Descriptive study of young disabled children aged 2-6, enrolled in mainstream schools, and benefiting from special needs assistants in the Bouches-du-Rhône in 2014.

BACKGROUND: Since the law of February 11, 2005, in France, the number of children with disabilities enrolled in ordinary schools has increased steadily. As a result, the amount of personal support provided by a special needs assistant (personal support) is also increasing. The aim of the study was to describe the diseases and impairments of disabled children aged 2-6, enrolled in mainstream schools and benefiting from personal support for schooling by special needs assistants in the Bouches-du-Rhône (France) in 2014. METHODS: A cross-sectional descriptive study was performed. Children included were benefiting from either an individual or shared personal support. Physicians from the territorial organization in charge of disability coded diseases and deficiencies using the International Classification of Diseases, 10th revision, and nomenclature inspired by the International Classification of Functioning, Disability and Health. RESULTS: Medical data were coded for 990 children out of 1260 of the total population. These young disabled children were most frequently children with pervasive developmental disorders (23.3%), lack of expected normal physiological development (19.9%), or mixed specific developmental disorders (13.5%), and most often had behavioral, personality, and relational skills disorders (61.8%), psychomotor function impairments (51.9%), or written or oral language learning impairment (43.2%). Finally, the two main types of impairments most represented among these children were psychological impairments (86.7%) and language and speech impairments (79.8%). The children were most often supported by an individual personal support (for one child only) than by a shared personal support (60% vs. 40%). They were mainly boys (almost 75%). CONCLUSION: This study provides working guidelines for the management of health policies relating to disability at the territorial or even national level.

The French Cochlear Implant Registry (EPIIC): Perception and language results in infants with cochlear implantation under the age of 24 months.

OBJECTIVE: Multi-centre study of the National French Registry (EPIIC) of patients with cochlear implants, focusing on infants who were operated-on under the age of 24 months between 2012 and 2016. PATIENTS AND METHODS: A total of 615 profoundly deaf infants, who received cochlear implants (CIs) before their second birthday, were included in the registry by different CI centers. Epidemiological, surgical, speech therapy and school, follow-up data were included in the registry, 12, 24, 36 and 48 months thereafter. The following parameters were studied: type of implantation (uni- or bilateral), complications, cause of deafness, category of auditory perception (CAP), Open-set word recognition score (OSW), speech intelligibility rating, lexical comprehension with EVIP (Peabody), communication mode and type of schooling. Bilateral simultaneous CI (BiCI) and unilateral CI (UniCI) groups were compared. RESULTS: There were 744 implantations. The explantation-reimplantation rate, within the four-year follow-up, was just 3.6%. Mean implantation age was 16.0 months, and similar in the two groups (BiCI/UniCI). A total of 51% of children had their first implant between 12 and 18 months, and 15% before 12 months. Implantation was unilateral in 52% of cases. Fifty-six percent of the bilateral procedures were sequential, with a mean delay of 16.8 months for the second implantation. The cause of deafness was unknown in 52% of cases. Of the 48% (297/615) of attributed cases, 32% had clear genetic causes. The remaining deafness was due to cytomegalovirus (CMV, 8%), inner-ear malformation (5%) and meningitis (3%). The main complications were from infections (47%) and internal device failure (25%). Four years post-operation, 84% of the UniCI and 75% of BiCl groups had a CAP≥5, and 83% of UniCl and 100% BiCI had OSW≥80%. Furthermore 74% of UniCI and 77% of BiCI communicated orally and 85% of UniCI and 90% of BiCI integrated into mainstream schooling. CONCLUSION: The French Registry of cochlear implants (EPIIC) is the only such national registry in the world. Our analysis illustrates the immediate benefits of, either single or double, cochlear implantation for language, perception skills and schooling.

College Access, Success and Equity for Students on the Autism Spectrum.

College may be considered a gateway to success, yet access to college is limited for young adults with autism. Given the research recommendations to elicit student experiences and to communicate among universities to improve college access, success, and equity, the present study examined the questions: What factors are perceived as pathways to success or barriers to success by college students on the autism spectrum? What university provided accommodations and/or support services do they prefer? Participants from four universities completed surveys and semi-structured interviews. Findings from the multi-university study suggest the need to provide transition planning and systematic non-academic social and emotional supports from the start of the college experience as well as specific training for faculty, staff, and peers.

Indonesian teachers' epistemological beliefs and inclusive education.

A growing number of children with intellectual disabilities attend inclusive schools in Indonesia. Previous research has suggested that teachers' type of school and experience influences their beliefs about inclusive education. This research collected questionnaire data from 267 Indonesian teachers and compared the responses from those working in inclusive, special and regular schools regarding their epistemological and pedagogical beliefs. The results showed that teachers in inclusive schools expressed stronger social constructivist beliefs than those in other schools. However, it was teachers' epistemological beliefs, rather than their type of school or experience, which were the significant predictor of their beliefs about inclusive education. The findings suggest that international epistemological research needs to have a more nuanced view of constructivist models of learning to better understand and inform how inclusive pedagogy is being enacted in different contexts.

Career and Technical Education, Inclusion, and Postsecondary Outcomes for Students With Learning Disabilities.

We used longitudinal data from Washington State to investigate the relationships among career and technical education (CTE) enrollment, inclusion in general education, and high school and postsecondary outcomes for students with learning disabilities. We replicated earlier findings that students with learning disabilities who were enrolled in a "concentration" of CTE courses had higher rates of employment after graduation than observably similar students with learning disabilities who were enrolled in fewer CTE courses. We also found that students with learning disabilities who spent more time in general education classrooms in high school had higher rates of on-time graduation, college attendance, and employment than observably similar students with learning disabilities who spent less time in general education classrooms in these grades.

A Comparison Between Caregiver-Reported Anxiety and Other Emotional and Behavioral Difficulties in Children and Adolescents with Autism Spectrum Disorders Attending Specialist or Mainstream Schools.

Increasing numbers of students with Autism Spectrum Disorder (ASD) are attending mainstream schools. Nonetheless, concerns about their emotional well-being and mental health in these settings have also been raised. This study sought to compare caregiver-reported anxiety and other emotional and behavioural problems in youth with ASD attending mainstream or specialist schools. Caregivers of 27 youth with ASD in mainstream schools (age 10.91 ± 3.44 years) and 69 youth with ASD in special schools (age 10.93 ± 2.81 years) matched for gender, age, adaptive functioning and autism symptom severity scores participated. Caregivers completed the Spence Children's Anxiety Scale-Parent, a measure of adaptive functioning, and a checklist of other emotional and behavioral difficulties. Students with ASD attending mainstream schools experienced higher levels of social anxiety symptoms compared to their specialist school counterparts. No other statistically significant differences were found in other aspects of emotional and behavioural functioning examined, but some differences emerged in item-level analyses. Uncertainties in navigating more complex social environments and increased social relating difficulties in mainstream schools are discussed as probable environmental triggers for increased social phobia related symptomatology, although other explanations for this small effect size difference are also considered. Limitations of the present study and recommendations for future research focusing on exploring environmental socio-ecological factors influencing anxiety and mental health in young people with ASD are also discussed.

Self-rated health and wellbeing among school-aged children with and without special educational needs: Differences between mainstream and special schools.

BACKGROUND: Studies among students with special educational needs (SEN) in separate special schools (SSS) and mainstream schools (MS) are particularly applicable to educational attainment and social participation. However, indicators of health and wellbeing have rarely been considered. AIMS: This study investigates two related topics: first, health and wellbeing differences between students with SEN in special schools (SSS) and students without SEN in regular schools, and second, the rarely considered question whether health and wellbeing among students with SEN differ between school settings (i.e. MS vs. SSS). METHODS AND PROCEDURES: Bivariate and multilevel analyses are applied with data from the German National Educational Panel Study (NEPS) with 5267 students (grade 7). OUTCOMES AND RESULTS: After having controlled for background characteristics, students in SSS report higher likelihoods of poor self-rated health compared to students in higher track schools. Self-rated health of students with SEN does not significantly differ between MS vs. SSS. For life satisfaction, students with SEN show higher likelihoods of low life satisfaction when attending MS. CONCLUSIONS AND IMPLICATIONS: Teachers in inclusive settings are encouraged to establish class work and teaching that support a real change from class placement to inclusive culture in order to suitably support students with SEN.

Mainstream school readiness skills of a group of young cochlear implant users.

OBJECTIVES: The aims of the study were to compare the mainstream school readiness skills of young cochlear implant (CI) users to that of a group of normal hearing (NH) children and assessed the inter-rater agreement between parents and teachers on school readiness skills of the CI children. METHODS: A total of 11 parents and 8 teachers of the 6-year old CI children participated and rated the children using the School Readiness Scale to Year One. Data from 207 6-year old NH children from five states in Malaysia were also collected using the same scale which has nine domains. Results from the NH children were categorized into the 25th and 75th percentile scores to be the reference cut-offs for below average (below the 25th percentile), average (25th to 75th percentile) and above average (above 75th percentile). RESULTS: The school readiness skills of the CI children were lower than the NH group as rated by teachers especially in the civic and language and communication domains. Comparisons between parents' and teachers' ratings for 8 CI children indicated that teachers tended to rate the CI children's school readiness poorer than that of parents especially in the academic domain. Intra-class correlation analysis revealed poor inter-rater agreement. CONCLUSIONS: The results suggest that our CI children, generally, need an intervention 'bridging' program to improve their school readiness skills. Parents and teachers had different views on the readiness of the CI children at school entry level.

Long-term outcomes of Universiti Kebangsaan Malaysia Cochlear Implant Program among pediatric implantees.

OBJECTIVES: Cochlear implant (CI) greatly enhances auditory performance as compared to hearing aids and has dramatically affected the educational and communication outcomes for profoundly deaf children. Universiti Kebangsaan Malaysia (UKM) pioneered CI program in 1995 in the South East Asia. We would like to report the long-term outcomes of UKM paediatric cochlear implantation in terms of: the proportion of children who were implanted and still using the device, the children's modes of communication, their educational placements, and their functional auditory/oral performance. We also examined the factors that affected the outcomes measured. STUDY DESIGN: This was a cross sectional observational study. METHODS: Two sets of questionnaires were given to 126 parents or primary caregivers of the implantees. The first set of questionnaire contained questions to assess the children's usage of CI, their types of education placement, and their modes of communication. The second set of questionnaire was the Parent's Evaluation Of Aural/Oral Performance of Children (PEACH) to evaluate the children's auditory functionality. RESULTS: Our study showed that among the implantees, 97.6% are still using their CI, 69.8% communicating orally, and 58.5% attending mainstream education. For implantees that use oral communication and attend mainstream education, their mean age of implantation is 38 months. This is significantly lower compared to the mean age of implantation of implantees that use non-oral communication and attend non-mainstream education. Simple logistic regression analysis shows age of implantation reliably predicts implantees (N = 126) would communicate using oral communication with odds ratio of 0.974, and also predict mainstream education (N = 118) with odds ratio of 0.967. The median score of PEACH rating scale is 87.5% in quiet, and this significantly correlates with an earlier age of implantation (r = -0.235 p = 0.048). CONCLUSIONS: UKM Cochlear Implant Program has achieved reasonable success among the pediatric implantees, with better outcomes seen in those implanted at the age of less than 4 years old.

Mismatch between diagnostic reports and special educational needs classification in a public educational system.

OBJECTIVE: To assess the diagnostic status, the sociodemographic and health profiles for students with special educational needs (SEN) in a public educational system, and to map their use of educational/social services. METHODS: The sample comprised 1,202 SEN students from a total of 59,344 students. RESULTS: Only 792 students of the 1,202 had an established diagnosis. The most prevalent SEN condition was intellectual disability. There was a low percentage (29.4%) of use of specialized educational services or support. It was found that, for some neurodevelopmental disorders, prevalence data suggest an under-reporting in the school system. CONCLUSION: Results suggest that there is a mismatch between the diagnostic reports and the SEN condition legally recognized according to Brazilian law, in addition to the under-reporting and under specialized service use of students with disabilities.

Mismatch between diagnostic reports and special educational needs classification in a public educational system / Descompasso entre os registros diagnósticos e a classificação de necessidade educacional especial em uma rede municipal de educação

ABSTRACT Objective To assess the diagnostic status, the sociodemographic and health profiles for students with special educational needs (SEN) in a public educational system, and to map their use of educational/social services. Methods The sample comprised 1,202 SEN students from a total of 59,344 students. Results Only 792 students of the 1,202 had an established diagnosis. The most prevalent SEN condition was intellectual disability. There was a low percentage (29.4%) of use of specialized educational services or support. It was found that, for some neurodevelopmental disorders, prevalence data suggest an under-reporting in the school system. Conclusion Results suggest that there is a mismatch between the diagnostic reports and the SEN condition legally recognized according to Brazilian law, in addition to the under-reporting and under specialized service use of students with disabilities.

RESUMO Objetivo Avaliar a situação diagnóstica, o perfil sociodemográfico e de saúde dos alunos com necessidades educacionais especiais (NEE) de uma rede municipal de educação, assim como mapear o uso de serviços educacionais e sociais. Métodos A amostra foi composta por 1202 alunos com NEE de um total de 59344 alunos. Resultados Dos 1202 alunos somente 792 tinha diagnóstico estabelecido. A condição de NEE mais prevalente foi a deficiência intelectual. Verificou-se um baixo percentual (29,4%) de uso de serviços educacionais especializados ou de apoio. Foi constatado que, para alguns transtornos do neurodesenvolvimento, os dados de prevalência parecem indicar uma subnotificação. Conclusão Os resultados sugerem um descompasso entre os registros diagnósticos e a condição de necessidade educacional especial segundo a legislação brasileira, além disso verificou-se uma subnotificação diagnóstica e baixo uso de serviços especializados entre estudantes com deficiências.

Examining Postsecondary Education Predictors and Participation for Students With Learning Disabilities.

Given the history of poor postschool outcomes for students with disabilities, researchers repeatedly sought to demonstrate the links between predictor variables and postschool outcomes for students with disabilities. This secondary data analysis used the National Longitudinal Transition Study-2 to examine the relationship between postsecondary education-related transition services and postsecondary education participation for students with learning disabilities. Logistic regression analyses indicated receiving core content area instruction in the general education classroom was positively related to postsecondary education participation. Frequency distributions indicated students with learning disabilities attended 2-year college at higher rates than other postsecondary education programs. The results suggest educators should consider inclusion in general education classroom for core content area instruction for students with learning disabilities with postsecondary education goals to the extent permitted by their least restrictive environment.

Improving access to school based education for South African children in rural areas who have a tracheostomy: A case series and recommendations.

OBJECTIVES: Currently few children with tracheostomies attend rural mainstreams schools in South Africa limiting their ability to gain an education. We sought to document the current school experience for the few children attending school who have tracheostomies and devise educational tools for teachers and administrators that will facilitate greater acceptance and safety in classrooms for this population. METHODS: The four patients that are currently attending school with a tracheostomy were identified from the patient records of a tertiary hospital with a pediatric tracheostomy home based care service. With the aid of a Zulu language translator, the mothers and classroom teachers completed a semi structured interview and closed item questionnaire in their home and school, respectively. Schools were visited to understand and describe the settings in which the children and their teachers were being asked to function. Tools for education were developed in conjunction with key stakeholders at schools already hosting such children. RESULTS: The key teacher-identified barriers to enrollment were: teacher unfamiliarity with tracheostomies, uncertainty about the school's liability, and concerns about the response of other children. The safety barriers identified were: greater than 60 children per classroom - limiting teacher's ability to attend to the child with a tracheostomy, lack of running water, pit latrines separate from school threatening hygiene and isolating the child when they leave to use the latrines & sandy classrooms which can result in sand entering the airway. Identified needs for successful school placement include providing tracheostomy supplies and suctioning equipment, hand hygiene materials and training teachers in: identification of respiratory distress, performance of emergency tracheostomy changes, CPR. CONCLUSIONS: Children with tracheostomies could likely successfully attend South African rural mainstream public schools with a training program for teachers. As a first step, an introductory booklet for teachers that explains tracheostomies and provides educational and safety suggestions was created. A list of recommendations for successful inclusion of students in the school system was developed together with and delivered to key stakeholders.

Factors contributing to the longitudinal development of social participation in individuals with cerebral palsy.

AIMS: We aimed to determine factors associated with the longitudinal development of social participation in a Dutch population of individuals with Cerebral Palsy (CP) aged 1-24 years. METHODS AND PROCEDURES: For this multicentre prospective longitudinal study, 424 individuals with CP aged 1-24 years were recruited from various rehabilitation centers in The Netherlands. Social participation was measured with the Vineland Adaptive Behavior Scales. We assessed associations with age, intellectual impairment, level of gross motor function, gender, type of CP, manual ability, epilepsy, hearing-, visual-, speech impairment and pain, internalizing- and externalizing behavioral problems, type of education and parental level of education. Each individual was measured 3 or 4 times. The time between measurements was 1 or 2 years. OUTCOMES AND RESULTS: Epilepsy and speech impairment were each independently associated with the longitudinal development of social participation. The effects were rather small and did not change with age. Also, a trend was found that children attending special education develop less favorably in social participation. CONCLUSIONS AND IMPLICATIONS: Our results might provide parents and caregivers with starting points to further develop tailored support for individuals with epilepsy, with speech impairment and/or attending special education at risk for suboptimal social participation.

The transition from primary to secondary school in mainstream education for children with autism spectrum disorder.

The transition from primary to secondary education (hereafter 'school transition') is a major ecological shift that poses considerable social, emotional, academic and organisational challenges. It is commonly assumed that this school transition is especially difficult for children with autism spectrum disorder, but that idea is mainly based on anecdotal evidence and requires systematic investigation. We describe change and continuity for children with autism spectrum disorder (N = 28, mean age = 11.29 years, mean full-scale IQ = 87.86) transitioning in mainstream education from primary to secondary school. Levels of psychopathology, adaptive functioning and peer victimisation were measured by parent, self and teacher report in the last year of primary school, and again after one term of secondary school. At follow-up, all participants were still in their secondary school, and there was no evidence for a marked escalation of difficulties during the transition. Instead, we observed high levels of psychopathology and maladaption at baseline which persisted across the transition and were in some cases under-recognised. By parent report, levels of bullying fell from primary to secondary school. Future research should investigate factors, such as school characteristics, that influence the move to secondary education in autism spectrum disorder, to inform the development of interventions to promote successful school transition.

A meta-analysis of the effects of placement on academic and social skill outcome measures of students with disabilities.

This study involved an investigation of differences between outcome measures of students with disabilities placed in more integrated settings with those of students placed in less integrated settings. A meta-analysis was conducted using the findings from 24 studies published in peer-reviewed journals from 1980 through 2013. Results from the analyses suggest that there were significant differences (p<0.0001) between placement settings with the majority of students with disabilities in more integrated settings outperforming those in less integrated settings on both academic and social outcome measures. Overall these findings, combined with those from two prior meta-analytic studies, provide evidence spanning over 80 years suggesting separate settings are not as beneficial as are more integrated settings. Implications related to practice and policy, as well as avenues for future study, are discussed.

Risk factors for bullying among children with autism spectrum disorders.

Although children with disabilities have been found to be at an increased risk of bullying, there are limited studies investigating predictors of bullying involvement in children with autism spectrum disorders. The current study presents findings from 1221 parents of children diagnosed with autism spectrum disorder who were selected from a national web-based registry. Parents completed a survey dedicated to the school and bullying experiences of their child, and multivariate logistic regression analyses were conducted to identify child and school risk factors for involvement as victim, bully, or bully-victim. Additional analyses examined the risk of bullying involvement based on the amount of time spent in general education classrooms. Children diagnosed with Asperger's disorder, attending a public school or a school with a general education population, were at the greatest risk of being victimized in the past month. Children with comorbid conditions and a high level of autistic traits were the most likely to be victims, bullies, and bully-victims. Finally, children in full inclusion classrooms were more likely to be victimized than those who spend the majority of their time in special education settings. Future research studies should be invested in finding appropriate supports for children with autism spectrum disorder placed in inclusive settings.

Impact of early intervention on children with autism spectrum disorders as measured by inclusion and retention in mainstream schools.

OBJECTIVES: To follow up the school/educational status of children with a primary diagnosis of Autism Spectrum Disorders (ASD), who had been enrolled in an Early Intervention (EI) program for 1-3 y, before the age of 6. METHODS: Data was collected through a questionnaire covering three specific areas-the families' success in following the recommendation given on completion of the EI program, issues in schooling and feedback on the EI program. The contact modes included email, post, telephonic interviews and face-to-face interviews. RESULTS: One hundred and two of the 296 children responded to the questionnaire. The responses were analyzed to identify, the number of families who had completed the program and were able to follow through with the recommendation given on completion of the EI program, difficulties faced if any, family feedback on the program and the additional help that they would have liked to receive. The reasons for failure to comply with the recommendations were analyzed. Of the 102 children who responded seven had dropped out midway through the program and 10 had discontinued after one year. Of the remaining 85 who completed the program, 71 were advised mainstreaming (83.5 %) and 14 were advised special school (16.5 %). Sixty-five of the 71 children, who were advised to enroll their child in the mainstream, were in regular school. 76.5 % of the children who completed the EI program were integrated in regular schools, 2 to 7 y after having completed the program. CONCLUSIONS: EI helps in enrolment and retention of substantial numbers of children with ASD in mainstream schools.

Patterns and predictors of participation in leisure activities outside of school in children and adolescents with Cerebral Palsy.

This study analyzed the patterns and predictors of participation in leisure activities outside of school of Spanish children and adolescents with Cerebral Palsy (CP). Children and adolescents with CP (n = 199; 113 males and 86 females) participated in this cross-sectional study. Their mean age was 12.11 years (SD = 3.02; range 8-18 years), and they were evaluated using the Spanish version of the Children's Assessment of Participation and Enjoyment (CAPE). Means, standard deviations and percentages were used to characterize the profile of participation, and linear regression analyses were employed to assess associations between the variables (child, family and environmental factors) and the diversity, intensity and enjoyment of participation. Children and adolescents with CP reported low diversity and intensity of participation and high levels of enjoyment. Participation in leisure activities outside of school was determined more by child and environmental factors than by family ones.