Are the health needs of children with disabilities being met at primary schools?

The aim of this study was to provide current information about the health profile and needs of mainstreamed primary school children with disabilities and special educational needs during their school hours. The Study population is composed of students with special educational needs and disabilities attending mainstream primary schools located in three selected Turkish districts with low, moderate, and high socioeconomic status and literacy rates separately. Parents of 404 students from 72 primary schools constituted the research sample. The study showed that 13.4% of the students with disabilities had chronic illnesses and 8.9% had health problems requiring access to emergency medical care when the condition recurs (such as epileptic seizures, fainting, or falling). Of the students with disabilities, 39.9% usually or sometimes needed medical care during school hours in the previous week. Health needs of nearly half of the students with disabilities were met at school. Special health needs and risks of children with disabilities also continue at school along with other possible health concerns.

Integrated psychology support and comprehensive cognitive evaluation improves access to special education services for children with sickle cell disease.

BACKGROUND: Children with sickle cell disease (SCD) are at risk for cognitive deficits. Limited data describe whether comprehensive cognitive evaluation improves education resources and whether caregivers perceive the assessment as beneficial. We tested our two hypotheses: (a) an integrated comprehensive cognitive evaluation program in children with SCD results in increased special education services allocation; and (b) caregivers will value comprehensive cognitive evaluation services provided. PROCEDURE: In a tertiary care medical facility, as part of quality improvement project, in a before-and-after evaluation between March 2011 and July 2014, we examined the impact of targeted comprehensive cognitive evaluation on change in special education services. We also evaluated the caregiver's perception regarding the utility of the provided services. RESULTS: A total of 21% (42 of 196) students (median age 11 years, range 3-18) with SCD were referred for cognitive assessment due to overt stroke (n = 11), silent stroke (n = 14), or concerns about cognitive or academic functioning without evidence of strokes (n = 17). At baseline, 45.2% received special education services and after the comprehensive cognitive evaluation 86.7% received special education services (P < 0.001). Among 33 caregivers who completed the survey, 97% reported that the assessment was helpful and 60% indicated that assessment led to beneficial changes for their children at school. CONCLUSION: Education advocacy coupled with comprehensive cognitive assessment in students with SCD improved access to special education services, and caregivers uniformly endorse this service as having added value.

Determining Need for School-Based Physical Therapy Under IDEA: Commonalities Across Practice Guidelines.

BACKGROUND AND PURPOSE: The Individuals with Disabilities Education Act (IDEA) includes physical therapy (PT) as a related service that may be provided to help students with disabilities benefit from their education. However, the IDEA does not provide specific guidance for the provision of school-based PT, resulting in variations in practice across the United States. The authors examined 22 state and local education agency guidelines available online to find commonalities related to the determination of a student's need for PT. RESULTS AND CONCLUSIONS: Seven commonalities found: educational benefit, team decision, need for PT expertise, establishment of Individualized Education Program (IEP) goal before determining need for PT, distinction between medical and educational PT, the student's disability adversely affects education, and the student's potential for improvement. These commonalities are discussed in relation to current PT and special education literature. This article suggests applying these commonalities as procedural requirements and questions for discussion during an IEP team meeting.

Improving Professional Development to Enhance Reading Outcomes for Students in Special Education.

The purpose of this article is to focus specifically on professional development that is needed to ensure that preservice and in-service teachers are prepared to deliver intensive intervention to enhance reading outcomes of students in special education. Our aim is to provide recommendations to ensure that special educators are prepared to design and implement data-based individualization in the area of reading. We highlight what special educators need to know to implement data-based individualization and provide recommendations for improving professional development using findings from federally funded projects. Implications for practice and next steps for research and policy are provided.

Commentary: The Tyranny of Time and the Reality Principle.

Each of the five articles in this special issue gets "into the weeds" in terms of studying actual classroom or school implementation of evidence-based or promising practices. Virtually all confront the issue of logistics and establishing an infrastructure for ensuring adequate implementation. In general, those studies that ask teachers to change their practice, be it core classwide instruction (Wanzek & Vaughn, this issue) or the whole-class adolescent literacy interventions described in LaRusso et al. (this issue) experienced a good deal more in the way of implementation challenges than those that provided schools with extra services and were able to hire their own personnel to train and oversee as part of an efficacy trial. Yet, as anyone who has ever conducted an efficacy trial in the schools discovers, and Foorman et al. (this issue) remind us, research teams confront challenges never even mentioned in most research methods courses.

Understanding the impact of special health care needs on early school functioning: a conceptual model.

Children with special health care needs (SHCN) have or are at increased risk for a chronic condition that necessitates more health and related supports than their peers. While it is generally accepted that these children are at risk for school failure, the mechanisms through which SHCN impact on children's experiences (and therefore opportunities to intervene) at school are still relatively poorly understood. Based on the current literature, this paper provides a conceptual framework to guide further discussion of this issue in research, policy and practice. Evidence from the literature was reviewed and existing frameworks examined. We propose that SHCN impact on four interrelated domains of children's functioning: (1) body functions and structures; (2) activities of daily living; (3) social participation; and (4) educational participation. Children's functioning is further influenced by risk and protective factors that can be identified at the level of the child, family and service systems. Together, these processes contribute to shaping either positive or negative trajectories of school functioning. The mechanisms influencing school experiences for children with special health care needs are complex, with opportunities for positive interventions at a range of levels. The proposed conceptual model provides an accessible tool for guiding discussion of the support needs of this vulnerable population.

"Measuring up" to ethical standards in service delivery to college students on the Autism Spectrum: A practical application of Powell's model for ethical practices in clinical phonetics and linguistics.

This paper examined an interdisciplinary college-based support programme, the Communication Coaching Program (CCP), designed for students diagnosed on the autism spectrum in light of six ethical constructs described by Powell. Collecting data to monitor the successes and ongoing needs of individual participants in the programme is of vital importance, of course, but only addresses a portion of the efficacy question. In addition, the authors, who co-direct the programme and represent different professional expertise and perspectives, recognize the importance of determining whether their evolving intervention model has also been successful in meeting the ethical standards of their respective professions. Careful review of the 4 years of the CCP's operation in terms of ethical constructs has yielded evidence that the CCP, although based on sound principles of theory and scholarship, should be further individualized to meet the particular needs of participants diagnosed with deficits in social communication and executive functioning skills.

Addressing public stigma and disparities among persons with mental illness: the role of federal policy.

Stigma against mental illness is a complex construct with affective, cognitive, and behavioral components. Beyond its symbolic value, federal law can only directly address one component of stigma: discrimination. This article reviews three landmark antidiscrimination laws that expanded protections over time for individuals with mental illness. Despite these legislative advances, protections are still not uniform for all subpopulations with mental illness. Furthermore, multiple components of stigma (e.g., prejudice) are beyond the reach of legislation, as demonstrated by the phenomenon of label avoidance; individuals may not seek protection from discrimination because of fear of the stigma that may ensue after disclosing their mental illness. To yield the greatest improvements, antidiscrimination laws must be coupled with antistigma programs that directly address other components of stigma.

What the DSM-5 portends for research, diagnosis, and treatment of autism spectrum disorders.

In May 2013 the APA will release DSM-5, which will restructure the diagnostic classification for autism spectrum disorders (ASDs) into a single category. The proposed changes in DSM-5 aim to better reflect the current state of research by consistently identifying the core features in social/communication and restrictive and repetitive behaviors that are specific to ASDs. This review describes the empirical and theoretical bases of research in the nosology of ASDs, given the impending shift in DSM-5 diagnostic criteria. General issues in diagnosis and prevalence are described, with differences between DSM-IV and DSM-5 highlighted. To address concerns about the application of the proposed DSM-5 criteria, the current literature assessing the sensitivity and specificity of the proposed DSM-5 criteria is reviewed. Last, we discuss the implications of the changes in DSM-5 for the treatment of ASDs and recommend areas for future research.

Between negative stigma (cultural deprivation) and positive stigma (learning disability): the historical development of two special education tracks.

This article posits an updated, broader perspective on the concept of learning disabilities (LDs) than that accepted in the local Israeli literature, revealing how it is immersed in class, ethnicity, and culture. This is shown through historical description, accreditation, and contrasting of the two special education discourses: the "cultural deprivation" discourse and the "LDs" discourse. There are three sections. Part One presents the theoretical, conceptual, and methodological background of the sociological and discursive debate about LDs. The social-constructivist model used in an analysis of the two categories is proposed as an alternative to the clinical-medical model. The definitions of LDs and cultural deprivation accepted in the Israeli discourse are presented in Part Two. The metamorphoses in the discourse about the category of LDs are uncovered through reference to their conceptual and historical antecedents. This part discusses the various understandings and constructions of learning difficulties. Part Three examines the textual representation of parents of children with disabilities in both cases, exploring the meanings of guilt, responsibility, and agency in each discourse. The conclusion clarifies the social and political significance of the distinct textual and rhetorical representations. It becomes evident that the discourse on LDs and the discourse on cultural deprivation are two special education tracks directed at different target audiences: the culturally enriched audience, well-off and educated on the one hand, and the Mizrahi audience of limited means and education on the other hand.

Writing instruction in elementary classrooms: making the connection to Common Core State Standards.

This study used a survey of primary general education teachers to examine the frequency of writing instructional activities and the genres composed most frequently by students in these classrooms. Surveys were completed by first-, third-, and fifth-grade general education teachers, with questions addressing writing activities, writing instruction, instructional strategies, writing genres, and writing environment. Means of teacher responses were calculated for each grade level to determine how many days per school year each activity occurred. To better understand the changes that occur in writing instructional practices and genres across grade levels, these means are compared and shifts are discussed. Results of this study revealed that the frequency of writing instructional practices and genre usage change across the primary grade levels, but that great variation also exists among teachers at each grade level. Links among the survey results, the Common Core State Standards for writing, and best practices for writing instruction will be made.

Managing the student with severe food allergies.

School nurses play a key role in managing students with food allergies. It is becoming more common to encounter students with severe allergies to multiple foods, putting them at risk for anaphylaxis. It is essential that the school nurse have a clear understanding of food allergies and how to effectively manage students in the school setting. Effective communication between families, health care providers, faculty, staff, and students, is of utmost importance when developing a plan of care to ensure the safety of the student with food allergies. Using an interdisciplinary approach to case management, the school nurse can develop comprehensive individualized health care plans for all students with food allergies.

The Arkansas Autism Developmental Disabilities Monitoring (AR ADDM) project: statewide autism surveillance in a rural state.

In 2002, the Arkansas Autism and Developmental Disabilities Monitoring (AR ADDM) project collected data on the number and characteristics of resident children aged 8 years using a retrospective record review standardized methodology. This paper provides a first-look epidemiology of ASDs among 8 year old Arkansas children using data from the 2002 study year. Overall prevalence estimates, demographic distribution and a temporal lag from concerns identified to diagnosis of ASDs among 8 year olds in Arkansas were similar to that in other sites. Dissemination of information that promotes timely resolution of developmental concerns and improving educational services will benefit children with autism in Arkansas.

The Impact of the COVID-19 Pandemic on Children With Special Needs: A Descriptive Study.

Amid the COVID-19 crisis, children with special needs may have challenges. To determine emotional and behavioral challenges, 116 children aged 4 to 6 years, who received special education, were evaluated. COVID-19 negatively affected the families at a rate of 94.6%; 76.5% of the children's daily routines were worsened. Although the one-on-one time duration with the mother and father increased (73.5% and 66.7%), reading books (40.6%), play (17.2%), and overall activity durations (25.7%) decreased. The median screen time increased from 1 to 3 hours. According to the families, there was a regression in development in 18.8% of children. Special education practices at home were ceased by 17.2% of families, and a significant difference was found between the groups with and without regression in development in terms of the frequency of continuing special education at home. The development of children with special needs is an ongoing urgent situation; thus, besides protecting and promoting physical health during the pandemic, families and children should also be supported for developmental needs.

Mentoring Students with Intellectual and Developmental Disabilities: Evaluation of Role-Specific Workshops for Mentors and Mentees.

Transitioning to post-secondary education is often challenging for students with intellectual and developmental disabilities (IDD). To address this, Florida International University, specifically FIU Embrace, piloted the Embrace Mentoring Program (EMP), which provided unique role-specific workshops to both faculty/staff mentors, and student mentees with IDD. A mixed-method design was used to analyze knowledge acquisition and participant perceptions of the workshops. Quantitative findings indicated knowledge improvement in a key area for mentors, while qualitative data demonstrated a positive response to workshop content, and highlighted areas of improvement for future workshops. Ultimately, the results from the pilot EMP demonstrated promise in supporting students with IDD towards academic and career-related goals, by providing mentorship training to both mentors and mentees.

Educating Students with Autism Spectrum Disorders: Is Teacher Certification Area Associated with Academic Outcomes?

Although typically taught by special educators, few studies have examined if certification area is associated with academic outcomes for students with autism spectrum disorders (ASDs). The purpose of this study was to determine whether students with ASD scored better on language arts and mathematics state assessments depending on teacher certification, and whether these associations varied by assessment type. We analyzed 3 years of state administrative data from students with ASD in grades 4-8 receiving special education services. Results showed students taking the regular or alternate assessment had similar academic outcomes regardless of teacher certification. Students who were taught by special education certified teachers and took the modified assessment had lower academic outcomes. Implications for practice, policy, and research are discussed.

Keys to engagement: A case study exploring the participation of autistic pupils in educational decision-making at school.

BACKGROUND: The UNCRC (1989) established the importance of listening to children's views globally. In England, seeking the views of pupils with special educational needs and disability about their education, and involving them in decision-making, has been mandatory since 2015. Autistic children's views and experiences are particularly underrepresented in this context. AIMS: To provide a detailed exploratory analysis of practices that enable autistic pupils to participate in educational decision-making, and to generate new knowledge about pupil participation in a school context, using the Framework for Participation (Black-Hawkins, 2010) as an analytical frame. SAMPLE: Four male pupils aged 11-15, with autism spectrum diagnoses, and 11 staff members from a specialist, independent school took part in this case study. METHODS: Observations were made of pupils in lessons, and pupils completed a photo-voice activity focusing on where they felt 'most listened to' in the school. Staff members participated in semi-structured interviews. RESULTS: A range of practices supported pupils' participation in everyday decision-making, underpinned by a respectful and positive culture led by the senior management team. The focus was on what learners can do and how they make decisions to facilitate achievement. Pupils and staff developed mutually respectful relationships, within which boundaries were negotiated and compromises offered. Flexibility through decision-making was provided within the timetabling and content of the curriculum. Pupils' special interests and expertise were valued as 'keys' to supporting their engagement. CONCLUSIONS: These insights provide a tool for reflection by educators and educational psychologists for considering how they might promote the participation of autistic pupils in different educational contexts.

Barriers to and Facilitators of Successful Early School Transitions for Children with Autism Spectrum Disorders and Other Developmental Disabilities: A Systematic Review.

Early school transitions are exciting, yet challenging, experiences for children with special needs, such as autism spectrum disorder (ASD), and their families. Transition to school support practices can help facilitate this difficult process for key stakeholders. The purpose of this systematic review was to synthesize the literature on transition to kindergarten support practice use for children with ASD and other developmental disabilities. Qualitative and quantitative studies were analyzed using textual narrative synthesis, following the guidelines from the Centre for Reviews and Dissemination. Overall, 39 individual studies were included. Results highlighted particular parent, child, and support staff needs during the transition to school, while also emphasizing the importance of collaborative practices in facilitating successful school beginnings.

Supports for Postsecondary Students with Autism Spectrum Disorder: A Systematic Review.

In order to survey extant literature examining support specifically for postsecondary students with Autism Spectrum Disorder (ASD), a systematic review of the literature was conducted through a synthesis of an established protocol of quality indicators for special education research and the methodology for PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses). Eight themes were identified describing features of programs, interventions, and supports that were implemented or described in the 21 studies reviewed. One of the themes, parent support, is underexamined in the literature relating to postsecondary institutions. Recommendations for needed research are included.