Developing a Structure of Essential Services for a Child and Adolescent Mental Health System.

Policy Points That child and adolescent mental health services needs are frequently unmet has been known for many decades, yet few systemic solutions have been sought and fewer have been implemented at scale. Key among the barriers to improving child and adolescent mental health services has been the lack of well-organized primary mental health care. Such care is a mutual but uncoordinated responsibility of multiple disciplines and agencies. Achieving consensus on the essential structures and processes of mental health services is a feasible first step toward creating an organized system.

"The Hopkins Mongol Case": The Dawn of the Bioethics Movement.

One of the earliest controversies in the modern history of bioethics was known at the time as "the Hopkins Mongol case," involving an infant with Trisomy 21 and duodenal atresia whose parents declined to consent to surgery. Fluids and feeding were withheld, and the infant died of dehydration after 15 days. The child's short life had a profound impact on the author's career and that of several others and ultimately led to changes in the care of children and adults with disabilities and the way difficult end-of-life decisions are made in US hospitals today. It also contributed to the growth of the modern bioethics movement and scholarship focused on pediatric bioethics issues.

Case Comment: Re D (A Child) [2019] UKSC 42.

How (if at all) can the right to liberty of a child under Article 5 European Convention on Human Rights ('ECHR') be balanced against the rights of parents, enshrined both at common law and under Article 8 ECHR? Is there a limit to the extent to which parents can themselves, or via others, seek to impose restrictions upon their disabled child's liberty so as to secure their child's interests? This case considers the answers to these questions given by and the implications of the decision of the Supreme Court in September 2019 in Re D (A Child) [2019] UKSC 42.

National Analysis of State Health Policies on Students' Right to Self-Carry and Self-Administer Asthma Inhalers at School.

BACKGROUND: Asthma has no known cure, and though manageable, it disrupts the everyday lives of over 6 million US children. Because children spend more than half of their waking hours in school, students must be able to carry and administer their inhaler at school to manage their asthma. METHODS: This policy paper is a comprehensive review of all 50 states and the District of Columbia's laws and policies for the self-carry and administration of quick-relief asthma inhalers among children in prekindergarten through 12th grade. RESULTS: All states permit students to carry and administer their inhalers at school, although each state differs in their development and implementation of policies for asthma self-management at school. This review examines how states regulate self-carry policies by looking at policy development, regulated school systems, relevant stakeholders, required medical records, and school liability. CONCLUSIONS: Each state's laws have nuances that create gray areas, increasing the potential of misinterpreted or incorrectly implemented policies for asthma self-management at school. As a result, children may not have immediate access to their inhaler for symptom management or in an emergency. State policymakers should reform current laws to remove barriers for students to carry and use inhalers at school.

The Fallacy of Choice: the Destructive Effect of School Vouchers on Children With Disabilities.

This Article addresses the impact of school voucher programs on students with disabilities. We show that for children with disabilities, the price of admission into so-called "school choice" programs is so high that it is effectively no real choice at all. School voucher programs require students with disabilities to sign away their robust federal rights and protections in the public school system. Under the Individuals with Disabilities Education Act (IDEA)--the preeminent legislative safeguard for students with disabilities--these rights include the right to a "free and appropriate public education" delivered through an "individualized education plan." By giving up these protections, children with disabilities are left at the mercy of private schools that have no legal obligation to provide them with an appropriate education, and, in the vast majority of cases, are not legally prohibited from discriminating against them on the basis of their disability. We argue that school voucher programs--including a proposed federal voucher program--put the education of students with disabilities back decades, and likely constitute a violation of the Equal Protection Clause of the U.S. Constitution.

School Bus Transportation of Children With Special Health Care Needs.

School systems are responsible for ensuring that children with special needs are safely transported on all forms of federally approved transportation provided by the school system. A plan to provide the most current and proper support to children with special transportation needs should be developed by the Individualized Education Program team, including the parent, school transportation director, and school nurse, in conjunction with physician orders and recommendations. With this statement, we provide current guidance for the protection of child passengers with specific health care needs. Guidance that applies to general school transportation should be followed, inclusive of staff training, provision of nurses or aides if needed, and establishment of a written emergency evacuation plan as well as a comprehensive infection control program. Researchers provide the basis for recommendations concerning occupant securement for children in wheelchairs and children with other special needs who are transported on a school bus. Pediatricians can help their patients by being aware of guidance for restraint systems for children with special needs and by remaining informed of new resources. Pediatricians can also play an important role at the state and local level in the development of school bus specifications.

A Texas Two-Step in the Right Direction--Looking Beyond Recent Legislation to Improve the Provision of Special Education Services in Texas.

This article analyzes the current state of the special education system in Texas following the 85th Legislative Session, focusing on the practical and legal implications of the limitation imposed by the Texas Education Agency in 2004 before analyzing Senate Bill 160, which requires Texas to remove the limitation on special education services, and its future impact on special education in Texas. Additionally, this article addresses Senate Bill 927, which outlined a plan to ensure that students who were previously denied services receive an adequate evaluation, why the legislation failed, and potential remedies for students who have been negatively impacted by the limitation over the years. Following this discussion, policy recommendations on how to further improve the current state of special education in Texas are proposed.

Assistance to States for the Education of Children With Disabilities and Preschool Grants for Children With Disabilities Program; Early Intervention Program for Infants and Toddlers With Disabilities. Final regulations.

The Secretary of Education (Secretary) amends the regulations implementing Parts B and C of the Individuals with Disabilities Education Act (IDEA). These conforming changes are needed to implement statutory amendments made to the IDEA by the Every Student Succeeds Act (ESSA), enacted on December 10, 2015. These regulations remove and revise IDEA definitions based on changes made to the definitions in the Elementary and Secondary Education Act of 1965 (ESEA), as amended by the ESSA, and also update several State eligibility requirements to reflect amendments to the IDEA made by the ESSA. They also update relevant cross-references in the IDEA regulations to sections of the ESEA to reflect changes made by the ESSA. These regulations also include several technical corrections to previously published IDEA Part B regulations.

O cuidado às crianças com condições crônicas e a garantia de seus direitos sociais

Introdução: as crianças com condições crônicas têm aumentado nas últimas décadas, porém, o atendimento das necessidades e a inclusão social dessas crianças são prejudicados pelas dificuldades que as famílias vivenciam para realizar os cuidados no domicílio e ter acesso aos serviços de saúde, assistência social e educação. Objetivo Geral: Analisar os direitos sociais garantidos às crianças com condições crônicas. Objetivos Específicos: Verificar as políticas públicas brasileiras relacionadas aos direitos sociais das crianças com condições crônicas; e analisar o acesso da criança com condição crônica aos serviços prestados pelas instituições educacionais, de saúde e de assistência social. Método: Foram desenvolvidos pesquisa documental das legislações brasileiras que configuravam políticas sociais e estudo de casos múltiplos etnográfico, com abordagem qualitativa. Como referencial teórico-metodológico, foram adotados a abordagem de cidadania e direitos sociais e os princípios da sociologia das ausências e das emergências de Boaventura Santos. A partir da indicação de crianças com condições crônicas em serviços da regional Norte do município de Belo Horizonte, Minas Gerais, foram estudadas as experiências de 3 crianças com condições crônicas e de suas famílias, por meio de entrevistas com familiares, gestores e profissionais das instituições de saúde, assistência social e educação, além de observação participante nos espaços sociais. Os critérios para a indicação foram a criança ter condição crônica (segundo Stein e colaboradores) e a experiência da família em relação à garantia dos direitos sociais. Para a análise dos dados foi utilizada Análise de Discurso Crítica, conforme proposta por Fairclough, e o desenvolvimento de ecomapas. Foram atendidas as diretrizes e normas regulamentadoras de pesquisas envolvendo seres humanos. Resultados:...

Introduction: children with chronic conditions have risen in the last decades, however, meeting the needs and social inclusion of these children are hampered by the difficulties that families experience in home care and access to health, social care and educational services. General objective: to analyze the social rights guaranteed to children with chronic conditions. Specific Objectives: to verify Brazilian public policies related to social rights of children with chronic conditions; and analyze access of children with chronic conditions to services provided by educational, health and social care institutions. Method: was carried out documentary research of Brazilian legislations that constituted social policies and multiple ethnographic case study with a qualitative approach. As a theoretical and methodological framework, we adopted the approach on citizenship and social rights and the principles of the sociology of absences and emergencies developed by Boaventura Santos. From the indication of children with chronic conditions in services of the northern region of Belo Horizonte city, state of Minas Gerais, the experiences of 3 children with chronic conditions, and their families were studied through interviews with family members, managers and professionals from health, social assistance and education institutions, also participant observation of children and their families in social spaces. The criteria for the indication were a child with a chronic condition (according to Stein and coworkers) and the family experience regarding the guarantee of social rights. For the data analysis was used the Critical Discourse Analysis proposed by Fairclough and the development of ecomaps. Guidelines and standards regulating research involving human beings were addressed. Results...

Assistance to States for the Education of Children With Disabilities; Preschool Grants for Children With Disabilities. Final regulations.

The Secretary amends the regulations under Part B of the Individuals with Disabilities Education Act (IDEA) governing the Assistance to States for the Education of Children with Disabilities program and the Preschool Grants for Children with Disabilities program. With the goal of promoting equity under IDEA, the regulations will establish a standard methodology States must use to determine whether significant disproportionality based on race and ethnicity is occurring in the State and in its local educational agencies (LEAs); clarify that States must address significant disproportionality in the incidence, duration, and type of disciplinary actions, including suspensions and expulsions, using the same statutory remedies required to address significant disproportionality in the identification and placement of children with disabilities; clarify requirements for the review and revision of policies, practices, and procedures when significant disproportionality is found; and require that LEAs identify and address the factors contributing to significant disproportionality as part of comprehensive coordinated early intervening services (comprehensive CEIS) and allow these services for children from age 3 through grade 12, with and without disabilities.

Primera infancia y discapacidad en Chile: revisión y enfoque actual a los programas de gobierno / Early childhood and disability in Chile: review and current approach to government programs

En el presente artículo se realiza una revisión acerca de la Primera Infancia en situación de discapacidad en Chile, se abordarán los programas de gobierno que existen, su actual enfoque y se analizará si las soluciones que ofrecen son pertinentes y eficientes para este importante grupo de niños y niñas. El trabajo toma como marco de referencia la Convención sobre los Derechos del Niño y la Convención sobre los Derechos de las Personas en Situación de Discapacidad, con el fin de evaluar el estado de los derechos de estos niños y si los programas de gobierno garantizan lo convenido en ambas convenciones.

In this article we review the current Chilean government programs about early childhood with disability. The current focus of these programs will be addressed in order to analyze whether the solutions they provide are relevant and efficient for this significant group of children. This article takes as a reference the Convention on the Rights of the Child and the Convention on the Rights of Persons with disability, to assess the state of the rights of these children and whether government programs guarantee what is enshrined in both conventions.

[Inclusion - pediatric and adolescent psychiatry aspects]. / Inklusion - kinder- und jugendpsychiatrische Aspekte.

The Convention on the Rights of Persons with Disabilities became legally binding in Germany in March 2009. "Inclusion" is the major concept­all people with any kind of handicap must have the same rights to full and effective participation and inclusion in society. Preceding inclusion come adjustments in society with regard to ethical, legislative, administrative, conceptual, structural, economical, and thus also to healthcare-political frameworks, in order to make disabilities are as far as possible no longer a handicap in an individual's everyday life. This review first outlines the present social status influencing the development of children, a child's welfare, and especially the healthcare of children and adolescents with psychiatric disorders and conditions indicating barriers to inclusion. It focuses on those articles of the UN convention which are relevant with regard to ethical attitude, epidemiology, healthcare framework, diagnostics, therapy, teaching, and research with respect to child and adolescent psychiatry. The analysis points to a significant backlog demand in child psychiatric healthcare, teaching, and research.

Patient Protection and Affordable Care Act of 2010 and children and youth with special health care needs.

The Patient Protection and Affordable Care Act (ACA) was designed to (1) decrease the number of uninsured Americans, (2) make health insurance and health care affordable, and (3) improve health outcomes and performance of the health care system. During the design of ACA, children in general and children and youth with special health care needs and disabilities (CYSHCN) were not a priority because before ACA, a higher proportion of children than adults had insurance coverage through private family plans, Medicaid, or the State Children's Health Insurance Programs (CHIP). ACA benefits CYSHCN through provisions designed to make health insurance coverage universal and continuous, affordable, and adequate. Among the limitations of ACA for CYSHCN are the exemption of plans that had been in existence before ACA, lack of national standards for insurance benefits, possible elimination or reductions in funding for CHIP, and limited experience with new delivery models for improving care while reducing costs. Advocacy efforts on behalf of CYSHCN must track implementation of ACA at the federal and the state levels. Systems and payment reforms must emphasize access and quality improvements for CYSHCN over cost savings. Developmental-behavioral pediatrics must be represented at the policy level and in the design of new delivery models to assure high quality and cost-effective care for CYSHCN.

Identification of learning disabilities: implications of proposed DSM-5 criteria for school-based assessment.

This article examines the recommended eligibility determination for learning disabilities (LD) in both the Individuals with Disabilities Education Improvement Act and the proposed changes in diagnostic criteria in the DSM-5. The focus is on the inclusion of the criterion of responsiveness to intervention (RTI) and the implications for practice of school psychologists and general and special education teachers. The research base on RTI for diagnostic purposes is examined, and considerations of changing roles for clinicians and school-based practitioners are discussed.