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.

Epidemiological survey of epilepsy in the special school population in the city of Buenos Aires. A comparison with mainstream schools.

BACKGROUND: Previous studies in special schools have shown a high prevalence of epilepsy, which is strongly associated with cerebral palsy and severe mental retardation. The conditions regulating school placement have also been described in those studies. In the City of Buenos Aires, information is known only for mainstream schools. OBJECTIVE: To determine the prevalence and characteristics of epilepsy in special schools and to compare results with common primary education settings. DESIGN AND METHODS: A cross-sectional study was carried out in special schools in the City of Buenos Aires, by adopting the same definitions, diagnostic criteria and questionnaire as those used in a previous study in the common primary school population. Responses from 1,682 children, aged 6-16 years, residing in the City of Buenos Aires, with mental retardation, visual or hearing impairment, psychiatric disorders and motor disabilities were analyzed. RESULTS: A total of 121 children with epilepsy were detected. Lifetime prevalence was 71.9 per thousand and active prevalence was 64.8 per thousand (22-25 times greater than rates in mainstream schools). Prevalence was highest in girls and generalized seizures prevailed over other seizure types. Ninety-two percent of cases received antiepileptic drugs, 57.9% as a single drug treatment and 85.1% in adequate doses. Only 56% of the children with a diagnosis of epilepsy proved to be true-positive cases, and almost 40% received antiepileptic drugs for nonepileptic disorders. Malformations/degenerative disease were the most common etiology. CONCLUSIONS: Special schools contain clusters of children with epilepsy as a comorbid condition. False high frequency is due to misdiagnoses and unnecessary treatments. These schools are an important target for educational interventions.