Table 2.

Overview of educational interventions involving educators with disorders of intellectual development and their impact on learners

Study / review number	Reference	Designb & Analysis methods	Sample size	Aim / questionc	Role of individual with Disorder of Intellectual Development	Key findings
1	[27]	Design: Qualitativ (Online survey, focus groups, expert interviews) with teaching students. Analysis Methods: Qualitative content analysis	N = 78 (Students only; Online survey: n = 62 Focus groups: n = 13 Expert interviews: n = 5)	To highlight the impact of educational offers by co-teachers on teaching students from the students’ point of view	Role: “Bildungsfachkräfte” (BFK); engl.: “Educational Experts“ Educational experts with lived experience of disability (BFK) are integrated into higher education teaching following a three-year qualification program, subsequent to their prior employment in sheltered workshops for people with disabilities. Within educational formats, BFK share their experiential knowledge and relate their perspectives to key concepts such as participation and accessibility. In doing so, they provide insights into their lived environments and enable participants to engage in direct dialogue with them.	Effects of inclusive teaching on students; three main categories: 1. “interpersonal skills (e. g., perspective taking), 2. perceptions on inclusion and persons with disabilities (e.g., self-reflection), 3. Professional knowledge (e. g., behavioural intention as a teacher)” (Mechler et al. 2023, S. 198)
2	[25]	Design: Quantitative (Pre- and Post Tests with medical students based on „The interaction disabled persons scale” (IDP) Analysis Methods: SPSS v11, repeated measures t-test (1-tailed)	N = 128	To evaluate changes in the attitudes of medical students towards people with developmental disabilities after participating in a communication skills training.	Role: Tutors wih intellectual disability (ID). Tutors with ID engaged in direct interaction with students following a structured teaching session. This session comprised an initial lecture providing a thematic overview of intellectual disability, followed by facilitated contact with tutors with ID, and concluded with a guided communication exercise. Accordingly, tutors with ID constituted an integral component of the intervention, which was evaluated using a pre–post study design.	The study demonstrates a small but statistically significant improvement in medical students’ comfort with interacting with people with developmental disabilities after a single 3-hour communication skills session, as measured on the Interaction with Disabled Persons Scale (IDP) and supplemented by qualitative student evaluations. The primary outcome was change in self‑reported discomfort in interactions with disabled persons, assessed with the IDP before and immediately after the session.DP total scores can range from 20 to 120, with higher scores indicating greater discomfort in social interaction. In this cohort of 128 fourth‑year medical students, mean IDP scores decreased from 73.7 (SD 10.6) pre‑session to 70.41 (SD 10.2) post‑session, indicating reduced discomfort. A one‑tailed repeated‑measures t‑test yielded a statistically significant result, t(127) = 5.07, p < .001, confirming that the observed reduction in scores is unlikely to be due to chance. Although effect sizes are not explicitly reported, the mean change of approximately 3.3 points on a 20–120 scale, relative to the baseline standard deviation of about 10.6, corresponds to a small within-subject standardized mean difference (roughly one-third of a standard deviation), suggesting a modest but measurable attitudinal shift at group level. IDP has previously demonstrated acceptable internal consistency (Cronbach’s alpha 0.74–0.86) and a six-factor structure, but they did not re-estimate reliability or factor structure in this sample.
3	[24]	Design: Quantitative (Pre- and Post Questionnaire, German version of „My Thinking about Inclusion (MTAI-D)) Analysis Methods: IBM statistics 22, t-Test, ANOVA	N = 45	To evaluate the impact of courses given by Individuals with Disorders of Intellectual Development on teaching students attitudes towards inclusion and their self-effectiveness.	Role: Educational Professionals In the seminar “Nothing About Us Without Us – People with Disabilities as Experts in Their Own Right,” educational professionals from the Inclusive Education project engage in practical encounters with students. Two of the six educational professionals independently and alternately conduct the seminar, contributing their expertise to academic teaching. They present the “Inclusive Education” project, illustrate the life trajectories and everyday experiences of people with disabilities, and engage students in discussions about personal experiences, interests, aspirations, their professional work, and living situations.	The study reports that participation in a semester-long seminar taught by educational specialists with intellectual disabilities is associated with high self-efficacy ratings and some item-level, but not scale-level, statistically significant changes in attitudes towards inclusion among pre-service teachers. The study used a pre‑post design with two measurement points within a single group of Bachelor‑level pre‑service teachers enrolled in the compulsory module “Heterogenität – Umgang mit Differenz” at Europa‑Universität Flensburg. The analytic sample comprised N = 35 students (66% women), aged 20–39 years (mean 23.48, SD 3.13), on average in the 4th semester (mean 3.93, SD 1.82). Attitudes towards inclusion were measured using the German version of “My Thinking about Inclusion” (MTAI‑D), which comprises three Likert‑type subscales: Core perspectives, Expected outcomes, and Classroom practices (19 items, 1–5 response format, higher values indicating stronger agreement). Teacher self‑efficacy was measured using Schwarzer & Schmitz’s 10‑item Lehrer‑Selbstwirksamkeitsskala (1–4 response format, higher values indicating greater self‑efficacy). Additional items captured previous contact with people with disabilities, prior inclusion‑related courses, and a single global item (“Hat sich Ihre Einstellung zur Inklusion … verändert?”) rated on a 6‑point scale. In response to the global change item, students reported a mean of 3.65 (SD 1.39) on a 6‑point scale, indicating that, on average, they “rather” agreed that their attitudes towards inclusion had changed through the seminar. 56% of respondents stated that their attitude had changed. For all scales, there were no statistically significant pre‑post differences at the scale level (paired‑samples t‑tests, p > .05 for all). The reported means (M) and standard deviations (SD) are: Expected outcomes (attitudes regarding learning gains of pupils with special needs in inclusive settings): T1: M = 3.28, SD = 0.67 T2: M = 3.41, SD = 0.49 Slight shift from “partly agree” towards “largely agree”, but not statistically significant at scale level. Classroom practices (perceptions of classroom impact and demands): T1: M = 2.37, SD = 0.49 T2: M = 2.29, SD = 0.54 Means remain clearly below the neutral midpoint (3.0), indicating rather negative expectations regarding inclusive classroom management; change not significant. Core perspectives (fundamental stance towards inclusion): T1: M = 3.65, SD = 0.46 T2: M = 3.73, SD = 0.51 Both time points above the neutral midpoint, indicating generally positive core attitudes; change not significant. Teacher self‑efficacy: T1: M = 3.18, SD = 0.36 T2: M = 3.14, SD = 0.34 Means close to “rather applies”, indicating overall high self‑efficacy; no significant scale‑level change. Paired‑samples t‑tests (two related samples) were calculated for each of the four main scales (Core perspectives, Expected outcomes, Classroom practices, self‑efficacy) between T1 and T2. None of these t‑tests reached statistical significance at α = 0.05; the authors explicitly state that the changes in scale means were not significant.
4	[29]	Design: Qualitative analysis of findings and discussion from two projects involving students and people with learning disabilities in a 3-year learning disability nursing programme. Project 1: questionnaire Project 2: Focus groups (students and people with Disorders of Intellectual Development) to evaluate the involvement of people with Disorders of Intellectual Development in educational activities Analysis Methods: EPICURE as a qualitative analysis framework	Project 1: questionnaire (n = 29, 29% response rate)	To illustrate a qualitative evaluation of including people with Disorders of Intellectual Development in educational courses in context of a 3-year learning disability nursing programme.	Role: Service Users (SU) Service users contribute to developing a faculty-wide service user strategy and are expected to represent as wide a diversity as possible within the learning-disability population. They help to plan and evaluate the course via workshops and recorded (video) input, thus influencing content and pedagogical design. Commissioning of courses: Course development and commissioning are explicitly driven by, and responsive to, the aspirations and wishes of service users through formal consultation processes. This positions people with learning disabilities as agenda‑setters rather than passive consultees. Marketing & publicity: Service users are “willingly and positively” involved in endorsing and marketing courses, indicating an ambassadorial role that supports public representation of the programme. Recruitment and admissions: Service users participate as key members of staff and student interview panels and share in decision‑making, embedding their perspectives into selection processes. Curriculum delivery: Service users teach students directly, for example through introductory “getting to know you” sessions, “sharing knowledge about health” sessions, and activities in a mental health in learning disability module. Assessment: Service Users are involved in practice assessment (e.g. poster evaluations and judging students’ abilities to assess aspects of health and communication), and they also participate in individual debriefings and more formal end‑of‑year feedback sessions for evaluation.	Planning to embed people with Disorders of Intellectual Development in educational activities requires more time, investment and development to find a way that fits to the ability of people with Disorders of Intellectual Development (in context with recruitment, teaching, learning, assessment) The involvement of people with Disorders of Intellectual Development leads to a deeper understanding and learning for students. Benefits also for involved people with Disorders of Intellectual Development.
5	[30]	Design: Qualitative (semi-structured interviews) Analysis Methods: Thematic analysis: Malterud’s systematic text condensation method	Lecturer with Disorders of Intellectual Development (n = 6)	To focus the experiences of lecturers with Disoders of Intellectual Development in higher education rather than the experiences of students being taught by people with intellectual disabilities.	Role: Individuals/Lecturers with Intellectual Disabilities (ID) All six individuals are formally employed as lecturers in a health and social education program at a Norwegian university, with employment contracts and payment on an equal footing with other external lecturers. Their specific assignment is to teach about their own experiences of living with “light or moderate cognitive impairment,” presenting life stories as service recipients and thereby functioning as “experts on their own lives.” They lecture for 1–2 h, once or twice a year, mainly in ordinary classroom teaching; another teacher may be present if the lecturer explicitly wants support.	Mainly positive experiences regarding their feelings of having social relations, learning new things and experience self-determination.
6	[21]	Design: Literature review Analysis Methods: Electronic search (Embase, Ovid MEDLINE(R), PsycINFO, Scopus, Web of Science (published after 2013).	24 studies	To enhance the understanding of medical students’ attitudes towards Individuals with Disorders of Intellectual Development.	Role: Target Group/People with Intellectual Disabilities (ID)/Patients/Service Users (SU). Structually central, yet analytically indirect group.	Results suggest that students’ attitudes changed after various interventions
7	[31]	Design: Literature review Analysis Methods: Electronic search (MedLine, English and French)	48 papers	To review what has been trialled and, if possible, the outcomes.	Role: People with ID/Persons with Disabilites (PWD) are regarded as teachers, workshop facilitators, standardized patients, community hosts, and recipients of in-service staff training.	To meet people with Disorders of Intellectual Development had the most positive change in attitudes
8	[6]	Design: Scoping review Analysis Methods: Electronic search (PUBMED, ERIC, Scopus, Web of science, after 1980) and grey literature	16 studies	To evaluate the educational interventions in context of intellectual disabilities and their effects.	Role: People with intellectual disabilities (ID) as experts in lived experience and educator roles. Across the 16 included studies, individuals with intellectual disabilities are mainly positioned as patients, simulated or standardised patients, and recipients of care, whose presence is intended to improve medical students’ knowledge, attitudes, communication, and clinical skills	Most studies involved Individuals with Disorders of Intellectual Development as living input in different ways. Different learning outcomes and difficult to evaluate the effect,
9	[26]	Design: Qualitative Analysis Methods: Thematic analysis (Braun and Clarke)	Questionnaires (n = 18) and focus groups (n = 4) with students	To analyse the experiences of social work students after participating in a course, designed and delivered by Individuals with Disorders of Intellectual Development.	Role: Adults with intellectual disabilities/people with intellectual disabilities (ID) as lecturers, tutors, and assessors. They are planning and delivering teaching sessions, interacting directly with students, and participating in the grading or evaluative process, rather than appearing only as guest speakers.	Positive impact on students’ empathy and increased feeling of comfort in interacting with Individuals with Disorders of Intellectual Development.
10	[28]	Design: Qualitative & Phenomenological (Interviews & Focus group with teachers with and without Disorders of Intellectual Development and students) Analysis Methods: Content analysis (MAXQDA 2022)	Interviews with co-teachers (n = 2) interview with teacher (n = 1) focusgroup with students (n = 3)	Understanding and analysing the perception of co-teaching activities from different point of views.	Role: Teachers with Intellectual Disabilities (ID) The central role is as university teachers and co-teachers. These teachers participate in joint planning of the module, meeting weekly with the tenured teacher to design sessions, select content, and refine teaching approaches, with the authors emphasising the evolution from a more rigid to a more flexible, co-constructed planning process. In classroom delivery, the tenured teacher primarily provides theoretical input, while the teachers with intellectual disabilities contribute experiential and autobiographical teaching, including accounts of their schooling (special vs. regular settings), employment, and preferred forms of inclusive classroom practice. They assume substantial pedagogical responsibility, leading sessions, inviting other “inclusive teachers,” stimulating discussion, and modelling inclusive practice; the paper notes that sessions in which they took more responsibility had the greatest reported impact on students.	Positive impact on personal & professional competences of the three teachers. Students learnt a lot about communication and their prejudices in terms of disability and inclusion.
11d	[23]	Design: Qualitative case study of an inclusive teaching initiative in qualifying social work education, informed by literature review on service user involvement and inclusion of people with profound and multiple learning disabilities Analysis Methods: Descriptive quantitative analysis of student self‑ratings (Likert scales) plus thematic analysis of open‑ended questionnaire responses; reflective qualitative analysis of discussions with Christian and his supporters (auto/biographical, auto‑ethnographic elements).	40 social work students completed evaluation questionnaires across three deliveries of a two‑day elective; 15–20 students per cohort; one man with profound and multiple learning disabilities (Christian) plus members of his circle of support involved as teaching team	To examine how people with profound and multiple learning disabilities, who are often excluded from service user involvement, can be meaningfully and inclusively involved in social work education, and what impact this has on students, the individual and his supporters	The man with profound and multiple learning disabilities is employed and commissioned as a visiting lecturer leading a two-day elective on working with people with learning disabilities; he designs and delivers teaching (with support), uses his own life story and materials (diaries, photos, videos) as auto-ethnographic content, and acts as an expert by experience whose presence, communication and relationships are central to students’ learning	Students reported increased self‑rated knowledge about working with people with learning disabilities, especially those without previous experience, and highlighted experiential learning about communication, personalisation, family perspectives, and challenging assumptions about capability. The initiative demonstrated that attitudes and low expectations are major barriers to inclusive involvement, and that employing a person with profound and multiple learning disabilities as a lecturer can subvert stereotypes, expand his social roles and networks, and promote recognition and parity of participation. At the same time, the paper notes practical, emotional and organisational challenges (room allocation, health fluctuations, emotional labour, risk of over‑burdening) and argues for careful, justice‑oriented development of inclusive involvement rather than tokenistic or romanticised participation.
12d	[22]	Design. Conceptual and practice-oriented guideline describing the development, implementation, and sustainable institutionalisation of a three-year full-time qualification programme for “educational specialists” with prior employment in sheltered workshops, preparing them for work at universities. Analysis Methods: Not primarily an empirical research study; synthesises conceptual foundations, curriculum and module descriptions, implementation experiences, and practice examples. Linked projects typically use mixed-methods evaluation (quantitative and qualitative data on effects for students, academic staff, and educational specialists)	No single defined study sample; the guide addresses adults with intellectual disabilities / learning difficulties who previously worked in sheltered workshops and are trained as educational specialists. On this basis, several cohorts (approximately 6–8 participants each) have completed the qualification at different universities.	To describe aims, content, organisational structures, and conditions of the programme “From sheltered workshop to university”: how adults with intellectual disabilities and workshop experience can be qualified and sustainably established as educational specialists in higher education in order to contribute lived experience of inclusion and exclusion to teaching and to open up new, non-segregated employment pathways.	Adults with intellectual disabilities (often described in practice as people with learning difficulties) and prior sheltered workshop experience are trained as “educational specialists” and, after completing the three-year full-time programme, are employed by universities. They act as experts by experience, co-design and co-deliver teaching (e.g. on inclusion, participation, and everyday life with disability), use biographical material in teaching, work in co-teaching tandems with academic staff, and function as change agents for inclusive institutional development.	The guide reports that the qualification is structured in several modules (e.g. inclusion and participation, biographical learning, methods of educational work) and systematically integrates theory, practice placements, and psychosocial support. On the basis of this model, multiple universities have implemented qualification cohorts and subsequently employed educational specialists as salaried teaching staff, which is associated with empowerment effects for the specialists (enhanced self-efficacy, social recognition, independent income) and with educational benefits for students and staff (reduction of stereotypes, increased competence in inclusion and disability, exposure to first-person perspectives on barriers and participation). The guide also targets sustainable structural anchoring (e.g. cooperation agreements, long-term funding, involvement in committees) and conceptualises educational specialists as permanent actors in inclusive higher education development.

a Seven primary studies included: Germany (n = 2), UK (n = 1), Australia (n = 1), Norway (n = 1), Ireland (n = 1), Spain (n = 1). Three literature reviews were conducted in the UK (n = 3)

b Studies 2 and 3 employed pre- and post-intervention assessments to evaluate changes in student attitudes; Study 3 specifically addressed attitudes toward inclusion and self-efficacy

c Studies 1 and 9 assessed the impact of educational interventions delivered by individuals with Disorders of Intellectual Development from the student perspective. Study 10 reported experiences of co-teachers and faculty. Study 4 evaluated both the process of inclusion and student outcomes. Study 5 investigated novel teaching tools and their effects on medical students in the context of Disorders of Intellectual Development. Review 6 examined medical students’ attitudes toward Individuals with Disorders of Intellectual Development; Reviews 7 and 8 evaluated educational interventions involving Individuals with Disorders of Intellectual Development and their impact on medical students

d Two project articles excluded by study design but relevant to the research question are listed separately. Article 11 is a case study with teaching evaluation on intervention implementation and outcomes. Article 12 provides guidelines for qualifying and establishing co-teachers