Inclusive Approaches in Italian Early Childhood Education and Care: The View of Practitioners

: This study presents the Italian practitioners’ perspective on the inclusion of children with disabilities in ECEC. Historically, Italy had a split system (0–3 and 3–6 divisions); only recently was the ZeroSix Integrated System established. Seven 0–3-division educators and seven 3–6-division teachers were interviewed. Their responses were analysed through a deductive content analysis, based on the eight dimensions of inclusion proposed by the European Agency for Special Needs and Inclusive Education (2017). The themes which were mainly mentioned as crucial for promoting inclusion were a child-centred approach; inclusive teaching and learning environment; inclusive social environment; and family-friendly environment. These same dimensions were also said to be challenging, together with the implementation of materials for all children. The strengths and weaknesses in inclusive processes partly di ﬀ ered between the two divisions. This study enriches the literature investigating how practitioners implement inclusive practices in ECEC, also analysing the di ﬀ erences between the 0–3 and the 3–6 divisions.


Introduction
Early Childhood Education and Care (ECEC) expresses a social priority and represents the foundation for a high-quality education system [1].The child's right to obtain the best opportunities for their potential development is reiterated, as enshrined in the Convention on the Rights of the Child [2].UNESCO defined the values of inclusive education through the international campaign World Declaration on Education for All [3], promoting the right to education for all children and especially for those in conditions of physical, social, or cultural disadvantage.Inclusion is a process of addressing and responding to the diversity and needs of all children, through increasing participation in learning, cultures, and communities, and decreasing exclusion and marginalization from educational processes [4].In 2017, the European Agency for Special Needs and Inclusive Education [5] proposed an operational definition of inclusion in ECEC settings, by publishing the Inclusive Early Childhood Education Environment Self-Reflection Tool, focusing on eight dimensions (see Section 2.3 for a list of the dimensions and its contents).
High-quality ECEC is strictly linked to inclusion, as it reduces inequalities throughout the life cycle and participation in early educational programs is particularly significant for children from disadvantaged groups and/or with difficulties [6][7][8].Among children with difficulties, we should consider those with disabilities.According to the International Classification of Functioning, Disability and Health, Children and Youth version (ICF-CY) [9], disability is a restriction on participation in daily life activities, due to a poor fit between the person's bodily structures and functions and the environmental factors relating to the living contexts.This bio-psycho-social model, therefore, shows how promoting the participation of children with disabilities in the activities within educational contexts can be an important driver of social inclusion.Promoting participation first requires an adjustment of environmental factors to ensure that, for example, the contexts and materials in the services, as well as the relationships and attitudes towards children by the staff working in these services, are actual facilitators rather than barriers for the participation of all children.
Specifically, in the Strategy for the Rights of Persons with Disabilities, adopted in 2021 for the 2021-2030 timeframe [10], one of the eight areas of intervention concerns the education and inclusion of children with disabilities in regular education systems, also in ECEC.UNICEF's position paper The Right of Children with Disabilities to Education also calls on governments to invest in inclusive ECEC policies [11].An increasing number of children with disabilities are accessing ECEC [1], but inclusive ECEC programs are implemented with significant discrepancies among European countries [12].
In Italy, the path towards the inclusion of children with disabilities in ECEC has shown differentiated paces in nursery schools and kindergartens [13,14].Currently, the Italian ECEC system is split: historically, the division of services for children from 0 to 3 years has been mainly under the auspices of the Ministry of the Interior and the Ministry of Health and has been financed at a municipality level, while the division of services for children from 3 to 6 years has been in charge of the Ministry of Education and has been financed at a statal level.Recently, the Law 2015/107 and the Legislative Decree 2017/65 established the ZeroSix Integrated System, which is still under development throughout the country (Table 1).On the one hand, the split system had an impact on the dissemination of national curricula; while the first guidelines for the 3-6 division were published in 1991, the national curriculum for the 0-3 division was only published in 2021, as a result of the institution of the ZeroSix Integrated System (Table 1).On the other hand, the split system also impacted the inclusion of children with disabilities in mainstream education; in 1971, the Law n. 30 guaranteed the inclusion of disabled children in mainstream education services, for children from 3 to 6 years, while the same happened in 1992 for disabled children from birth to 3 years.Moreover, while the Law 1992/104 established the presence of an additional specialised teacher in classes with children with disabilities from kindergarten onwards, at the moment, the same position in nursery schools is regulated by regional, not national, norms.Finally, the presence of a split system is probably the main reason why in 2020 a unique national model for the Individualized Educational Plan, a mandatory document for children with disabilities in the school system, was published by the Italian Government, but only for children involved in educational services from 3 years upwards (Table 1).Consider the fact that, in the school year 2021-2022 in Italy, 1.4% of children attending nursery schools and 2.5% of children attending kindergartens had a disability [15,16].
Very recently, a few studies have analysed the view of European ECEC practitioners on inclusion, by using content analysis.Bouillet and Domović [17] interviewed 10 Croatian ECEC professionals about their experiences of inclusive education and the risk of social exclusion, and they found two main themes to define inclusion: "the values of personal and social development have taken first place" and the "emphasis on every child, regardless of their chronological age, developmental abilities" (p.960).Symeonidou and Loizou [18] interviewed seven ECEC teachers in Cyprus and found that the inclusion of children with disabilities pertained to three main elements: creating learning opportunities for all children, refusing the idea that there was just one normal way to learn; rejecting an ableist approach, which brought adults to think that some children were unable to learn; and responding to all children's needs by working with and through other adults.Roberts and Callaghan [19] collected 194 Irish ECEC practitioners' perceptions and attitudes towards the inclusion of children with educational needs.Inclusion was related to "actively involving [children] in all aspects of preschool life, at a level that can be adapted to the child's capabilities" (p.786), by creating learning opportunities and by responding to children's interests; also, the respondents reported the need for continuous training and support to develop inclusive competencies, as some of them were concerned about their ability to properly promote inclusion.In Sweden, 27 teams working in ECEC services filled the Self-Reflection Tool; the results showed that the themes of inclusion, belongingness, engagement, and learning were related to each other, yet evidence was lacking that they were fully realised for all children [20].
Based on these considerations, our study aimed to provide a picture of inclusion in Italian ECEC settings from the practitioners' perspective.The findings contribute to a deeper understanding of ( 1) what ideas practitioners have about the inclusion of children with disabilities and how they implement these during everyday practice; (2) what difficulties or critical aspects practitioners encounter in implementing inclusive practices; and (3) whether there are differences in inclusive practices between nursery schools (0-3 division) and kindergartens (3-6 division).

Procedure
From May 2023 to January 2024, 14 semi-structured interviews were conducted with 7 nursery school educators (0-3 division) and 7 kindergarten teachers (3-6 division), by a psychologist from our research team (BR).The interviews took place online and lasted about 45 min.The participants were recruited through contact with the setting leaders.Participants took part in the study voluntarily and signed an informed consent.
Anonymity was guaranteed.The research was approved by the Bioethical Committee of the University of Turin, Turin, Italy.

Participants
All the 14 practitioners worked in ECEC settings in northwest Italy.They were women between 28 and 62 years (M = 41.8,SD = 8.9).All had valid degrees to work in ECEC (five high school degrees and nine university degrees).There were six nursery school educators, four kindergarten teachers, two support teachers, and two service coordinators.

Measures
The semi-structured interviews were based on the Self-Reflection Tool [5] to provide a picture of the setting's inclusion, especially focusing on the social, learning, and physical environment.The Self-Reflection Tool addresses eight dimensions: (1) overall welcoming atmosphere, (2) inclusive social environment, (3) child-centred approach, (4) child-friendly physical environment, ( 5) materials for all children, (6) opportunities for communication for all, (7) inclusive teaching and learning environment, (8) family-friendly environment.Thus, the interview was made up of 16 questions (see Appendix A) to address the Self-Reflection Tool's dimensions.First, participants were asked whether the services were inclusive towards children and families; then, they were asked to focus on a specific child with disabilities they had recently worked with, and to answer questions about how they implemented inclusive practices.
The coding system was made of 8 categories, each of them divided into 5 or 6 sub-categories (Table 2).Each code can be assigned a "yes" or "no" depending on the fact that the interviewee explicitly referred to the presence or the absence of a certain category ("yes": "Being a disability nursery school in the past, we had a lot of material"; "no": "Often there isn't the money to buy the materials, so more budget would be needed to buy specific materials for certain children").
. The setting is safe and healthy for the children 3 ) 4.4.The furniture and equipment are suitable for all children 6 (4) 0 * In the table, the absolute numbers (i.e., how many times a code is mentioned on the whole interviews) and the weighted numbers in brackets (i.e., number of interviews in which a specific code is present at least once) are reported.

Data Analysis
The interviews were analysed using deductive content analysis [21]; the researchers built 8 categories and 45 sub-categories (i.e., codes) according to the Self-Reflection Tool's definition of inclusion (see Table 2).The software ATLAS.ti23.4 was used for coding and text analysis.First, each interview was analysed sentence by sentence, and the text of interest was coded.The frequency of each code (both "yes" and "not") was the frequency with which certain sentences were associated with specific codes.A single sentence might have been coded with multiple codes and not every sentence received one or more codes, i.e., "sentence" was not the unit of analysis.The data coding was performed independently by AM and BR on the text of all interviews; the percentage of agreement was 89.9%.The coders discussed and solved the disagreements.Second, the ATLAS.tiCode-Document Table function was used to compare the code frequency ("yes" and "not") between the 0-3 (nursery schools) and 3-6 divisions (kindergartens).

Results
We comment on the results of Table 2 which we consider most relevant for the objectives of our study.For each category, the two most cited inclusion practices (the most frequent codes in the "yes" column) and the most critical aspects (the most frequent codes in the "no" column) are reported.Subsequently, we present the most relevant differences between the two types of service (0-3 and 3-6 divisions).
Adapting materials to facilitate play and learning for all children was reported as difficult, e.g., "We could work on [inclusion] but we lack the primary materials such as books, pillows, ….".

Opportunities for Communication for All
Almost all participants referred to the presence of opportunities for communication for all, e.g., "Images were useful for us to understand him and to allow him to understand us.As verbal language gradually appeared, we started using pictures less and less.Images were helpful […] to make him acquire routines".The most positively mentioned aspect was the practitioners' effort to organise settings that allowed all children to communicate and use language.A difference between the divisions regarded the opportunity to communicate for children with different mother tongues, which was mainly mentioned by the kindergarten teachers.

Inclusive Teaching and Learning Environment
Participants mainly referred to the presence of an inclusive teaching and learning environment, e.g., "She liked painting, it was something she was very interested in […].In my opinion, it was a need because she had had little opportunity to move around and to have tactile experiences in the environment, so all the manipulative, creative, and sensory aspects helped her a lot".The majority of interviewees reported practices that allow all children to participate in regular learning activities and the observation and monitoring of children's engagement, learning, and support needs by the staff.This latter aspect, along with the use of diversity and children's strengths and resources in learning activities, was more frequently cited by kindergarten teachers than nursery school educators.Moreover, the all participants mentioned their dedication to acknowledging all children's efforts and achievements.

Family-Friendly Environment
Participants mainly referred to the family's involvement, e.g., "It is essential to create a trustful relationship with families; this is the basis.Starting with the settling-in phase, whether they primarily trust us, then it becomes easier for everyone".For almost all the participants, a family-friendly environment meant developing trustful relationships with families and giving parents opportunities to get involved in decision-making about their child's learning, development, and support needs.However, trustful relationships with families were also cited as critical, especially by kindergarten teachers, e.g., "It is difficult for us [to establish a trustful relationship with the families] because it is hard for them to accept that their child may have something that is not typical, especially when comparing him/her to other children… and when we try to point it out, they often feel attacked.Some accept it and go check the situation.Others feel attacked 'No, you are wrong, my child is not like that' so it is quite difficult".

Discussion
The current study contributes to a better understanding of what inclusion means for practitioners working in Italian ECEC settings and which practice could support or hamper the inclusion of children with disabilities.Semi-structured interviews based on the Self-Reflection Tool [5] were conducted and the qualitative content analysis revealed that the inclusion of children with disabilities was put into practice by the interviewed practitioners mainly by making all children and their families feel welcomed, personalising children's support for learning, acknowledging all children's efforts and achievements, and involving families in trustful relationships and decision-making about their child's learning, development, and support.
Regarding the welcoming atmosphere, ECEC practitioners paid attention to welcoming families and children and recognising their specificities, providing support and care.They reported that families were reassured by knowing that their child with disabilities would be "treated like everyone else", albeit respecting individual specificities.
Educational services should aim at making families feel well-received and accepted, welcoming differences as something ordinary [22].This aspect is fundamental and is clearly reported in an Italian ministerial document about ECEC (Pedagogical Guidelines for the Ze-roSix Integrated System and National Curriculum for Early Child-hood Educational Services, see Table 1), which highlights the role of educational services in welcoming and respecting everyone's uniqueness [23].Also, a welcoming environment and a nice setting are factors that might influence parents' satisfaction with a nursery school [24], as parents conceive high-quality settings where their children's needs are met to be a safe, bright, and joyful environment, which provides care and love [25,26].
In the current interviews, the availability of specialised personnel who adopted personalised strategies was frequently mentioned to facilitate children's inclusion.The support teachers were considered fundamental, because they did not just plan specific activities based on the child's particular characteristics, but they were also valid support in moments of particular difficulty, and they were perceived as figures who sustained the entire work group, as also reported by [22].Practitioners also stressed the importance of having additional or external support whenever needed; in fact, many recognized that the presence of specialised disability professionals helped promote synergistic work among experts to support children's needs.However, many participants complained about the lack of such a specialised figure, and pointed out how they often felt left alone, which is a critical issue that can be an obstacle to an inclusive environment, as reported by [20].
Moreover, all practitioners stressed the importance of making children's efforts and achievements visible and communicating them to the families.The professionals realised that, when talking about disabilities, they might concentrate on children's difficulties and failures, whereas it was essential to give value to strengths and progress and to give children explicit feedback to start a virtuous circle and encourage their continued participation, as reported also by [23,27].As also reported in an Italian ministerial document about ECEC, an educational context is inclusive when it values individual differences, recognizes and develops potential, focuses on the individual, and makes everyone feel active and involved in their own personal growth path [23].
Finally, almost all practitioners stressed the importance of getting families involved, by developing a good relationship, in decision-making about the children's learning, development, and support.The practitioners acknowledged the importance of collaborating with families to share the educational objectives they want to achieve with children, thanks to initial and periodic meetings, and also getting other professionals involved, such as neuropsychiatrists and speech therapists who work with the children.Indeed, building good cooperation by having regular communication between professionals and families is a key point of inclusion [28] to create a common educational goal, an aspect that both educators and families strongly value [24,26].This aspect is one of the central issues also reported in the Pedagogical Guidelines of Italian ECEC, in which explicit reference is made to the importance of mutual knowledge and communication between parents and professionals, and to the co-planning of educational paths, which are essential elements for creating a strong, cooperative education and building and maintaining trustful relationships with families [23].
The theme of a trustful relationship with families turned out to be a noteworthy finding, as it was cited both as a positive and a critical aspect in the process of inclusion.Collaboration with parents and consistency in educational approaches among adults are essential in supporting children's needs, as found also in [24].Furthermore, parents can find a source of support in the relationship with professionals, sharing their insights and concerns with them [26].However, sometimes, building positive relationships and communication could be challenging, as many parents struggle to accept their child's difficulties, e.g., "[The father] did not accept that his child had a problem, even if it was certified.Therefore, there was no dialogue with the father".Thus, many practitioners reported the fundamental need to accompany families toward such an awareness without making them feel judged.For parents of children with disabilities, experiencing a relational space where they can share both worries and joy for small daily achievements is an important form of support and ECEC services can be a privileged context for creating such a relationship with the practitioners [29].In many cases, in fact, ECEC settings are the contexts in which children's special needs and disabilities are actually noticed for the first time; recognizing them is often difficult for parents, and therefore the presence of sensitive, responsible, and competent educators/teachers is essential to start a constructive dialogue based on a positive perspective of the child's growth [23].
Notably, the Self-Reflection Tool allowed for an analysis of the environmental factors that support inclusion, which are fully coherent with the bio-psycho-social model of the ICF [9].The themes that emerged were mainly related to the factors "Products and technologies for communication" and "Products and technologies for education" (e.g., opportunities for communication for all, materials for all children, child-friendly physical environment) and to the factors "Support and relationship with people of position of authority" and "Individual attitudes of people in positions of authority", i.e., the practitioners of the services (e.g., overall welcoming atmosphere, inclusive social environment, child-centred approach, inclusive teaching and learning environment, family-friendly environment).
One of the objectives of the current study was to identify differences between the two types of services, the 0-3 and 3-6 divisions.We found that kindergarten teachers more frequently mentioned the effort to encourage children to develop positive behaviours toward peers, such as cooperative behaviours, or getting engaged in interactive play.Valuing and promoting prosocial behaviours are crucial to contribute to the development of a difference-conscious attitude that allows every child to feel recognized for her/his own characteristics [22].
Another aspect in which differences between types of services were found concerned the materials for all children; kindergarten teachers referred more frequently than the nursery educators to the presence of interesting, easily accessible, and engaging toys for all children.They also commented more frequently on encouraging children to play and share toys and materials with peers.Kindergarten teachers were more likely to offer children their favourite materials, which were also offered at home and so were more familiar.Moreover, they tried to serve as mediators when the children had difficulties accepting the presence of peers during play activities.
Regarding the opportunity to communicate for children with disabilities and with mother tongues other than the Italian language, kindergarten teachers underlined the effort and positive results that the children achieved in expressing themselves and being understood by peers and staff, whereas nursery school educators did not.In some cases, kindergarten teachers mentioned understanding children's needs through gestures.Helping children understand and use language is an important developmental aspect that practitioners generally care about [30].
The last aspects recalled more frequently by kindergarten teachers than by nursery school educators concerned the effort to create an authentic inclusive teaching and learning environment.Specifically, kindergarten teachers more often mentioned the use of diversity and children's strengths and resources in learning activities and the observation and monitoring of children's engagement and learning.This is in line with an integrated vision of the person, considered in their entirety, going beyond the diagnosis and highlighting the potential of the individual rather than their shortcomings, aiming to lead to a renewed perspective of inclusion [23].Moreover, kindergarten teachers often reported using strategies such as peer tutoring to promote the inclusion of the child with disabilities.Peer tutoring is useful for facilitating relationships among children and encouraging the gradual inclusion of the child with disabilities into the larger group.Moreover, it stimulates modelling and role-playing [22].Kindergarten teachers also stressed the importance of systematically observing children's engagement and support needs and documenting the observations using diaries in order to share information with other professionals and with families.Diaries are also useful for documenting the history and the identity of the children and for keeping memories of their growth [31].
Our study presents some limitations.First, a small number of participants were involved; therefore, we cannot generalize the results to all Italian educational services.Furthermore, we conducted a deductive content analysis, based on the eight dimensions of the Self-Reflection Tool, and a future inductive content analysis could discover other themes that were present in the interviews but were not detected by the coding system.Also, each question of the interview focused on some inclusion dimensions, and this might have raised certain responses and not others.Finally, it is possible that the practitioners' answers might have been influenced by social desirability.

Conclusions
The current study enriches the literature on the topic of inclusion in ECEC services, as it reports Italian professionals' points of view on their practices.Regarding the first aim of the study, in the practitioners' view, a central aspect of inclusion is that all children are equally welcomed and valued, while at the same time their individual needs and requirements are taken into account in the organization of everyday life and educational opportunities.As for the second aim of the study, according to practitioners, especially the availability of specialised disability professionals as well as a trustful and cooperative relationship with the children's families are critical for successful inclusive processes.Finally, concerning the third aim of the study, compared to practitioners working in nursery schools, kindergarten teachers more frequently mentioned supporting prosocial behaviours, fostering peer interaction, focusing on the ability to express oneself and being understood by peers and staff, and using peer tutoring to promote the inclusion of a child with disabilities.
Our paper contributes to the literature that discusses the view of European ECEC practitioners about inclusion.The current results are in line with what was observed in other countries.In Croatia [17], the themes that emerged, i.e., 'taking the values of personal and social development in first place' and 'emphasis on every child' seem to be pertinent with the dimension 'child-centred approach' that we reported.In Cyprus [18], the professionals discussed the themes of 'creating learning opportunities for all children' and 'responding to all children's needs by working with and through other adults', which are in line with the dimensions of a 'child-centred approach', 'materials for all children', 'opportunities for communication for all', and an 'inclusive teaching and learning environment'.In Ireland [19], inclusion was related to 'actively involving [children] in all aspects of preschool life, at a level that can be adapted to the child's capabilities', an aspect that also is in line with several dimensions of our analysis.Interestingly, in Sweden [20], the awareness that a full realization of inclusion is not actually present for all children also emerged and, in the current paper, this aspect has been evidenced for children with disabilities through the discussion of the presence or the absence of each category that was taken into account.
Since in Italy, historically, the ECEC system has been mainly split, our study analysed the differences in inclusive practices between nursery schools (0-3 division) and kindergartens (3-6 division); to our knowledge, no other study with the same characteristics as ours has been published to date.Beyond the specific differences in how each individual category was mentioned by nursery school educators and kindergarten teachers, the various dimensions of inclusion were cited in the narratives of the professionals, demonstrating how they shared very similar underlying epistemologies.
In conclusion, this study adds to the current literature on how practitioners implement inclusive practices for children with disabilities in different countries, and what barriers or critical aspects might hamper inclusive processes.Despite the critical issues, from the interviews in the present study, an idea of inclusion which is coherent with the aims of the ministerial document of Italian ECEC emerges [23], where the inclusion of all children within educational services should overcome the logic of mere "integration" of children with disabilities and should embrace a broader perspective of education that truly welcomes, supports, and values the differences of each individual.Welcoming the diversity and special needs of children is therefore a priority of ECEC services, which means recognizing the right to education of all children.

Table 1 .
Summary of the main legislative turning points for public education and inclusion in Italian ECEC.Children with disabilities' right to education from birth • The presence of a specialised teacher to support children with disabilities and the class as a whole from the maternal school upwards, while their presence in nursery school is regulated by each Italian region's legislation Establishment of the ZeroSix Integrated System (Law 2015/107 and Legislative Decree 2017/65) 2020 The Inter-ministerial Decree 2020/182 introduces a unique model of an Individualized Educational Plan based on the ICF biopsychosocial model for children with disabilities from 3 to 18 years 2021 Publication of the Pedagogical Guidelines for the ZeroSix Integrated System

Table 2 .
Occurrences of the coding system used for the content analysis.