A LITERATURE REVIEW : FACILITATING SPIRITUALITY IN CHILDREN WITH INTELLECTUAL DISABILITIES

Children with intellectual disabilities are often treated as having less value. Increased awareness of holistic personhood, however, brought questions to the need to facilitate spirituality in these children, besides facilitating the development of other aspects. Previous studies argued that children with intellectual disabilities have potentials to develop spiritually despite the very few studies addressing the spirituality in children with intellectual disabilities. This literature review, then, aims to explore methods and interventions to facilitate spirituality in children with intellectual disabilities, through a comprehensive analysis and synthesis of the themes drawn from existing literatures and research studies. After the analysis and synthesis process, four themes emerged for intervention methods to facilitate spiritual development in intellectually challenged children, which are: narratives (from Scripture and personal narratives); symbols, liturgies, and rituals; arts and kinesthetic learning; and community, group, and social support. Further research studies, especially using quantitative methods, are encouraged to be conducted in the future in order to assess the efficacy of each method of interventions.


INTRODUCTION
Children with deficits in intellectual abilities share history of being the underserved population and experience stigmatization of being "less" than so-called "normal" children.In some cultures, children with disabilities are viewed as having "lesser value," "undesirable," and often victimized with stigma, rejection, trauma, and abuse; even in some Western cultures (such as Roman Empire), they were terminated (O'Hara, 2014).However, as the awareness of equality in human rights emerges, awareness of developing holistically is urgently raising.Jones and Butman (2011), calling this holistic approach as "biopsychosocialspiritual" model, promote holistic understanding of human as a biological, psychological, social/cultural, and spiritual being.as play therapy (Astramovich, Lyons, & Hamilton, 2015), behavior modification (McRay, Yarhouse, & Butman, 2016), and Individual Educational Program (IEP) in schools and special needs classes (Easom & Irwin, 2007).It also provides supports for social interventions, such as parenting class, support groups, equal employment advocacy, and anti-bullying programs.
However, spiritual aspect of children with intellectual disabilities is almost neglected.
Very few studies conducted to address this issue, and very few organizations are advocating for it.Therefore, this literature review aims to answer how to facilitate spiritual development in intellectually challenged children.
There are many definitions of spirituality.
Spirituality, from both psychology and theology, is a common core concept of searching for the sacred (Thomas, 2008).
As Roehlkepartain, Benson, King, and Wagener (as cited in Thomas, 2008) reported, researchers usually viewed spirituality in three perspectivesas an integral part of religiosity, as separate from religiosity, and as synonymous with religiosity.Throughout the sources used in this review, most authors viewed spirituality as an integral part of religiosity.
In their studies, researchers often

RESULTS
A matrix was used to organize data. of symbols (5), and community, group, and social support (6).See Table 1.(Francis, 1994), liturgical group celebration (Volgezang, 2001), small group to share stories, encouragement, and service learning to learn social issues around them (Zhang, 2010), and school-wide organized activities for staff to better address spiritual issues in children in special education settings (Zhang, 2010).Some groups even have names and organizations, such as L'Arche movement and Special Religious Education for People with a Developmental Disability (SPRED; Watts, 2011).

Narratives
Narratives are commonly taken from the Scripture or Bible stories (Thomas, 2008;Webster, 2004) or by using personal narratives, either from themselves (telling their stories), others (other tells their stories and the others listen), or story books (Dennis, 2002;Thomas, 2008;Zhang, 2010;Zhang & Wu, 2012).Dennis (2002) asked each child to tell their stories, then someone in the group will act the story out.
Kinesthetic learning is also utilized with children with intellectual disabilities, such as in the use of outdoor activities (Zhang, 2010), or physical activities (Volgezang, 2001).

Symbols, Liturgies, and Rituals
Liturgy or ritual in worship and activities might effectively facilitate spiritual development in intellectually disabled children (Francis, 1994;Hauerwas, 1995;Vogelzang, 2001).Watts (2011) explored the use of symbols in teaching children with intellectual disability, from sacraments, liturgy, or simply, things that they can see, hear, taste, smell, and touch.Francis (1994) voiced the need for intellectually disabled individuals to participate in sacraments, and for church community (parents, pastors, ministers) to monitor them and assess their readiness to participate in sacraments.Vogelzang (2001) described an activity using an Easter candle and liturgy.They light the candle on, circle around the candle, sing and make music, talk to each other quietly, fellowship (eating food), and then put the candle off.

Personal Relationship as Foundational
These interventions are carried out on the foundation of personal relationship with the child and the acknowledgement of their personhood, which can be pragmatically expressed, such as welcoming each person with name (Volgezang, 2001), or activities together with them (Zhang, 2010).

DISCUSSION
Spirituality is an integral part of holistic personhood.This statement stands true even for children with intellectual disability.
Recent neurocognitive studies scientifically support facilitating spirituality in children with intellectual disability.They found that cognition and affection are interrelated and function together; even if one is impaired, a person will not compartmentalized each part and function solely on it (Webster, 2004).Love (in Thomas, 2008, p. 39) also states, "One's level of cognitive There are two kinds of knowingthe scientific knowing and the artistic-symbolic knowing (Francis, 1994).Children with intellectual disabilities might experience difficulties to comprehend scientifically, but they can learn and understand in artistic-symbolic ways.It implies that teaching (including religious education) should target cognitive and affective dimensions (Webster, 2004).Education involving both intellect and emotion will provide a holistic way of being.God created us with cognitive processes, "so then He would appeal to His creation through theses cognitive functions" (Thomas, 2008).The same thing also applied for affection.God created us with affection, so then He would appeal through affection.This notion is supported by Saroglou (2011) through one of the dimensions in religiosity scale, Bonding, the affective dimension of spirituality.
Believing in transcendence is connected with meaning-making process (Park, 2005).
Creative methods associate to children's affect in making meaning spiritually, in which they learn through affective knowing.Through narratives, children learn to appreciate events and language, and derive meaning from associating with the stories affectively (Webster, 2004).Using stories through preaching, Scripture reading, and personal testimony might affect Long-Term Retrieval (LTR) in children with cognitive deficits, which is the domain that helps one to have mental representation of God and understands one's relationship with that perception (Thomas, 2008).By telling and listening to stories or narratives, children also learn to develop social and emotional skills, life management skills, and meaning and values (Zhang & Wu, 2012).Liturgy and sacraments also provided symbolic, experiential nature to spiritual meaning, and are very helpful for children with intellectual disabilities as they reflect human actions in everyday life (Francis, 1994).
In regards of sacraments, Francis (1994) mentioned, "It is crucial to be aware of the With this understanding of holistic approach to treatment, it becomes pertinent to look at the development of children with intellectual disabilities.Extensive research studies and interventions are dedicated for the physiological or cognitive well-being of these children, for example, the research on neurocognitive development and psychopharmacology.Many interventions have also been applied and proven to be effective to help children with intellectual disabilities function psychologically, such

Further
evaluation was conducted on the abstracts to screen out research focus and scope, participants, and suitability to the aim of this literature review (on the interventions/methods).Nine sources were selected.Most of the reviewed sources used qualitative research design, and only one literature used quantitative research design.The writer then organized them into a matrix addressing the type of study / literature, research question / aim of study, findings / ideas, and coding for each literature.
the Scriptures / literatures / story books or personal narratives) (4), language Bibliotherapy (story books in which children identify with the characters of the books and learn from the characters' experiences) is proposed to encourage sense of values, meaning, and purpose by talking about important things and people in their lives, values, fears, and dreams(Zhang, 2010;Zhang & Wu, 2012).
development need not be similar to one's spiritual development, though because they both relate to the development of meaningmaking, it is hard to imagine a situation where they would be significantly divergent in an individual."The statements give objectives to provide spiritual resources for these children.
to learn about themselves and to express themselves.Knowledge of God does not stand independently from knowledge of self.John Calvin (2007) famously wrote, "Without knowledge of self, there is no knowledge of God." From listening and acting out of stories, children learn about themselves and others.Dennis (2002) noted that through playback theater/drama, children with intellectual disabilities learn listening, taking risk, expressing themselves in a genuine way, growing in awareness, building relationship, maintaining a sense of fun, and taking pride in what they achieve.The outcomes, they become more comfortable to express emotion toward God and church.Arts, music, and play help children to express their inner world and experience the world (Zhang & Wu, 2012).From the pastoral point of view, these methods, conducted properly in church, might serve as an advocacy and conscious expressions from the church in including children with intellectual disabilities as part of the church.Ministry to children with intellectual disabilities has the potential to convey the message of justice and hope, served as validations for the children as well as their families, and in result, promotes spiritual growth.Church community have to be aware that spirituality is an integral part of a holistic person and might be a great source of resilience."Faith can bring a message of hope, healing, and growth"

Table 1
Matrix of Reviewed Literature

Table 2
Methods of Interventions to Scaffold or Promote Spirituality in Children with Intellectual Disability