Introduction
Multiple disabilities refer to the coexistence of two or more disabling conditions that collectively intensify limitations in cognitive, motor, social, and self-care functioning. Learners with multiple disabilities often require lifelong educational and rehabilitative support due to the compounded nature of their impairments.1 These learners frequently depend on assistive devices and structured interventions to participate meaningfully in daily activities and learning environments.
From a functional perspective, the World Health Organization defines multiple disabilities as the presence of more than one disability that significantly affects an individual’s functioning and participation in society.2 In educational contexts, the Individuals with Disabilities Education Act emphasizes that learners with multiple disabilities require comprehensive and integrated support systems, as they cannot be adequately served through programs designed for single disabilities.3 This highlights the need for instructional approaches that address the learner as a whole rather than focusing on isolated deficits.
Recent studies emphasize that inclusive education for learners with multiple disabilities remains particularly challenging in low- and middle-income countries (LMICs), where resource constraints, limited professional training, and high teacher workloads persist.4-6 Teachers in special education settings frequently report elevated stress levels, emotional exhaustion, and physical fatigue, especially when supporting learners with severe and multiple disabilities.7,8 However, teacher resilience is strengthened through collaboration, reflective practice, and continuous professional development.9
At the Naval Central School SPED Center in the Philippines, a public-school setting with limited resources, a special education teacher supports a learner diagnosed with microcephaly, autism spectrum disorder, cerebral palsy, and moderate intellectual disability. This rare and complex combination of conditions presents unique instructional, emotional, and physical challenges that are seldom documented in local literature.
Although international research has explored multiple disabilities broadly, there is limited empirical evidence capturing the lived experiences of special education teachers handling rare combinations of disabilities within Philippine public schools. Existing studies often generalize multiple disabilities as a category, overlooking the contextual realities, adaptive strategies, and coping mechanisms employed by teachers in resource-constrained environments.
This study addresses this gap by providing an in-depth examination of a single intrinsic case involving a special education teacher supporting a learner with a rare combination of multiple disabilities in a Philippine public SPED Center. The findings contribute localized, practice-based insights that may inform inclusive education policies, teacher training, and school-level support systems.
Research Questions
This study sought to answer the following questions:
What challenges does a special education teacher encounter when supporting a learner with multiple disabilities?
What instructional strategies does the teacher employ to address the learner’s complex needs?
What coping mechanisms does the teacher use to manage professional and emotional demands?
Materials and Methods
Research Design
This study employed a single intrinsic case study design, as described by Stake.10 An intrinsic case study focuses on a particular case of unique interest rather than aiming for generalization. This design was appropriate because the study centered on a specific teacher–learner dyad involving a rare combination of disabilities within a public SPED context.
The design allowed for an in-depth exploration of the teacher’s experiences, instructional decisions, and coping mechanisms within their real-life educational setting. Data collection was conducted from August to October 2024, enabling sustained engagement with the participant and triangulation of data sources.
Research Locale
This study was conducted in Naval Central School SpEd Center. The Naval Central School SpEd Center is situated along P.I. Garcia St. in Naval, Biliran.
Research Participant
The participant of this study was a special education teacher who handled a unique learner with multiple disabilities, including microcephaly, autism spectrum disorder, cerebral palsy, and moderate intellectual disability, at the Naval Central School SPED Center. The teacher was selected based on the following criteria:
holds a degree in Special Education;
has received specialized training or professional development in handling learners with multiple disabilities;
is proficient in implementing various instructional and communication strategies tailored to the learner’s needs;
possesses years of teaching experience in special education, particularly with learners with complex or multiple disabilities;
demographic details such as age and gender were noted.
The teacher played a crucial role in implementing specialized interventions and strategies designed to meet the learner’s unique needs. Additionally, insights from the teacher provided valuable information on the challenges encountered in the classroom, the effectiveness of the methods employed, and how inclusive education practices were applied within this SPED setting.
Research Instrument
A semi-structured, interview guide developed by the researcher served as the primary data collection tool. The open-ended questions were formulated based on existing literature, earlier studies, and professional readings. The guide was validated by an authorized expert to ensure content validity. Supporting instruments included: field notes for recording observations, an audio tape recorder to capture interview responses, student records, and classroom observations to triangulate findings.
Data Collection Procedure
Permission to conduct the study was sought from the school administration through formal letters, which outlined the objectives and purpose of the research. After approval, the researcher scheduled interviews with the participant at a mutually convenient time. The semi-structured interviews were conducted in both English and local dialects (Cebuano/Waray). Interviews were supplemented by direct classroom observations and review of student records. Field notes and audio recordings were collected for accuracy.
Data Analysis
Data were analyzed using thematic analysis following Braun and Clarke’s sixphase framework.11 First, interview transcripts, observation notes, and documents were read repeatedly to achieve familiarization with the data. Initial codes were generated by identifying meaningful segments related to challenges, instructional strategies, and coping mechanisms.
Second, related codes were grouped to develop preliminary themes that captured broader patterns across the dataset. These themes were reviewed and refined to ensure coherence and alignment with the research questions.
Third, trustworthiness was ensured through peer debriefing, bracketing, and member checking. An expert qualitative researcher reviewed the coding and thematic structure, while reflexive bracketing was practiced to minimize researcher bias. The final themes were returned to the participant for validation, ensuring that findings accurately reflected her lived experiences.
Ethical Considerations
Prior to data collection, the study sought approval from the appropriate ethics review committee.16 The participant was provided with an informed consent form containing details of the study’s purpose, significance, and procedures. Participation was voluntary, and confidentiality was ensured through anonymization of data. Trust and privacy were prioritized during the interviews and observations to create a safe environment for open sharing.13
Researcher’s Reflexivity
Reflexivity was maintained throughout the study to account for the researcher’s positionality and potential biases. Self-examination of the researcher’s background, values, and assumptions was conducted to minimize undue influence on the research process. Positionality factors such as age, gender, social class, and educational background were acknowledged as potential influences on interpretation. Continuous reflexivity was practiced during data collection, analysis, and reporting to ensure transparency and integrity.14,15
Results
This chapter presents, analyzes, and interprets the findings gathered from the single intrinsic case study focusing on a Special Education teacher handling a learner with autism spectrum disorder (ASD), cerebral palsy (CP), microcephaly, and moderate intellectual disability (MID) at the Naval Central School SpEd Center.
Three major categories emerged: (1) challenges faced by the teacher, (2) educational strategies used, and (3) coping mechanisms employed. The themes that emerged are presented in Table 1 below.
Table 1
Summary of Major Themes and Subthemes
| Main Categories | Themes | Description / Focus |
|---|---|---|
| Challenges Faced by the Teacher | 1. Emotional and Physical Challenges | Emotional strain and physical demands of handling students with multiple disabilities. |
| 2. Difficulty in Providing Individualized Instruction | Struggles in designing instruction that fits the learner’s complex and diverse needs. | |
| Educational Strategies Used | 1. Holistic Approach | Focus on cognitive, behavioural, emotional, and physical development. |
| 2. Integration of Behavioural, Emotional, and Life Skills | Inclusion of functional and practical life skills alongside academics. | |
| 3. Play-Based Learning as a Necessity | Use of play and fun activities to reduce stress and foster engagement. | |
| Coping Mechanisms Employed | 1. Collaboration through Parent-Teacher Conferences (PTC) | Strengthening home-school connection and shared responsibility. |
| 2. Professional Growth through Seminars and Research | Continuous learning to enhance teaching competence and resilience. |
The themes presented in Table 1 illustrate a dynamic and interrelated process rather than isolated categories. The challenges faced by the teacher, particularly emotional and physical strain and difficulty in providing individualized instruction, directly informed the educational strategies employed in the classroom. In response to these challenges, the teacher adopted a holistic approach, integrating behavioural, emotional, and life skills, and utilized play-based learning to sustain engagement and reduce learner stress. These instructional strategies, in turn, necessitated the development of effective coping mechanisms, such as sustained collaboration with parents and continuous professional growth. Collectively, the themes demonstrate how instructional decision-making and coping practices function as adaptive responses to the complex demands of teaching a learner with multiple disabilities within an inclusive education context.
Discussion
This study examined the challenges, instructional strategies, and coping mechanisms of a special education teacher supporting a learner with autism spectrum disorder, cerebral palsy, microcephaly, and moderate intellectual disability in a Philippine public SPED setting. The findings illustrate how teaching learners with multiple disabilities involves interconnected emotional, instructional, and professional demands that require adaptive and holistic responses.
Challenges Faced by the Special Education Teacher in Teaching Learners with Austism Spectrum Disorder, Cerebral Palsy, Microcephaly, and Moderate Intellectual Disability
Theme 1: Emotional and Physical Challenges of Teaching Children with Multiple Disabilities
A teacher recounted their own experience, mentioning:
As a committed special education teacher handling learners with multiple disabilities, I face many challenges that are not only academic but also emotional and physical.
The findings indicate that the teacher experienced substantial emotional and physical strain, consistent with literature describing special education teachers as assuming multiple roles that extend beyond instruction to caregiving and emotional support.1 The physically demanding tasks observed—such as assisting with mobility, feeding, and attention regulation—combined with behavioural and communication challenges, contributed to emotional exhaustion. Similar patterns have been reported in studies highlighting high levels of stress and burnout among teachers handling learners with severe and multiple disabilities, particularly in resource-limited contexts.4,7
Theme 2: Difficulty in Providing Individualized Instruction
Developing and implementing individualized instruction posed another challenge due to the learner’s combination of disabilities affecting cognition, motor function, and communication. The teacher shared:
Honestly, one of the biggest challenges is creating individualized instruction that truly fits their diverse needs.
In addition, the difficulty of providing individualized instruction emerged as a significant challenge. The learner’s overlapping disabilities required constant modification of lesson plans and instructional materials, often on a daily basis. This finding confirms Hunt and Marshall’s assertion that learners with multiple disabilities require intensively individualized instruction that simultaneously addresses cognitive, physical, and emotional domains.17 While individualized education is a cornerstone of inclusive practice, this study highlights the considerable time, creativity, and emotional labour required from teachers, especially in public school settings with limited support.
Educational Strategies Used by the Special Education Teacher Supporting Learners with Autism Spectrum Disorder, Cerebral Palsy, Microcephaly, and Moderate Intellectual Disability
Theme 1: Holistic Approach
To address these challenges, the teacher adopted a holistic approach, emphasizing the learner’s overall development rather than academic outcomes alone. She stated:
Honestly, one of the most effective strategies I use is the holistic approach.
The findings align with inclusive pedagogy and Universal Design for Learning principles, which advocate flexible and responsive instructional practices that accommodate diverse learner needs.18 The integration of academic tasks with motor, sensory, and emotional activities reflects an understanding that functional participation and emotional regulation are essential indicators of progress for learners with multiple disabilities.
Theme 2: Integration of Behavioral, Emotional, and Life Skills
The teacher consistently integrated behavioral management, emotional awareness, and daily living skills into her lessons. She remarked:
To be honest, I don’t just focus on academics but also on their behavioral, emotional, and life skills.
The integration of behavioural, emotional, and life skills further demonstrates the teacher’s focus on long-term functionality and independence. Emphasizing daily living skills such as self-feeding, routines, and basic communication supports previous research that prioritizes functional and adaptive skills over conventional academic benchmarks for learners with severe disabilities.19 This strategy underscores the importance of preparing learners for meaningful participation beyond the classroom.
Theme 3: Play-Based Learning as a Necessity
Another obstacle was making certain that learning stays enjoyable and free from pressure. To tackle this, the teacher turned to play-based learning, employing it not just as a tactic but also as a means of coping to reduce stress and avoid disengagement in the student. She explained:
For me, I use fun and play-based learning to keep them from feeling pressured and to let them learn at their own pace.
The use of play-based learning emerged as both an instructional strategy and a protective mechanism against learner stress. By creating a low-pressure and emotionally secure learning environment, the teacher enabled engagement and minimized frustration. This finding supports Turnbull et al.’s emphasis on emotionally safe learning environments, particularly for learners who are easily overwhelmed by traditional instructional demands.20
Coping Mechanisms Employed by the Special Education Teacher to Address the Challenges Met
Theme 1: Collaboration through Parent-Teacher Conferences (PTC)
One of the teacher’s coping strategies was to keep in touch with the student’s family via Parent-Teacher Conferences. She recognized the difficulties but highlighted the significance of teamwork:
Addressing challenges as a SPED teacher requires strength, patience, and collaboration. Honestly, one of my main coping mechanisms is regularly providing feedback to parents through Parent-Teacher Conferences.
The teacher’s coping mechanisms highlight the role of collaboration and professional growth in sustaining resilience. Regular communication with parents through Parent–Teacher Conferences strengthened consistency between home and school, supporting shared responsibility for the learner’s development. This finding confirms existing evidence that strong home–school partnerships are essential for effective inclusive education, even when parental engagement may be constrained.20
Theme 2: Professional Growth through Seminars and Research
The educator managed the emotional and teaching responsibilities of her position by participating in continuous professional development. She disclosed:
For me, I also attend seminars and read new studies to continue my professional growth.
Continuous professional development through seminars and research served as a key coping strategy, enabling the teacher to refine instructional practices and manage occupational stress. This aligns with Florian and Black-Hawkins’ emphasis on reflective and adaptive practice as central to inclusive pedagogy.21 The teacher’s commitment to ongoing learning reflects an understanding that inclusive education is a dynamic process requiring continual adaptation.
The findings suggest several important implications. For teachers, adopting holistic and flexible instructional strategies may enhance both learner engagement and teacher resilience. For schools, providing institutional support—such as access to training, collaborative planning time, and emotional support systems—is critical in sustaining inclusive practices. At the policy level, strengthened investment in special education teacher development and structured parent–school collaboration is necessary, particularly in public schools serving learners with complex disabilities.
Conclusion
This single intrinsic case study highlights the complex realities of teaching learners with multiple disabilities in a public SPED context. Effective support requires holistic, flexible, and inclusive instructional approaches, alongside strong emotional resilience from teachers.
As a single-case study, findings are context-specific and not intended for generalization. The perspectives of other stakeholders were not included.
Schools should strengthen professional development opportunities, enhance home–school collaboration, and provide systemic support for special education teachers. Future research should examine multiple cases across diverse regions to deepen understanding of inclusive practices in LMIC contexts.
Acknowledgement
The researcher extends sincere gratitude to the school head, administrators, and the Special Education teacher at Caibiran Central School – SPED Center for their support and cooperation throughout the conduct of this study.
Funding
This research received no external funding and was personally supported by the researcher.
Conflicts of Interest
The author declares no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.