More than Just Pictures: Using Picture Books to Broaden Young Learners’ Disability Understanding

This paper describes a research-intervention path that aims to deal explicitly and consciously with the topic of disability in the classroom, providing children with honest images of disabilities in order to stimulate their awareness, understanding and acceptance. The project, realized by Primary Education Degree students in some Aosta Valley schools, was based on the use of picture books as an educational mediator in which images and text merge together to tell a story, thus becoming a tool used to deal with complex and delicate subjects that characterize the reality in which every child lives, including that of disability.


Introduction
Tackling a sensitive subject like disability at school requires, in the first instance, the teachers' willingness and their awareness of the importance of dealing with it in the classroom and of the educational and didactic implications of such programs on children.The Italian school, characterized by a long tradition in inclusion of children with disabilities, has always promoted maximum inclusiveness for everyone; it now needs the structuring of specific and peculiarly organized proactive interventions, so as to provide children with specific, accurate, and honest images of disability by using specific didactic mediators, in order to stimulate their empathy.
Among such tools, picture books are an essential resource often used as a teaching tool for primary students [1,2], especially for challenging contents [3]: teachers use picture books to teach topics as diversity, bullying and acceptance, and similarly, picture books portraying children with disabilities provide a viable tool for addressing disability.Illustrations in these books are particularly important for children because they look at pictures before identifying and understanding messages in written language [4].

Picture Books, Some Features
A picture book is a device composed of morphological and functional features, which combine written and illustrated languages, design skills, metaphors and visions of the world, energies that together contribute to the production of a physical object [5].It refers to books containing both texts and illustrations that together tell a story, or represent objects and environments, or expose concepts [6].
The meaning is created and transmitted through the interaction between words and images [7,8] the written and iconic parts establish continuous references and recalls between them, so to define an indivisible whole, where neither of the two expressive means has its own narrative autonomy [7][8][9].
Illustrations in children's picture books have been perceived as being 'on equal footing' with the text.Readers make meaning from both the text and the illustrations, and this process involves moving back and forth across these systems to fully comprehend a book [10].Illustrations can help determine the mood, define and develop the characters or the plot, provide a different view-point or reinforce the text or the story [11].
Picture books are powerful and popular in the world of educating and caring for young children [12].Beyond skills development, the words and illustrations in children's books can serve as means for developing children's identity and sense of self, and their understanding of other people and cultures as well [13].Looking closely at the illustrations, as well as the text, can be revealing of the ways in which the characteristics of individuals, communities and cultures are represented.
The picture books are also considered by many authors [14,15] as one of the most effective mediators in order to communicate both cultural messages and society values to children and as an interesting tool in helping the understanding of the world and in addressing complex issues which could characterize the reality in which each child lives.

Disability through Picture Books: Theoretical Framework
Disability and difference have always been dealt with picture books, and interest has been increasing especially in recent years: stories without any kind of commiseration, where the protagonists are children with autism, deafness, or Down syndrome who deal with everyday life [16].These picture books do not have a didactic tone, nor any form of pity, they do not teach or explain, but they show situations and events in order to make the readers become aware of disability and make them think.The picture books can be an interesting teaching tool, used for a specific didactic purpose with a specific instructional strategy to tackle the topic of disability, soliciting and building moments of dialogue and reflection with which children can compare their own images and ideas of disability.These books reflect everyday life and amplify children's knowledge by offering new narrative experiences of disability.
Using picture books in the classroom is useful to introduce children to the characteristics of their peers with disabilities, in a delicate way which may lead to positive impacts on student acceptance [1].All students benefit from increasing awareness and identification of the characteristics, strengths, and challenges experienced by students with a disability; children's books about disability provide an accessible tool for modeling and encouraging positive and accepting relationships among students.These picture books and the characters in them can also serve to enhance the classroom environment by highlighting diversity, social justice, acceptance, and empathy for students with disabilities [3].
Through book-reading and discussions, teachers can promote disability awareness by leading to greater understanding about individuals with disabilities, and provide all children in the class with a vocabulary that is current, appropriate, and relevant.These activities could include books depicting pictures and stories of children with disabilities, introducing children to sign language, or using visual supports to increase understanding and participation of all children.However, choosing appropriate books about disabilities and using them effectively to facilitate the understanding of children with special needs can be a difficult process [17].
Storybooks about children with disabilities may be beneficial to the early childhood experience for two reasons.First, exposure to information about disabilities increases children's understanding about human differences.Young children have often limited or incorrect understandings about individuals with disabilities and of the adaptive equipment associated with the related impairment [18,19].Through book-reading and discussions, young children can learn about individuals with disabilities they have not personally encountered, get in touch with the terminology associated with disabilities, and receive information about relevant adaptive equipment: this will help clarify misconceptions.A second reason for early exposure to information about peers with disabilities stems from the fact that such exposure can increase children's acceptance of the fact that children may show varying degrees of abilities [20].
Reading books about individuals with disabilities constitutes a natural extension of real-life experiences with students who have special needs; this book-reading activity also provides a vehicle for discussion and reflection.For young children who do not have regular contact with students who have some kind of impairment, reading books about disabilities at home or at school may provide an important platform for discussing issues of similarity and difference at an early age.

Disability through Picture Books: Theoretical Aspects of an Educational Proposal
The presence of children with disabilities does not guarantee itself the emergence of spontaneous peer interactions and the development of positive attitudes towards such a delicate and complex theme.This is because just being present in the same setting does not necessarily result in positive attitude toward peers with disabilities [18].The attitudes of a subject towards persons with disabilities can be conceived as complex multicomponent constructs learned from direct experiences (such as meeting an individual with disabilities) and indirect experiences (such as books, media, and conversation about individuals with disabilities), and are highly influenced by the child's primary social group [17].
In the literature review, there are several educational proposals [1,[21][22][23] that aim to promote acceptance of peers with differences, including disabilities by using picture books.This goal is achieved through different and linear paths that are conceived around three theoretical constructs: awareness, comprehension and acceptance.
Using this theoretical framework identified in the studies analyzed, the proposition presented in this contribution this article represents an educational path based on the use of picture books and built around these three constructs, awareness, understanding and acceptance.The three constructs are placed, unlike the settings analyzed, in a context of interconnection and circularity with increasing complexity; this means that they certainly do not represent the logical consequence of the other, but rather skills that are built and completed each other.The desire to understand the other, for example, can be the last step of the awareness on which to return then when the understanding grows again.These three constructs are explained in the following part.

 Awareness
Children live ever since in contact with the diversity of the human being.Such contact, which can also be represented by the presence of classmates with disabilities, can facilitate the development of an 'awareness' of this fact; awareness is defined as 'knowing that something exists and is important' (Oxford Advanced Learner's Dictionary, 2015).This natural development can also be increased thanks to specific 'awareness programs', as a the first step in promoting positive and accurate perceptions of persons with disabilities [24].Some guiding questions can be significant in designing these programs: "Are there physical and attitudinal barriers that need to be broken?Are the students aware of similarities as well as differences?How do students interact with their peers with disabilities?…" [24] (p.3).These questions, considered represent the starting point to structure didactic interventions with two fundamental objectives: understanding what is it like to live with disabilities and accepting individual differences.The achievement of these aims is more probable if the activities proposed by teachers promote positive contact experiences combined with the provision of information and knowledge on disabilities.

 Understanding
The Oxford Advanced Learner's Dictionary (2015) proposes different definitions of the construct of understanding: (1) "the knowledge that somebody has about a particular subject or situation" and (3) "the ability to understand why people behave in a particular way and the willingness to forgive them when they do something wrong".If the term knowledge, therefore, suggests a superficial level of knowledge as limited to knowing the existence of something, the term comprehension suggests a higher level of involvement by the subjects [1].Referring to the second definition given by the dictionary, it is evident that the ability to 'understand why' can not be regarded as simply innate, but it is also based on the knowledge provide by the environment to the subject and may also be characterized by the presence of misunderstandings and overgeneralizations [25].For this reason, it is important that children are helped through specifically designed activities to develop in-depth an accurate knowledge on disability and its related aspects.In this sense the use of picture books allows the child to explore everyday life and the challenges faced by the protagonists to better understand him or herself, his/her feelings and others' [1].By telling the ordinariness of the experiences of these characters, it is possible to start, as suggested by Boutot [26], discussions and activities about how the protagonists move, act, learn and relate and also to providing children with precise and specific terms and information on disability.

 Acceptance
Acceptance-the last of the three considered constructs-can be defined as "the process of allowing someone to join something or to be a member of a group" (Oxford Advanced Learner's Dictionary, 2015).Accepting a subject from the perspective of belonging to a group is an important outcome of inclusive education, and it has been defined as "taking a full and active part in school-life, be a valued member of the school community and be seen as an integral Member" [27] (p.117).Acceptance depends on several factors, such as the tolerance feeling in the group or the absence of violent and aggressive attitudes, including the two theoretical constructs described above [26] and, at the same time, it has its own autonomy because many people can be aware of human diversity and can understand the nature of specific disabilities but never come fully to accept those who are different in one way or another [1].In this sense, it is not to be understood as the automatic result of an educational path, but it continually requires that educational action is oriented to provide the child with opportunities for training and chances in which to freely choose to live adequately the co-existence with persons with disabilities.Finally, acceptance is also the basis for building friendship relationships, acceptance of children with disabilities is a precursor to the growth of friendship [26] and from which it begins to increase awareness and desire for greater understanding.

Disability through Picture Books: A Didactic Proposal
The University of Aosta Valley (IT), in the initial training for future infant and primary school teachers, has structured a traineeship course linked to the Course of Inclusive Pedagogy with the aim of providing knowledge and skills in a totally inclusive perspective to the university students.
The apprenticeship project has been developed during the second year of the training course, lasted 15 h, and aimed at leading students to use a specific teaching tool, the picture book, with the purpose of introducing the theme of disability in the infant and primary school classes, giving children the possibility to discuss and reflect on disability.
This project is structured on the basis of the theoretical framework illustrated above and based on the constructs of awareness, understanding and acceptance.
This first experience aims at investigating: • the availability of school teachers and university trainees to tackle the topic of disability in the classroom; • if and how the theme of disability is already treated in the classroom through specific activities; • if this topic is addressed through images and which ones; • if the used picture books give children more knowledge about general or specific aspects of disability; • the potential efficacy of the picture book as a teaching functional mediator to talk about disability in the classroom.

Participants
The experience involved 12 teachers and 22 university students, organized in groups, who worked in 2 primary schools and 8 infant schools located in the Aosta Valley.In all classes there was at least one child with a certified disability.Children with disabilities who were involved: 1 pupil with Down syndrome, 1 with hearing disability, 2 with intellectual disability, 3 with Autism Spectrum Disorder, and 2 with Oppositional Defiant Disorder.

Selection of Picture Books
After an analysis of the existing book proposals of the most important Italian publishing houses (Arnoldo Mondadori, Salani, Giunti, Feltrinelli, …), addressed to children between 3 and 10 years, a first list of picture books was produced.The basic condition for including the book in the list was the presence of at least one character with disabilities.However, niche publishers have also been identified (Open City, Uovonero, Kalandraka, …), which have many books concerning disabilities in their catalogs.
The inclusion criteria used to select the picture books were: a. the character with disabilities is human (not an animal or animated) and preferably a child; b. the book is addressed to the 3-6 or 6-10 age range; c. the book is relatively recent (edited after 1990); d. the overall design, the images and the photographs are credible and realistic.
The final list contains 56 books, that were identified by title, author, year, publishing house, brief abstract of the history and type of disability presented.Most of them have been purchased.In comparison with the initial list, some works were selected (Table 1) also related to the disability presents in the class.This choice was agreed with the tutor teachers who supported the activities in the classroom, in a dedicated meeting.Previously to start this activity, the trainees had presented themselves to the classes, and spent some time to observe the contexts and the classes.

Research Tools
In the first year of the experience, it was considered appropriate to identify some tools for initial monitoring of the use of the picture books.Three tools were identified and developed to investigate the teachers' propensity and willingness to speak about disabilities in their classrooms and the appreciation of the proposal by pupils and trainees, and to highlight strengths and critical points in view of planning further developments of this initiative:


a questionnaire addressed to teachers;  children's drawings (including, for the primary school, also brief written comments from students on some aspects of the proposal);  final reports written by the university trainees.
The questionnaire, sent by mail to all involved teachers, consists of 18 open-ended questions to investigate the willingness and intent of teachers to:


talk about disability within their class group (e.g., Before this apprenticeship did you already have a chance to talk about disability with your class group?If so, which kind of didactic activity did you realize?Which methodologies?Which materials?What were your motivations in activating such a path?). provide information on any questions asked by children about this topic (e.g., Did children of your class spontaneously ever ask questions about their peer's disability?Did children in your classroom spontaneously ever ask questions on disability in general?).
The drawings (defined with the expression 'disability cards') were realized after reading the picture books.Through them, children were able to represent the characteristics, difficulties, abilities as well as the technical aids of the story characters.The evaluation of the information obtained with the use of this tool includes also the analysis of the comments written by pupils on the drawings; they were mainly simple sentences produced by children that express their level of appreciation of the stories and of the activities proposed.
The last survey tool is the final report written by the trainees.It is an elaboration that is drawn up at the end of each apprenticeship experience and is divided into three areas: organizational aspects, reflections on experience and self-assessment.

Procedure
The picture book was presented to children by the trainees: it was shown and introduced by asking them to make predictions about its contents and inviting them to expose ideas and opinions about the subject.
The reading was followed by a guided discussion with specific questions, centered on three main elements: the story contents, the type of disability and its vocabulary, the similarities between the main character of the book and the character.
The next step was the development of the disability cards of the character; pupils were asked to draw some specific elements of him/her: his/her portrait, the difficulties encountered, his/her strength and/or the supports or the technical aids represented.Subsequently, children were involved in activities aimed at investigating certain aspects related to the disability of the character, such as the ability to write their own name with the Braille alphabet in the case of visual impairment, or to build a paper model of a wheelchair in the case of motor impairment.During the last moment, the pupils were involved in a game-"capture the flag"-not in its original version but with different variations, in order make the children experience themselves the difficulties or limitations associated with the disability presented in the picture book.
In some cases the trainees, in agreement with the teachers and the teacher tutor, decided to propose more than one picture book.
The picture book and its character accompanied the pupils throughout the project, and each time, at the end of the lesson, the story was re-read and commented again with the class, in the light of the new reflections and the increased awareness reached thanks to these activities.

Discussion
The answers of the questionnaire that a substantial availability by teachers to talk about disability in the classroom as well as the childrens interest in this topic.However, specific didactic activities previously realized have not been reported.Only a teacher stated that he had used the picture book Pezzettino (Lionni & Marconi, 2006) to address this issue.This is a significant response as the book in question suggests a reflection on diversity in general and not on disability in particular.
The use of picture books approaching the theme of diversity appears to be widespread as it has emerged during the project presentation with the university students and the school teachers.Some students, in particular, during their first experiences as provisional teachers, said they usually use picture books, including Le loup qui voulait changer de couleur (Lallemand & Thuillier, 2009), Jean de la lune (Ungerer, 1969) and Elmer: l'elefantino variopinto (McKee, D. 1990) to talk about disability; however, a shared reflection on these texts has shown that these are interesting proposals on the publishing market to address the issue of differences but not precisely that of disability.In these texts the protagonists are not children with disabilities, but animals or beings with particular features.From a future point of view, it will be useful to foresee a re-formulation of the questionnaire by putting questions that explore in a distinct manner the approach to diversity and disability.
The drawings allowed children to reflect on the fact that not all disabilities are characterized by obvious somatic traits or by the presence of a technical aid: in fact, children have found it relatively easy to independently visualize hearing impairment (represented by the cochlear implant), but had considerable difficulties with the oppositional defiant disorder and they needed the continuous mediation of the adults.This aspect is related to the construct of understanding; in fact, especially in young children, the understanding of disabilities is probably dominated by visible, concrete elements.Moreover, the ability to draw technical aids has allowed children to enrich their vocabulary with specific terms.
Drawings allowed to catch some of the elements related to the understanding of childhood disability; however for a future development of the research, it would be desirable to have specific tools to be used directly with children to capture their pre-knowledge and their representations.In addition, the realization of this didactic activity revealed the need to consider more in-depth the criteria for choosing the picture books as well as the methodologies to use them in the classrooms in order to modify or enrich the disability representations in children.Primary school children added to the drawings some writings about their liking on the proposed activities and the picture books, expressing their interest in images and texts.The analysis of these outputs allowed us to grasp, overall, the appreciation of the proposed project, highlighting the substantive success of the experienced activities.
The analysis of the final apprenticeship reports, drawn up by the university trainees, highlighted some strengths and some critical points of the experience.A first element, common to almost all reports, is the interest in the project shown by the teachers: "We have noticed a particular involvement and participation also by the class teachers and support teachers who were curious and amused by the proposed activities".This interest, which finds a substantial correspondence with the teachers' answers to the questionnaire, has not always been put into effect with the actual availability to deal with specific disability like motor impairments: "the construction of the wheelchair was not possible because the support teacher considered it inappropriate to do this kind of activity".
This difficulty seems to be correlated to the type of impairment that should be presented to the children and as a consequence to the choice of the picture book.On the whole, seven on the eight groups of trainees analyzed the theme of the oppositional defiant disorder by reading the picture book Che rabbia!This choice is not exclusively related to the disability presents in the classroom (2 oppositional defiant disorders over 8 pupils with disabilities), but to the fact that, as some students pointed out, "teachers, although willing to deal with this issue, then expressed their perplexity or reticence to treat a specific disability and preferred to work on more general issues such as rage and emotions".This choice, in some cases, has in some way distorted the objectives of the apprenticeship, leading for example one students to write: "This internship was, in my opinion, very interesting as it allowed to speak and to make everyone aware of a difficulty, in this particular case of anger management, a difficulty that can, in a different way, concern everyone at any time of the day".Such an orientation obliges, in the future, to share the theoretical framework and the project objectives more in-depth with the trainees and the teachers and to monitor more strictly the choice of the picture book.
In comparison with the list of books proposed, those actually used were four: Che rabbia!, Il pentolino di Antonino, Laura and Gli occhi neri.The first element that emerges from some of the reports is that the picture book has proved effective in motivating the pupils: "Even those children who during our period of observation and the moments of group work seemed to act in a less attentive way in their class, proved were active in listening and analyzing the book".All the reports present also considerations on the strengths and the critical aspects of the adopted books.For what Che rabbia! is concerned, many teachers and trainees have highlighted "the strong communicative power of images".However, the way in which the hero's (Roberto) anger is illustrated, represented a problem for children: "For most children, anger, coming out of Roberto's mouth, became a sort of stranger, separated by the protagonist (it is represented by a red monkey!)".This thought obliges to identify, for the future, some criteria to analyse these aspects in a systematic and scientific way.
As to the picture book I disegni della principessa Annabella, (where the protagonist is a girl with Down Syndrome) some trainees highlighted how the written text prevailed over the iconic code, making it difficult to read them simultaneously: "The greatest difficulty I encountered in this experience was, while reading the story, to focus the attention of children on the character's traits of the protagonist of the book and try to make them think about similarities and differences without facing the issue of disability: the children did not really appreciate these details because they were more interested in the story, also because they probably did not seize anything different from them in the of iconic representation of the little girl".The illustrations did not help the children in their understanding: "Even the pupil in the class who has a sister with a Down syndrome did not associate her sister's distinctive features with those of the protagonist Annabella".
Again with regard to the images, the following reflection was made concerning Occhi neri, a book on a child with visual impairment: "In fact, I was also initially frightened because I was afraid that, for second grade primary children, the book would be too strong at the image level".
From these first analyses, the picture book seems to be an interesting and very promising educational mediator to tackle the issue of disability.However, it will be necessary to investigate more and critically the iconic and textual elements of this instrument, as well as the didactic methodology to adopt for presenting them in the classrooms.

Conclusions
In our view, it is crucial to address the issue of disability in the classroom for pedagogical reasons, concerning the construction and cohesion of a group of pupils able to recognize with awareness the differences, all included, even the most 'special' ones concerning disability [28,29], and to include them appropriately and authentically [30].Other reasons include the adoption of a care attitude to human growth [31] in order to implement the civic role of all pupils, which also implies increased co-responsibility [32].It is crucial to address the issue of disability in the classroom also for sociological and social psychological reasons applied to disability, since it is known that by concealing or not recognizing it, it is a serious damage to the individual's growth of identity and the awareness of community, which is not helped to perceive and deal with disability naturally [33].There are also educational policies and didactic reasons in supporting and revitalizing (even re-establishing) the inclusive choice of the Italian school, which demands new energies that make sense, and allow them to face new obstacles to their journey [34].
Using children's book as a resource is common in primary school and could address and increase awareness and acceptance of disability among students.This work is intended also to invite teachers to feel more comfortable in using picture books that portray children with disabilities in their classroom as a teaching tool for learning about and understanding disability.By acknowledging and openly discussing the issue, disability may become part of a celebration of the overall human diversity-and not characterized by as tragedy [35] and commiseration.By including this kind of picture books into the classroom through read-aloud and discussions, students are introduced to characters who show empathy and acceptance toward peers with disabilities, and they are offered the occasion to learn to appreciate both differences and unique specificities in all individuals.

Table 1 .
Selected picture books.