational system, we need to study the experiences with inclusive education, the preferences, and the values of pupils and their families. Understanding the experiences of students with SEN and their parents can help us uncover both the shortcomings and achievements of the new system, as well as the conditions under which they resulted [6]. In this paper, we focused on the mother of a pupil who suffered a traumatic brain injury (TBI). TBI is often connected to serious disability, for example, a negative impact on one’s overall development, mobility, behavior, perception, speech, and social skills, as well as one’s cognitive functions [7]. TBI has also a serious impact on the family [8] and parental support. A cooperative relationship, special services, and a professional attitude from teachers seem to be of the highest importance [9]. If parents meet multiple barriers in the educational environment, they may become frustrated, inpatient, or angry. However, the primary cause of these feelings is the lack of understanding and fear about their child and about the future [10]. Authors of qualitative systematic reviews [8–10] often describe education as an important area of life influenced by TBI and suggest that an understanding of the parental experience by the school staff helps improve the educational process for a pupil with TBI.Furthermore, because the system of inclusive education grows stronger in most countries worldwide, it is important to study the parental experience in the context of inclusive education. Through a recent scoping review, this area was found to be under-researched [11] because there are not enough qualitative studies that focus on the experiences of parents of learners with TBI within an inclusive educational environment [12]. The research focused on this population and the phenomenon of interest is completely missing in the Middle European context [11, 13].The objective of this qualitative study is to examine the personal experience of the mother of the pupil with TBI (acquired in early childhood) within the inclusive environment of the current Czech educational system. The following research question was identified for this research: “What are the lived experiences of the mother of the pupil with traumatic brain injury within the inclusive education in Czech schools?”


## 2. Materials and Methods

### 2.1. Study Design

A qualitative design research method was carried out according to Dilthey’s philosophy [14]. The phenomenologically oriented methodology of van Manen’s analysis of lived experience [15] was used, akin to previous similarly focused research studies (e.g., [16]). This unique method offers researchers a deep understanding of how the mother of the pupil with TBI experienced her son’s inclusion and the influence of inclusion on the pupil’s and the family’s lives, identifying the positive and negative aspects associated with inclusive education [15]. Van Manen’s method [15] enabled the determination of the understandable significance of the participant’s experiences, and each experience was thought about in a broader context, including its reflection after it had been experienced [17]. The research was conducted between 2020 and 2021. The research was approved by the Ethics Committee of the Faculty of Education, Palacký University in Olomouc (6/2019). The participant had signed the informed consent as an agreement to participate in this study, as well as record data and publish them, provided that anonymity would be respected.


### 2.2. Subjects

The participant of the study was a mother of a pupil with TBI who is educated in a regular primary school in a medium-sized town. The school is located in an older building that is not barrier-free, much like most traditional schools in Czech towns. The first contact with the mother was done by e-mail, where she was asked by the researcher for cooperation and informed about the aim of the research and conditions related to the research process (e.g., allowing access to school documentation; a possibility to talk to her son or some teachers, if necessary; etc.). All the details dealing with the conditions of data collection, publication, anonymity, and so on were then introduced in the written informed consent that was subscribed by the participant before the research itself. The personal and family details are placed in Table1.Table 1
The participant’s details.
The mother of the pupil with TBI in early childhoodMother: abbreviation, ageM, 52The pupil with TBI in early childhoodPupil with SEN: sex, pseudonym, age at the time of the interviewA boy Norbert, 14 years oldSiblings: sex, age, SEN, school, family background(i) a sister, 19, without SEN, grammar school(ii) a complete family living together in a family house with a garden in a suburb of the town—mother, father, two childrenType of school at the time of the interviewElementary school (lower secondary school)—7th gradeThe circumstances of disabilityTraumatic brain injury at the age of 6 months—caused accidentally by a fall from a heightFunctional abilities/support measures(i) Limited motion(ii) Limited movement of left arm and limited fine motor skills(iii) Slow working pace(iv) Absence of abstraction and generalization(v) Difficulties in self-service(vi) Increased fatigue(vii) Emotional abilitySupport measures(i) Teaching assistant(ii) School psychologist(iii) Verbal evaluation in maths and physics(iv) Modified curriculum in maths, chemistry, physics, Czech language, and English language(v) Relieved from the second foreign language and information technologies(vi) Need for copied materials like textsNumber of interviews2


### 2.3. Procedures and Data Collection Method

Autobiographical semistructured interviews with the mother of the boy with TBI were used for data collection, together with getting supplementary information via content analyses of school documentation provided by parents and, with their consent, by the school management, along with short structured interviews with some school staff members and with the pupil with TBI himself. The interviews were preceded by providing information on the course and purpose of the research and the publication of the outputs in the written informed consent, which was signed beforehand.The interviews with the mother were conducted in the form of narratives that depicted the course of her son’s education from entering kindergarten to the present. The interviews focused mainly on the educational experiences gained in recent years when the educational system and the school environment began to change as a result of legislative changes and the support of inclusion. Through this qualitative research, we tried to understand this experience in terms of the student’s previous educational history, as well as his perspectives for the future. The interviews took place in the mother’s favorite café, according to her wish, and took about 1 hour each. She was left free space for her narration, just when it was necessary, for example, when she was not able to reflect more deeply on her experiences or when she deviated too far from the topic, the interviewer used some complementary questions or supportive topics for the conversation. The supportive topics coincided with the focused areas stated above. Some members of the school staff (the educational consultant, the school psychologist, and the special education teacher) and the pupil with TBI were briefly interviewed at school (about 20–30 minutes each). The information obtained from them allowed the researchers to create an overall picture of the pupil’s situation. All the interviews took place in a quiet, undisturbed environment and were recorded on a mobile phone, using the Dictaphone application (version 1.8.0, ALON Software Ltd.).


### 2.4. An Outline of the Method Used for Analysis

The data analysis process was carried out according to van Manen’s approach [15]. The first step was a verbatim transcription of the recordings of the interviews into the program Pages (for the sake of clarity, some of the statements quoted in the following chapter were slightly stripped of speech incomprehensibility and sensitively modified without interference with the meaning and nature of the message). This was followed by six phases of van Manen’s analyses [15]:(i)
“Turning to the nature of lived experience”—this phase contains the formulation of the research question(ii)
“Exploring the lived experience”—this phase represents the deepening of knowledge about the participant’s experience via in-depth interviews(iii)
“Reflecting on important themes that characterize researched phenomenon”—this phase uses the process of thematic analysis that enables the identification of key themes for the phenomenon(iv)
“Describing the researched phenomenon by the art of writing and retelling”—this phase retells the participant’s experiences so that the participant’s thoughts, feelings, and attitudes are visible(v)
“Keeping strong and transparent relation to the studied phenomenon”—this phase highlights that it is necessary to focus on the research question(vi)
“Balancing research context by thinking about both the whole context and its parts”—it is based on the assumption that the ratio of the overall results to the importance played by the individual parts in the overall structure is taken into account [15]van Manen’s analyses do not require precise adherence to the given order of the individual phases, but vice versa, the process enables one to respond flexibly to the growing data and emerging topics, so it is possible to go back or move forward as needed [15]. An important part of the analysis process was the thematic analysis that enabled the definition of themes expressing the ideas related to the research question that gradually emerged during the analysis process [18]. The thematic analysis respected van Manen’s [15] three-step process, consisting of detailed repeated reading of the text, an explanatory approach, and a holistic approach. The aim of repeated reading of the interviews’ transcription was to answer the question of what the read sentence or the part of the text reveals about the studied phenomenon. For that purpose, codes were identified, wherein the statements that were related to them were marked. The aim of the explanatory approach was to find out which statements best described the nature of the studied phenomenon. Similar passages were connected under narrower subthemes or broader themes, which captured the overall impression of the conversation. The number of emerging themes and subthemes gradually expanded during the analysis process. The identified themes in this text are supplemented by illustrative statements from the mother of the pupil with TBI.


## 2.1. Study Design

A qualitative design research method was carried out according to Dilthey’s philosophy [14]. The phenomenologically oriented methodology of van Manen’s analysis of lived experience [15] was used, akin to previous similarly focused research studies (e.g., [16]). This unique method offers researchers a deep understanding of how the mother of the pupil with TBI experienced her son’s inclusion and the influence of inclusion on the pupil’s and the family’s lives, identifying the positive and negative aspects associated with inclusive education [15]. Van Manen’s method [15] enabled the determination of the understandable significance of the participant’s experiences, and each experience was thought about in a broader context, including its reflection after it had been experienced [17]. The research was conducted between 2020 and 2021. The research was approved by the Ethics Committee of the Faculty of Education, Palacký University in Olomouc (6/2019). The participant had signed the informed consent as an agreement to participate in this study, as well as record data and publish them, provided that anonymity would be respected.


## 2.2. Subjects

The participant of the study was a mother of a pupil with TBI who is educated in a regular primary school in a medium-sized town. The school is located in an older building that is not barrier-free, much like most traditional schools in Czech towns. The first contact with the mother was done by e-mail, where she was asked by the researcher for cooperation and informed about the aim of the research and conditions related to the research process (e.g., allowing access to school documentation; a possibility to talk to her son or some teachers, if necessary; etc.). All the details dealing with the conditions of data collection, publication, anonymity, and so on were then introduced in the written informed consent that was subscribed by the participant before the research itself. The personal and family details are placed in Table1.Table 1
The participant’s details.
The mother of the pupil with TBI in early childhoodMother: abbreviation, ageM, 52The pupil with TBI in early childhoodPupil with SEN: sex, pseudonym, age at the time of the interviewA boy Norbert, 14 years oldSiblings: sex, age, SEN, school, family background(i) a sister, 19, without SEN, grammar school(ii) a complete family living together in a family house with a garden in a suburb of the town—mother, father, two childrenType of school at the time of the interviewElementary school (lower secondary school)—7th gradeThe circumstances of disabilityTraumatic brain injury at the age of 6 months—caused accidentally by a fall from a heightFunctional abilities/support measures(i) Limited motion(ii) Limited movement of left arm and limited fine motor skills(iii) Slow working pace(iv) Absence of abstraction and generalization(v) Difficulties in self-service(vi) Increased fatigue(vii) Emotional abilitySupport measures(i) Teaching assistant(ii) School psychologist(iii) Verbal evaluation in maths and physics(iv) Modified curriculum in maths, chemistry, physics, Czech language, and English language(v) Relieved from the second foreign language and information technologies(vi) Need for copied materials like textsNumber of interviews2


## 2.3. Procedures and Data Collection Method

Autobiographical semistructured interviews with the mother of the boy with TBI were used for data collection, together with getting supplementary information via content analyses of school documentation provided by parents and, with their consent, by the school management, along with short structured interviews with some school staff members and with the pupil with TBI himself. The interviews were preceded by providing information on the course and purpose of the research and the publication of the outputs in the written informed consent, which was signed beforehand.The interviews with the mother were conducted in the form of narratives that depicted the course of her son’s education from entering kindergarten to the present. The interviews focused mainly on the educational experiences gained in recent years when the educational system and the school environment began to change as a result of legislative changes and the support of inclusion. Through this qualitative research, we tried to understand this experience in terms of the student’s previous educational history, as well as his perspectives for the future. The interviews took place in the mother’s favorite café, according to her wish, and took about 1 hour each. She was left free space for her narration, just when it was necessary, for example, when she was not able to reflect more deeply on her experiences or when she deviated too far from the topic, the interviewer used some complementary questions or supportive topics for the conversation. The supportive topics coincided with the focused areas stated above. Some members of the school staff (the educational consultant, the school psychologist, and the special education teacher) and the pupil with TBI were briefly interviewed at school (about 20–30 minutes each). The information obtained from them allowed the researchers to create an overall picture of the pupil’s situation. All the interviews took place in a quiet, undisturbed environment and were recorded on a mobile phone, using the Dictaphone application (version 1.8.0, ALON Software Ltd.).


## 2.4. An Outline of the Method Used for Analysis

The data analysis process was carried out according to van Manen’s approach [15]. The first step was a verbatim transcription of the recordings of the interviews into the program Pages (for the sake of clarity, some of the statements quoted in the following chapter were slightly stripped of speech incomprehensibility and sensitively modified without interference with the meaning and nature of the message). This was followed by six phases of van Manen’s analyses [15]:(i)
“Turning to the nature of lived experience”—this phase contains the formulation of the research question(ii)
“Exploring the lived experience”—this phase represents the deepening of knowledge about the participant’s experience via in-depth interviews(iii)
“Reflecting on important themes that characterize researched phenomenon”—this phase uses the process of thematic analysis that enables the identification of key themes for the phenomenon(iv)
“Describing the researched phenomenon by the art of writing and retelling”—this phase retells the participant’s experiences so that the participant’s thoughts, feelings, and attitudes are visible(v)
“Keeping strong and transparent relation to the studied phenomenon”—this phase highlights that it is necessary to focus on the research question(vi)
“Balancing research context by thinking about both the whole context and its parts”—it is based on the assumption that the ratio of the overall results to the importance played by the individual parts in the overall structure is taken into account [15]van Manen’s analyses do not require precise adherence to the given order of the individual phases, but vice versa, the process enables one to respond flexibly to the growing data and emerging topics, so it is possible to go back or move forward as needed [15]. An important part of the analysis process was the thematic analysis that enabled the definition of themes expressing the ideas related to the research question that gradually emerged during the analysis process [18]. The thematic analysis respected van Manen’s [15] three-step process, consisting of detailed repeated reading of the text, an explanatory approach, and a holistic approach. The aim of repeated reading of the interviews’ transcription was to answer the question of what the read sentence or the part of the text reveals about the studied phenomenon. For that purpose, codes were identified, wherein the statements that were related to them were marked. The aim of the explanatory approach was to find out which statements best described the nature of the studied phenomenon. Similar passages were connected under narrower subthemes or broader themes, which captured the overall impression of the conversation. The number of emerging themes and subthemes gradually expanded during the analysis process. The identified themes in this text are supplemented by illustrative statements from the mother of the pupil with TBI.


## 3. Results

Seven main themes were defined from the interviews with the mother of the boy with TBI, while each theme contained two or more subthemes. The themes are as follows: (1) what helps, (2) barriers, (3) active life and well-being of the pupil, (4) decision-making, (5) participation, (6) environment approach, and (7) the future.


### 3.1. What Helps

The most discussed theme dealt with was what helps the pupil with SEN and his family. This broad theme included subthemes, such as cooperation with the school and the maximum parents’ participation in the educational process and support from the psychologist. These two subthemes were described in detail, and their importance was emphasized by the mother of the pupil with TBI many times during the interview. The mother considers the mutual cooperation of the parents and parents’ full and active involvement in the educational process to be two of the key elements in supporting the maximum development and successful integration of the pupil. The cooperation takes place mainly with a teaching assistant and a special education teacher, on a daily basis, and then, to a lesser extent and according to their current needs, with other teachers or the school management. “At the highest level, it’s (communication with school staff) here. But, of course, it’s mainly my big initiative here—for me to show them how they can actually work with these children. But they are very accommodating and helpful, and they don’t have the slightest problem.”She also highly values the support and advice of the child psychologist, who has accompanied them and offered her help since pre-school education and has provided counseling services not only to her family but also to teachers, both in kindergarten and at primary school. “She, Doctor V (name of the psychologist), for example, when he was in the first grade, she was explaining to those teachers that he got tired very easily, so she told them to try to tie (immobilize) their left arm for the whole day, yeah. And really, one could see how it drains the brain, when you’re like… just working on one side. Well, one of his teachers really tried it and said that it’s a crucial discovery for them. They really could understand that he would only be able to sit there the fourth lesson, to be present there, but it’s impossible to require any performances from him.” The psychologist’s advice is also connected with providing enough time for relaxation and avoiding the pupil’s excessive overloading. “In the afternoon, he can relax with some of his TV series, which he likes. Then we have some learning, and then he likes to write about, for example, the series that he likes watching. He has piles of papers, where he has costumes, photos, the names of the actors and in which series they played, and so on. These are his interests. And time spent on learning? Minimum, really minimum. We do what is necessary for school, we mostly go through any subject that is needed, but only… the psychologist recommended to me just thirty to forty minutes, not to overload him, so we do this and that’s all.”The topic of respect for the special needs of a pupil with limited mobility both at school and beyond is also very important and helpful in the mother’s view. Other subthemes were a positive school and class climate, where the mother attaches an important role especially to the work of the class teacher and to the collective composition of classmates. Other subthemes were cooperation with school counseling facilities, the use of an individual educational plan, and use of support measures. They played a key role in the adaptation of the educational process according to the individual needs of the pupil, from curriculum modification, through the reduction of required outcomes, to the method of evaluating his performance. Another subtheme was parents working in health care, as the mother considers her and her husband’s medical expertise to be an advantage, as this facilitates their involvement in certain extracurricular school activities, such as participation in school trips and multiday school events.Last, but not least, was the importance of services provided by the special kindergarten, where the boy was placed shortly after the injury. At that time, the family needed a lot of support and professional help, and it was possible to get this only in a special educational environment (the boy was refused by a typical kindergarten). The mother appreciated the possibility of placing the pupil in this type of school when it was necessary and its benefits, such as professionals, therapy, and special equipment. “There was an amazing approach. He had speech therapy, canine therapy was there, then motor skills… they did it all in their own direction—I always agreed to all to them according to that educational plan… yeah. And I did only Vojta’s method (physiotherapy) myself.”


### 3.2. Barriers

Another broad theme was barriers. This theme contains subthemes such as architectural barriers at Czech schools associated in part with a lack of space for privacy or rest. (“He has only the sitting bag bought here, the relaxing one, and he can use the seats here, nothing more. I think it’s a bit missing at this school, even for the other kids there. Whoever would take advantage of it; I think that there is not any place where they could have a bit privacy, so it would be quite appropriate.”) Most of the Czech town primary schools are located in old buildings, which are not architecturally fully adaptable for educating pupils with limited mobility due to the absence of barrier-free access to the building, the presence of thresholds, insufficiently wide doors, absence of elevators, insufficient space in toilets and changing rooms, missing elevators, and other barriers. “Well, he actually uses his wheelchair only outside, when he needs to go on a longer route, so otherwise he wouldn’t be there (in this school) … they probably wouldn’t have accepted him, in my opinion, here at this school, if he couldn’t walk. There is actually nothing that… the stairs are actually up to the entrance door. The door to the school, in that main entrance, opens out, so for handling the wheelchair, it’s absolutely unsuitable.”Other subthemes were problems in the pupil’s enrollment system into a suitable group, factors leading to psychological discomfort of the pupil (e.g., stress caused by high school demands or by methods of pupil’s knowledge verification, inappropriate approach, or misunderstanding of the teacher), nonindependence, and self-care difficulties (or social problems), while their negative impact deepened with the growing age of the pupil and the pupil’s dependence on his mother.The mother mentioned some social problems connected with placing her son into the kindergarten with a prevalence of pupils with intellectual disability:“…in the special kindergarten, they put him in a class with intellectually disabled children and there he seemed to more or less remain exactly where he was, yeah, you know…. If I had the experience, the opportunity again, I would either wish to decide on a normal school with an assistant or a school for pupils with communication disorders, so…. There were some intellectually disabled children, some were also aggressive….” However, there were also some benefits of the challenging placement: “on the other hand, he was one of the best there, so they paid attention to him to the highest degree.”Concerning the self-care difficulties and their psychosocial impact, the mother mentioned “Well, going to the toilet, for example, he manages it, but of course he doesn’t poop there, he leaves it for home, and sometimes, he more or less kept urinating so that he didn’t have to go there either, but with his…. These are exactly the minimal problems that the others can’t see, but they are essential for us. Actually, I dealt with it with his psychologist, because he felt ashamed to undress completely at the urinal, for him it was a shame, actually, that he had to strip there. So he actually went to the toilet cabin, where are normal toilets, but there again were some troubles. At home, he is used to pee while sitting, but there again, for hygienic reasons, because he’s careful about himself, so maybe he didn’t hit it sometimes and urinated on the floor… so the teacher—he informed me, warned me, so…. But Norbert struggled with me again, he said he wouldn’t go to pee at school…. I thought that someone might have seen that he hadn’t hit it, and that it happened more often, so it was also uncomfortable for him. And these are exactly those social problems that this child bears with difficulty, you know.” In this case, this problem is also related to the pupil’s gender.


### 3.3. Active Life and Well-Being of the Pupil

This theme overlaps with the theme of “what helps,” but because it is not directly related to education, although it also affects it and has a much greater scope in the areas of influence on the student’s life and is linked to the efforts of the whole family, it is stated separately. Supporting the pupil’s active life at school and beyond, in his free time, had a positive impact on his well-being. The positive experiences helped the pupil in building peer relations because he could share experiences with peers, and they found common themes and interests. The psychological well-being of the pupil was reflected also in his school performance and in his self-esteem. In addition, some activities led to the expansion of knowledge and skills in various fields. The main role was played here by all family members, who supported the pupil in participation in various sports activities and games, as well as in creating opportunities to pursue his favorite activities and hobbies. “The whole family is involved. He swims; we have a pool, so he actually swims at home, and he does everything. We even skied with him until a certain age, till he managed it, because the ski boots actually kept him. But when he was taller, we didn’t manage to pick him up anymore on the slope, neither my husband nor me, actually, his height—it’s so difficult. If you fall, it’s easy, someone will help you and you stand up easily, but when he falls like a pancake, unable to use the movement, what a healthy person can do, he can’t, and so you have to lift 70 kilos up, it’s a lot of weight. So we haven’t been skiing like that for two years, we’ve already rejected that. But my husband goes to the frozen pond with him instead and he plays hockey, but he only has shoes, not the skates. And he’s a goalkeeper. He loves all activities and talks about it with enthusiasm.” In this case, this problem is also related to the pupil’s gender.


### 3.4. Decision Making

The most important moments of making decisions that the parents of the pupil with TBI had to face were associated with the choice of school at pre-elementary and elementary levels, and they are currently dealing with the issue of choosing another educational path that awaits the boy in two years, after finishing the primary school. In both cases in the past, they considered carefully the possible impacts of the choice on their son and consulted their decision with the pupil’s psychologist. Therefore, the first educational institution was a special kindergarten, and with the support of their son’s psychologist, they finally decided to educate their son at an inclusive elementary school. The mother said they appreciated the positives of both schools, while each was, according to her, the right choice, given the situation of the family and their son, as well as the son’s age. “Kindergarten? More or less, when we had to sign up for the pre-school educational system, we tried the normal kindergarten and there, they actually told me that the special kindergarten was needed, so actually the recommendation from the normal kindergarten made our decision.” “Well, it was very difficult to decide for the elementary school, but in my opinion he was the kind of a traumatic child, you know, his condition, so I thought his brain could develop and I didn’t want to let him stagnate completely, but of course on a very careful and thorough examination of our son and on a decision made with our psychologist, because I was already at that time of the kindergarten… she was already commuting there, so she reassured me… she is a supporter of inclusion of these children, so I let her to advise me not to take a wrong step….”


### 3.5. Participation

The boy’s mother found the participation of her son in all possible activities very beneficial and did everything to achieve his maximum participation. There were certain complicating facts that could not be eliminated, such as the movement limitation, due to which he could not participate in the ski training school course or have an individual educational plan, based on omitting some subjects, which were replaced by increased lessons to reinforce important school subjects in need. “He is fully integrated. He just wasn’t on the ski course, that’s clear.” “Instead of ICT, for example, they go to a lesson of English to a lower grade class, to 6th, and it is actually an English class, where the same teacher teaches them, so they get their assignments, which they practice and revise.”


### 3.6. Social Environment Approach

Even in modern society, the family faced prejudices, judgment at first sight, and inappropriate awareness of the needs of people with disabilities, resulting in an inappropriate approach to these people. It concerned not only the classmates and their parents but also some teachers or other school staff.Awareness of the needs of these children and their parents is still insufficient, and as the mother in our case pointed out, it would be appropriate to include education in this field in school classes so that children could learn from their childhood how to adequately approach these people and how to behave in different situations. “… my daughter told me that even if it’s a lame person, then the older pupils spoke about him that he was handicapped, he was retarded. And she fought for him, and always told them ‘no, he’s not’ and often, when she had a speech exercise at school, she talked about the prejudice towards those people that points to them and says that the person actually, yeah… that he should go away from that society. She fought for him a lot and thus opened my eyes a lot, because he is not disabled, or he is disabled, but it is a physical disability—this is a crucial word, so she trained the children in her class. But I met with situations like when I arrived with him in that wheelchair and the kids just made me a space, but no one told me ‘Could I help you? Should I hold the door for you? Do you need anything?’ No, I think that they didn’t know how to react promptly in that situation… that there is lack of talk on the topic of that kind in those ordinary elementary schools, yeah. When I came across it at the deputy’s office, and I told her that I thought it should be involved in education, she told me that it was on their parents to inform them. But they wouldn’t have experience with a disability, so….”Misunderstanding by some teachers was also a problem, and as this mother said, it was more about the older teachers, who had ingrained views, habits, and methods and did not incline toward any radical changes. “The young teachers take it completely differently. I have a great experience with a history teacher who came just after university and they had special pedagogy there and they are ready to solve this problem here and they take it completely differently, so there really was no such thing as a communication problem. With the older generation, it’s as if the person explicitly doesn’t have any empathy, it was often a complete struggle with them to outline the situation that would relieve me and him, like getting ready for school, and that he just would not have to deal with it in such detail.” “He actually has minimal outputs, and he can handle them at an A level, but then there is a problem with that teacher, because he doesn’t really want to give the A to him, because… how he can rate him an A, when he has a quarter of the information in his head, compared to the A of a healthy pupil.”


### 3.7. The Future

The theme of the future, in this case, was based mainly on the optimism of both parents on their practical and sober views associated with their son’s abilities and his development and on the important role that they attached to achieving the greatest possible independence and maximum life well-being of their son. The main aim was to avoid his stagnation and complete dependency. “And I think that these children have the same chances and opportunities if they have the supportive background at home. I’m very consistent and we are trying to return Norbert into the normal life as soon as possible. We want him to be happy…. As he already has a hard life, so this is a priority for me. The school is a huge burden for him, but on the other hand, the life will never be easy. So he has gone through something already, and I think it’s better when he already knows that there will be people like that and he will meet them, that life is not a bed of roses, but that there will be someone who will not try to help him or will not want to be ready for him. Adolescence is a period that is more complicated now and for those handicapped children, when you already know…. A lot of people, for example, ask me, or are surprised that I am willing to go through all that, but I think it’s like our task, if something like this happens here, we must give the child a chance and not actually write him off and condemn him at the beginning of his life.”The subthemes dealt with the choice of other education and future employment, independence regarding moving outdoors (his orientation and safe movement), the question of independent living and mastering self-service activities, defending his rights, and coping with shortcomings compared to the others. “The question of future is not easy for us at all. When he was a little boy, we didn’t think about it, but now, when he’ll go to the 8thgrade …so the plan is some kind of apprentice school, for sure. I don’t know where it will be at all. The basic information for me was that we could obtain subsidies from the EU for the employment of a disabled person. His psychologist helps me even here. She told me that if he was employed at a city or county office, where he would just carry papers from one office to another, or if he picked up the phones in our surgery and ordered patients, it would be a crucial step for the child. Especially not to leave him at home to stagnate. So, this is definitely my goal.” “I’d also like to let him live alone somewhere; you know. It can be in housing with assistance, but to let him be simply independent.” “…then there is the problem with his orientation in space, but on the other hand…. Again, with age, and as he gets older, he will learn. When he leaves this school that keeps us very busy, I will teach him how to go to places, how to behave in different situations, at the pedestrian crossing and… he actually has no estimate of the distance, that the car is going at a certain speed so that he can safely cross over. These are the things that are just awaiting me.” “So, I think we can be optimistic with his future, even people who are worse off can do it.”


## 3.1. What Helps

The most discussed theme dealt with was what helps the pupil with SEN and his family. This broad theme included subthemes, such as cooperation with the school and the maximum parents’ participation in the educational process and support from the psychologist. These two subthemes were described in detail, and their importance was emphasized by the mother of the pupil with TBI many times during the interview. The mother considers the mutual cooperation of the parents and parents’ full and active involvement in the educational process to be two of the key elements in supporting the maximum development and successful integration of the pupil. The cooperation takes place mainly with a teaching assistant and a special education teacher, on a daily basis, and then, to a lesser extent and according to their current needs, with other teachers or the school management. “At the highest level, it’s (communication with school staff) here. But, of course, it’s mainly my big initiative here—for me to show them how they can actually work with these children. But they are very accommodating and helpful, and they don’t have the slightest problem.”She also highly values the support and advice of the child psychologist, who has accompanied them and offered her help since pre-school education and has provided counseling services not only to her family but also to teachers, both in kindergarten and at primary school. “She, Doctor V (name of the psychologist), for example, when he was in the first grade, she was explaining to those teachers that he got tired very easily, so she told them to try to tie (immobilize) their left arm for the whole day, yeah. And really, one could see how it drains the brain, when you’re like… just working on one side. Well, one of his teachers really tried it and said that it’s a crucial discovery for them. They really could understand that he would only be able to sit there the fourth lesson, to be present there, but it’s impossible to require any performances from him.” The psychologist’s advice is also connected with providing enough time for relaxation and avoiding the pupil’s excessive overloading. “In the afternoon, he can relax with some of his TV series, which he likes. Then we have some learning, and then he likes to write about, for example, the series that he likes watching. He has piles of papers, where he has costumes, photos, the names of the actors and in which series they played, and so on. These are his interests. And time spent on learning? Minimum, really minimum. We do what is necessary for school, we mostly go through any subject that is needed, but only… the psychologist recommended to me just thirty to forty minutes, not to overload him, so we do this and that’s all.”The topic of respect for the special needs of a pupil with limited mobility both at school and beyond is also very important and helpful in the mother’s view. Other subthemes were a positive school and class climate, where the mother attaches an important role especially to the work of the class teacher and to the collective composition of classmates. Other subthemes were cooperation with school counseling facilities, the use of an individual educational plan, and use of support measures. They played a key role in the adaptation of the educational process according to the individual needs of the pupil, from curriculum modification, through the reduction of required outcomes, to the method of evaluating his performance. Another subtheme was parents working in health care, as the mother considers her and her husband’s medical expertise to be an advantage, as this facilitates their involvement in certain extracurricular school activities, such as participation in school trips and multiday school events.Last, but not least, was the importance of services provided by the special kindergarten, where the boy was placed shortly after the injury. At that time, the family needed a lot of support and professional help, and it was possible to get this only in a special educational environment (the boy was refused by a typical kindergarten). The mother appreciated the possibility of placing the pupil in this type of school when it was necessary and its benefits, such as professionals, therapy, and special equipment. “There was an amazing approach. He had speech therapy, canine therapy was there, then motor skills… they did it all in their own direction—I always agreed to all to them according to that educational plan… yeah. And I did only Vojta’s method (physiotherapy) myself.”


## 3.2. Barriers

Another broad theme was barriers. This theme contains subthemes such as architectural barriers at Czech schools associated in part with a lack of space for privacy or rest. (“He has only the sitting bag bought here, the relaxing one, and he can use the seats here, nothing more. I think it’s a bit missing at this school, even for the other kids there. Whoever would take advantage of it; I think that there is not any place where they could have a bit privacy, so it would be quite appropriate.”) Most of the Czech town primary schools are located in old buildings, which are not architecturally fully adaptable for educating pupils with limited mobility due to the absence of barrier-free access to the building, the presence of thresholds, insufficiently wide doors, absence of elevators, insufficient space in toilets and changing rooms, missing elevators, and other barriers. “Well, he actually uses his wheelchair only outside, when he needs to go on a longer route, so otherwise he wouldn’t be there (in this school) … they probably wouldn’t have accepted him, in my opinion, here at this school, if he couldn’t walk. There is actually nothing that… the stairs are actually up to the entrance door. The door to the school, in that main entrance, opens out, so for handling the wheelchair, it’s absolutely unsuitable.”Other subthemes were problems in the pupil’s enrollment system into a suitable group, factors leading to psychological discomfort of the pupil (e.g., stress caused by high school demands or by methods of pupil’s knowledge verification, inappropriate approach, or misunderstanding of the teacher), nonindependence, and self-care difficulties (or social problems), while their negative impact deepened with the growing age of the pupil and the pupil’s dependence on his mother.The mother mentioned some social problems connected with placing her son into the kindergarten with a prevalence of pupils with intellectual disability:“…in the special kindergarten, they put him in a class with intellectually disabled children and there he seemed to more or less remain exactly where he was, yeah, you know…. If I had the experience, the opportunity again, I would either wish to decide on a normal school with an assistant or a school for pupils with communication disorders, so…. There were some intellectually disabled children, some were also aggressive….” However, there were also some benefits of the challenging placement: “on the other hand, he was one of the best there, so they paid attention to him to the highest degree.”Concerning the self-care difficulties and their psychosocial impact, the mother mentioned “Well, going to the toilet, for example, he manages it, but of course he doesn’t poop there, he leaves it for home, and sometimes, he more or less kept urinating so that he didn’t have to go there either, but with his…. These are exactly the minimal problems that the others can’t see, but they are essential for us. Actually, I dealt with it with his psychologist, because he felt ashamed to undress completely at the urinal, for him it was a shame, actually, that he had to strip there. So he actually went to the toilet cabin, where are normal toilets, but there again were some troubles. At home, he is used to pee while sitting, but there again, for hygienic reasons, because he’s careful about himself, so maybe he didn’t hit it sometimes and urinated on the floor… so the teacher—he informed me, warned me, so…. But Norbert struggled with me again, he said he wouldn’t go to pee at school…. I thought that someone might have seen that he hadn’t hit it, and that it happened more often, so it was also uncomfortable for him. And these are exactly those social problems that this child bears with difficulty, you know.” In this case, this problem is also related to the pupil’s gender.


## 3.3. Active Life and Well-Being of the Pupil

This theme overlaps with the theme of “what helps,” but because it is not directly related to education, although it also affects it and has a much greater scope in the areas of influence on the student’s life and is linked to the efforts of the whole family, it is stated separately. Supporting the pupil’s active life at school and beyond, in his free time, had a positive impact on his well-being. The positive experiences helped the pupil in building peer relations because he could share experiences with peers, and they found common themes and interests. The psychological well-being of the pupil was reflected also in his school performance and in his self-esteem. In addition, some activities led to the expansion of knowledge and skills in various fields. The main role was played here by all family members, who supported the pupil in participation in various sports activities and games, as well as in creating opportunities to pursue his favorite activities and hobbies. “The whole family is involved. He swims; we have a pool, so he actually swims at home, and he does everything. We even skied with him until a certain age, till he managed it, because the ski boots actually kept him. But when he was taller, we didn’t manage to pick him up anymore on the slope, neither my husband nor me, actually, his height—it’s so difficult. If you fall, it’s easy, someone will help you and you stand up easily, but when he falls like a pancake, unable to use the movement, what a healthy person can do, he can’t, and so you have to lift 70 kilos up, it’s a lot of weight. So we haven’t been skiing like that for two years, we’ve already rejected that. But my husband goes to the frozen pond with him instead and he plays hockey, but he only has shoes, not the skates. And he’s a goalkeeper. He loves all activities and talks about it with enthusiasm.” In this case, this problem is also related to the pupil’s gender.


## 3.4. Decision Making

The most important moments of making decisions that the parents of the pupil with TBI had to face were associated with the choice of school at pre-elementary and elementary levels, and they are currently dealing with the issue of choosing another educational path that awaits the boy in two years, after finishing the primary school. In both cases in the past, they considered carefully the possible impacts of the choice on their son and consulted their decision with the pupil’s psychologist. Therefore, the first educational institution was a special kindergarten, and with the support of their son’s psychologist, they finally decided to educate their son at an inclusive elementary school. The mother said they appreciated the positives of both schools, while each was, according to her, the right choice, given the situation of the family and their son, as well as the son’s age. “Kindergarten? More or less, when we had to sign up for the pre-school educational system, we tried the normal kindergarten and there, they actually told me that the special kindergarten was needed, so actually the recommendation from the normal kindergarten made our decision.” “Well, it was very difficult to decide for the elementary school, but in my opinion he was the kind of a traumatic child, you know, his condition, so I thought his brain could develop and I didn’t want to let him stagnate completely, but of course on a very careful and thorough examination of our son and on a decision made with our psychologist, because I was already at that time of the kindergarten… she was already commuting there, so she reassured me… she is a supporter of inclusion of these children, so I let her to advise me not to take a wrong step….”


## 3.5. Participation

The boy’s mother found the participation of her son in all possible activities very beneficial and did everything to achieve his maximum participation. There were certain complicating facts that could not be eliminated, such as the movement limitation, due to which he could not participate in the ski training school course or have an individual educational plan, based on omitting some subjects, which were replaced by increased lessons to reinforce important school subjects in need. “He is fully integrated. He just wasn’t on the ski course, that’s clear.” “Instead of ICT, for example, they go to a lesson of English to a lower grade class, to 6th, and it is actually an English class, where the same teacher teaches them, so they get their assignments, which they practice and revise.”


## 3.6. Social Environment Approach

Even in modern society, the family faced prejudices, judgment at first sight, and inappropriate awareness of the needs of people with disabilities, resulting in an inappropriate approach to these people. It concerned not only the classmates and their parents but also some teachers or other school staff.Awareness of the needs of these children and their parents is still insufficient, and as the mother in our case pointed out, it would be appropriate to include education in this field in school classes so that children could learn from their childhood how to adequately approach these people and how to behave in different situations. “… my daughter told me that even if it’s a lame person, then the older pupils spoke about him that he was handicapped, he was retarded. And she fought for him, and always told them ‘no, he’s not’ and often, when she had a speech exercise at school, she talked about the prejudice towards those people that points to them and says that the person actually, yeah… that he should go away from that society. She fought for him a lot and thus opened my eyes a lot, because he is not disabled, or he is disabled, but it is a physical disability—this is a crucial word, so she trained the children in her class. But I met with situations like when I arrived with him in that wheelchair and the kids just made me a space, but no one told me ‘Could I help you? Should I hold the door for you? Do you need anything?’ No, I think that they didn’t know how to react promptly in that situation… that there is lack of talk on the topic of that kind in those ordinary elementary schools, yeah. When I came across it at the deputy’s office, and I told her that I thought it should be involved in education, she told me that it was on their parents to inform them. But they wouldn’t have experience with a disability, so….”Misunderstanding by some teachers was also a problem, and as this mother said, it was more about the older teachers, who had ingrained views, habits, and methods and did not incline toward any radical changes. “The young teachers take it completely differently. I have a great experience with a history teacher who came just after university and they had special pedagogy there and they are ready to solve this problem here and they take it completely differently, so there really was no such thing as a communication problem. With the older generation, it’s as if the person explicitly doesn’t have any empathy, it was often a complete struggle with them to outline the situation that would relieve me and him, like getting ready for school, and that he just would not have to deal with it in such detail.” “He actually has minimal outputs, and he can handle them at an A level, but then there is a problem with that teacher, because he doesn’t really want to give the A to him, because… how he can rate him an A, when he has a quarter of the information in his head, compared to the A of a healthy pupil.”


## 3.7. The Future

The theme of the future, in this case, was based mainly on the optimism of both parents on their practical and sober views associated with their son’s abilities and his development and on the important role that they attached to achieving the greatest possible independence and maximum life well-being of their son. The main aim was to avoid his stagnation and complete dependency. “And I think that these children have the same chances and opportunities if they have the supportive background at home. I’m very consistent and we are trying to return Norbert into the normal life as soon as possible. We want him to be happy…. As he already has a hard life, so this is a priority for me. The school is a huge burden for him, but on the other hand, the life will never be easy. So he has gone through something already, and I think it’s better when he already knows that there will be people like that and he will meet them, that life is not a bed of roses, but that there will be someone who will not try to help him or will not want to be ready for him. Adolescence is a period that is more complicated now and for those handicapped children, when you already know…. A lot of people, for example, ask me, or are surprised that I am willing to go through all that, but I think it’s like our task, if something like this happens here, we must give the child a chance and not actually write him off and condemn him at the beginning of his life.”The subthemes dealt with the choice of other education and future employment, independence regarding moving outdoors (his orientation and safe movement), the question of independent living and mastering self-service activities, defending his rights, and coping with shortcomings compared to the others. “The question of future is not easy for us at all. When he was a little boy, we didn’t think about it, but now, when he’ll go to the 8thgrade …so the plan is some kind of apprentice school, for sure. I don’t know where it will be at all. The basic information for me was that we could obtain subsidies from the EU for the employment of a disabled person. His psychologist helps me even here. She told me that if he was employed at a city or county office, where he would just carry papers from one office to another, or if he picked up the phones in our surgery and ordered patients, it would be a crucial step for the child. Especially not to leave him at home to stagnate. So, this is definitely my goal.” “I’d also like to let him live alone somewhere; you know. It can be in housing with assistance, but to let him be simply independent.” “…then there is the problem with his orientation in space, but on the other hand…. Again, with age, and as he gets older, he will learn. When he leaves this school that keeps us very busy, I will teach him how to go to places, how to behave in different situations, at the pedestrian crossing and… he actually has no estimate of the distance, that the car is going at a certain speed so that he can safely cross over. These are the things that are just awaiting me.” “So, I think we can be optimistic with his future, even people who are worse off can do it.”


## 4. Discussion

The mother in this study was fully convinced that inclusive education is very beneficial and that it contributed positively to the maximum development of the pupil, and similar experiences of parents of learners with physical disabilities were also reported in other studies [19, 20]. She attributed the success of inclusion mainly to the factors that helped, which repeatedly appeared during the whole interview. Supporting factors like, for instance, cooperation with the school and the maximum parents’ participation in the educational process were described here and also in similar studies focused on pupils with SEN [4, 19, 21]. Sufficient cooperation requires a consistent approach from the parent and characteristics such as assertiveness, optimism, or defensibility [22]. In addition, in this study, the mother also considered any expertise of the parent in a field compatible with the educational process useful and beneficial because, if the parent works, for example, in the healthcare sphere, as it was in this case, it is possible to easily involve the parents into the educational process, and both the pupil and the school staff can benefit from it.This study suggests that cooperation with parents and their (often time-consuming and demanding) efforts positively reflect in the teachers’ approaches to the pupil, the pupil’s academic results, and his relationships with his classmates, while positive school and class climate were also valued here, as well as in other research works [16, 23–25]. For this purpose, it is helpful to use any existing opportunity to increase the parent’s participation in education [26]. The presence of cooperative attitudes was highly valued by the mother in this study, whereas in some other studies these qualities were found missing [12, 27–29]. As the mother claimed, the professionals must believe in inclusion and the new generation of teachers may be essential for changing attitudes towards inclusive education.Demands on the parent’s active participation and interventions in education were also related to decision making, which was (from the parental point of view) usually associated with the choice of a convenient school, mainly the decision between special and inclusive environment, and, later on, the professional path of the child. Parents of children with special needs take every step influencing the future of their children more seriously and to a greater extent than most parents of healthy children, from their early childhood [30,31]. Adolescence is an important milestone in deciding on a pupil’s further education and future career, like in the case of healthy children, but parents of pupils with SEN need to also deal with the possibility of their child living on its own [32]. In this context, the mother in our study counted on the need for other planned goals with her son, including teaching him to handle safe movement in the locality of his residence and activities important for independent functioning, from the use of means of transport through going to doctor’s, shopping, and protecting his rights. Such plans for the future that appeared in this case are associated with this mother’s clear idea of her son’s future and her aim to support his highest possible independence.Decision-making between the two individual educational systems (inclusive and special) is also described in the experiences of parents of children with different types of physical disabilities (PD) [33–35]. In this study, we could meet positive contributions as well as barriers in both types of educational facilities. The problem of an inclusive environment in the Czech Republic is still in the absence of important services that are offered more so in special schools. In some periods of family life, these services may be crucial and influence the decision of parents for special school placement. On the other side, the population of students in Czech special schools transformed in the past 20 years. There is a prevalence of pupils with intellectual disability, autism spectrum disorder, multiple disabilities, and other serious conditions, as a result of the placement of pupils with a lower degree of special needs into mainstream schools. Considering these reasons, the synergy of special and mainstream education may be beneficial for many Czech families, and this benefit has also been reported in other studies [36–38]. However, the policymakers should consider the availability of special services for pupils with SEN and their parents too in the mainstream environment.Although the mother in our case study had a strong positive impact on the social environment, it is obvious that the attitudes of the social environment were not always positive. The pupil’s mother encountered various attitudes based on prejudice and a lack of awareness of people with physical disability and their needs in society, even among some teachers. Such barriers are reflected in many studies [27, 39, 40]. The pupils with SEN and their parents in the Czech Republic still face a number of obstacles in the mainstream environment [5]. A lack of experience and a long decades-tradition of educating these children, especially those with PD, in special schools have strongly influenced the thinking of people here, and these deep-rooted views, attitudes, and approaches to pupils with SEN still remain [41]. Some people’s attitudes, the lack of awareness of special needs in society, the lack of teachers with special pedagogical education in typical schools, and architectural barriers belong to the factors that make inclusive education more difficult, and although these are the topics that are being worked on, the situation is only slowly improving.Some troubles can be further associated with the lack of expertise of stakeholders. Similarly, the teaching staff that do not have the appropriate personal traits or expertise can harm the pupil because their approach can lead to stress and discomfort; it can negatively affect the pupil’s self-concept and can lead to a negative attitude towards the subject, learning, and school [12, 27, 28]. Nonindependence and self-care difficulties seemed to be the key problems in this particular case. The barriers of this kind as described in our study point to difficulties concerning the teenager’s intimacy, feelings of embarrassment, and shame, which strongly affected his self-concept and self-confidence. This school, which, in our opinion, is not any exception in the Czech environment and did not count on the low level of functioning, that is, in the usage of the toilet, and no one realized that the feelings he experienced when being watched by classmates, halfway undressed, or in the event of an accident (wetting the floor), reduced his self-confidence and his human dignity and this negative impact worsened with growing his age. There is a lack of privacy for these pupils in many other schools, as well as a lack of space to rest.A specific kind of barrier for pupils with a physical disability is the architectural barrier [27, 42, 43]. They usually play the key role in deciding on a convenient school in the case of a pupil with PD. For decades, there was a legal requirement to build barrier-free buildings in the Czech Republic [44], but because of missing penalties, this law was often ignored. Nowadays, many schools are laden with architectural barriers that can make the education of students with severe physical disabilities impossible.This study, despite a few obstacles, was dominated by positive views on inclusive education, which, from the pupil’s mother’s point of view, supported the pupil’s development and contributed to his quality of life. This is just one example, but it presented the ways how problems can be prevented, and possible obstacles overcome. In our opinion, future research could focus on the effect of strategies and approaches mentioned in this study for pupils with TBI. It is also possible to explore if such strategies may work for the inclusion of pupils with other types of SEN into the inclusive environment.The authors are aware of some limitations of the study. Although they are both experienced teachers of students with SEN, neither of them has deep personal experience with a pupil suffering from TBI in an inclusive environment. Therefore, to deepen the understanding of this case, they tried to use multiple sources of data, including the narration of the pupil himself. However, the low level of reflectivity of the pupil did not enable them to work with the data from this source as with complimentary information. At the same time, it was not possible to reach other family members.


## 5. Conclusion

This qualitative study brought a deeper understanding of the experiences of a mother parenting a son with TBI who is educated in an inclusive environment in the Czech Republic. The predominantly positive experience of the mother was strongly influenced by cooperation with the school, the maximum parents’ participation in the educational process, and support from the school staff. The parents need professional support from special teachers or psychologists, mainly in some transitory periods of a pupil’s life connected to decision making, for example, selection of the appropriate school. Moreover, it is important to focus on the overall experience of pupils with TBI including enjoyable free time and educational activities, as they contribute to better peer relationships, positive self-concept, and better school results.Even in the cases of relatively successful inclusion, there are some barriers and challenges, for example, a lack of intimacy (for self-care activities) or a lack of knowledge or positive attitudes of some important stakeholders, as we described in this case. Based on this study, the quality of inclusive education should be closely connected to the level of active participation of the pupil with SEN and their family experiences during the education process.


## 6. Consent

Written informed consent to participate in this study was provided by the participant. The inclusion of identifiable human data in this text is in accordance with the signed informed consent.



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*Source: 7986085-2022-06-27.xml*