Need For Special Education Services Research Articles

Healthcare Disparities in Early Childhood Brain Injury

<h3>Research Objectives</h3> While healthcare and educational disparities are known to impact minoritized groups, few research studies have been conducted to examine disparities after childhood acquired brain injury (ABI). The purpose of this study was to explore child factors associated with referral (i.e., race, socioeconomic status, type and time since injury, length of hospital stay), parent education, and long-term need for children who experienced an early childhood ABI. <h3>Design</h3> Secondary-analysis of data collected through retrospective cohort chart review and prospective caregiver phone surveys. <h3>Setting</h3> Large, urban Trauma 1 pediatric hospital in the Midwestern US. <h3>Participants</h3> 29 caregivers of children who experienced an ABI before five years of age and currently in elementary or middle school. <h3>Interventions</h3> Not applicable. <h3>Main Outcome Measures</h3> Medical records and a 10-min phone survey that included a series of yes/no and short open-ended questions. <h3>Results</h3> Logistic regressions indicated a significant association between child factors and 1) referral to services at hospital discharge (p = .004) and 2) caregiver-reported long-term need for special education services (met and unmet; p = .009). The models for caregiver-reported receipt of education on ABI and caregiver-reported unmet need for special education were not significant. For both significant models, there were no significant individual predictors, but some factors appear to have stronger associations than others. <h3>Conclusions</h3> Differences in acute and long-term service provision and need after childhood ABI are likely influenced by a complex interaction of individual, injury, and social-environmental factors. Future research should consider how healthcare and education practice and policy might account for these interactions to support more equitable access to and utilization of services to improve long-term outcomes for all children with ABI. <h3>Author(s) Disclosures</h3> Jessica Salley Riccardi and Jennifer Lundine have no financial or non-financial relationships to disclose.

Promoting Anti-Racism Practices and the Cycle of Critical Consciousness within Positive Behavior Interventions and Supports Frameworks

Note this manuscript has supplementary files that will only be available online and does not need to be included in the printed version. text for online abstract: The interpretation of behavior of from marginalized backgrounds is susceptible to prejudice, bias, and racist ideology. This is especially true when evaluations include subjective assessment of perceived challenging behaviors which has historically led to overrepresentation of student from marginalized backgrounds at-risk of or with an emotional disturbance. While Positive Behavior Intervention and Supports (PBIS) frameworks are increasingly used in schools to support students behaviorally and decrease the need for special education services, students of color continue to be overrepresented as needing supports within these frameworks. One possible cause for this overrepresentation is implicit bias in evaluation and intervention of behavior for marginalized students. In an effort to increase the cultural responsiveness of PBIS frameworks, we describe the incorporation of anti-racist actions and the concept of critical consciousness in evaluating student behavior.

Toddler Neurodevelopmental Outcomes Are Associated With School-Age IQ in Children With Single Ventricle Physiology

To examine whether neurodevelopment at preschool age predicts IQ levels and needs for special education services in school-age children with single ventricle (SV) physiology. Thirty-five patients with SV physiology were assessed using the Bayley Scale of Infant and Toddler Development (BSID) II or III at 3 years and the Wechsler Intelligence Scale for Children-Fourth Edition (WISC) at 8 years. Whether the children were receiving special education services was also determined. Factors associated with the mental developmental index (MDI) of the BSID, the full-scale IQ (FSIQ) of the WISC, and special education services were also analyzed. The MDI and FSIQ of children with SV physiology were significantly lower than the values in healthy children (P < 0.01). The MDI at 3 years was moderately correlated with FSIQ at 8 years (P < 0.01, R2 = 0.41). Ten patients (28.6%) received special education services in their school. Children with MDI <85 were more likely than those with MDI ≥85 to require special education services at school age (53% and 10%, respectively, P < 0.01). Weight at birth and stage II were correlated with the MDI, extracorporeal circulation time at stage II was correlated with FSIQ, and age at Fontan operation was correlated with FSIQ and special education services. The toddler neurodevelopment index may predict not only IQ levels but also the need for special education services in school-age children. Children with low neurodevelopmental scores need to be followed closely for a long time.

Late Morbidity and Mortality Among Medulloblastoma Survivors Diagnosed Across Three Decades: A Report From the Childhood Cancer Survivor Study.

Treatment of medulloblastoma has evolved from surgery and radiotherapy to contemporary multimodal regimens. However, the impact on long-term health outcomes remains unknown. Cumulative incidence of late mortality (5 or more years from diagnosis), subsequent neoplasms (SNs), and chronic health conditions were evaluated in the Childhood Cancer Survivor Study among 5-year survivors of medulloblastoma diagnosed between 1970 and 1999. Outcomes were evaluated by treatment exposure, including historical therapy (craniospinal irradiation [CSI] ≥ 30 Gy, no chemotherapy), high risk (CSI ≥ 30 Gy + chemotherapy), standard risk (CSI < 30 Gy + chemotherapy), and by treatment decade (1970s, 1980s, 1990s). Rate ratios (RRs) and 95% CIs estimated long-term outcomes using multivariable piecewise exponential models. Among 1,311 eligible survivors (median age, 29 years [range, 6 to 60 years]; median time from diagnosis, 21 years [range, 5 to 44 years]), the 15-year cumulative incidence rate of all-cause late mortality was 23.2% (diagnosed 1970s) versus 12.8% (1990s; P = .002), with a recurrence-related mortality rate of 17.7% versus 9.6% ( P = .008). Lower late mortality rates as a result of other health-related causes were not observed. Among 997 survivors who completed a baseline survey, the 15-year cumulative incidence of SNs was higher among survivors with multimodal therapy (standard risk, 9.5%; historical, 2.8%; P = .03). Survivors treated in the 1990s had a higher cumulative incidence of severe, disabling, life-threatening, and fatal chronic health conditions (56.5% in 1990s v 39.9% in 1970s; P < .001) and were more likely to develop multiple conditions (RR, 2.89; 95% CI, 1.31 to 6.38). However, survivors of standard-risk therapy were less likely to use special education services than high-risk therapy survivors (RR, 0.84; 95% CI, 0.75 to 0.93). Historical changes in medulloblastoma therapy that improved 5-year survival have increased the risk for SNs and debilitating health conditions for survivors yet reduced the need for special education services.

Cognitive outcomes and age of detection of severe mucopolysaccharidosis type 1.

The US Secretary of Health and Human Services recommended in February 2016 that mucopolysaccharidosis type 1 (MPS I) be added to the recommended uniform screening panel for state newborn screening programs. One of the key factors in this decision was the evidence suggesting that earlier treatment with hematopoietic cell transplantation (HCT) for the most severe form, Hurler syndrome (MPS IH), would lead to improved cognitive outcomes. Consistent evidence from peer-reviewed studies suggests that transplantation in the first year of life is associated with improved developmental quotient or intelligence quotient and continued cognitive growth, with earlier age of treatment associated with improved outcomes. However, available evidence suggests that cognitive functioning and attention can still lag behind unaffected age-matched children, leading to the need for special education services. Verbal and nonverbal cognitive abilities outcomes may be affected differently by HCT. With the recent addition of MPS I to the recommended uniform screening panel, future work is needed to evaluate the impact of earlier, presymptomatic detection and treatment initiation and other supportive therapies on cognitive outcomes.Genet Med advance online publication 26 January 2017.

Screening for mucopolysaccharidoses in patients with short stature of unknown etiology

The US Secretary of Health and Human Services recommended in February 2016 that mucopolysaccharidosis type 1 (MPS I) be added to the recommended uniform screening panel for state newborn screening programs. One of the key factors in this decision was the evidence suggesting that earlier treatment with hematopoietic cell transplantation (HCT) for the most severe form, Hurler syndrome (MPS IH), would lead to improved cognitive outcomes. Consistent evidence from peer-reviewed studies suggests that transplantation in the first year of life is associated with improved developmental quotient or intelligence quotient and continued cognitive growth, with earlier age of treatment associated with improved outcomes. However, available evidence suggests that cognitive functioning and attention can still lag behind unaffected age-matched children, leading to the need for special education services. Verbal and nonverbal cognitive abilities outcomes may be affected differently by HCT. With the recent addition of MPS I to the recommended uniform screening panel, future work is needed to evaluate the impact of earlier, presymptomatic detection and treatment initiation and other supportive therapies on cognitive outcomes.Genet Med advance online publication 26 January 2017

The Economic Returns to Early Childhood Education

One way to assess the value of preschool education programs is to compare their upfront costs with the economic benefits they produce, measured by such outcomes as less need for special education services, improved high school graduation rates, higher earnings and less criminal activity in adulthood, and so on. What do such benefit-cost analyses tell us about the wisdom of investing in greater access to preschool? In this article, Lynn Karoly carefully reviews the evidence.

Congenital Heart Defects and Receipt of Special Education Services.

We investigated the prevalence of receipt of special education services among children with congenital heart defects (CHDs) compared with children without birth defects. Children born from 1982 to 2004 in metropolitan Atlanta with CHDs (n = 3744) were identified from a population-based birth defect surveillance program; children without birth defects (n = 860 715) were identified from birth certificates. Cohorts were linked to special education files for the 1992-2012 school years to identify special education services. Children with noncardiac defects or genetic syndromes were excluded; children with CHDs were classified by presence or absence of critical CHDs (ie, CHDs requiring intervention by age one year). We evaluated the prevalence of receipt of special education services and prevalence rate ratios using children without birth defects as a reference. Compared with children without birth defects, children with CHDs were 50% more likely to receive special education services overall (adjusted prevalence rate ratio [aPRR] = 1.5; 95% confidence interval [CI]: 1.4-1.7). Specifically, they had higher prevalence of several special education categories including: intellectual disability (aPRR = 3.8; 95% CI: 2.8-5.1), sensory impairment (aPRR = 3.0; 95% CI: 1.8-5.0), other health impairment (aPRR = 2.8; 95% CI: 2.2-3.5), significant developmental delay (aPRR = 1.9; 95% CI: 1.3-2.8), and specific learning disability (aPRR = 1.4; 95% CI: 1.1-1.7). For most special education services, the excess prevalence did not vary by presence of critical CHDs. Children with CHDs received special education services more often than children without birth defects. These findings highlight the need for special education services and the importance of developmental screening for all children with CHDs.

A Survey of Response to Intervention Team Members' Effective Practices in Rural Elementary Schools

This study examined the perceptions of general and special education teachers regarding the effectiveness of intervention teams in rural elementary schools. The passage of IDEIA 2004 brought considerable support for the use of the Response to Intervention (RtI) process providing research-based interventions to students who are struggling. Response to Intervention emphasizes the use of multidisciplinary teams to problem solve and identify instructional interventions that will address educational deficits and curtail the need for special education services. This process presents a challenge for rural schools to develop effective team practices with limited resources and staff. The researcher surveyed general and special education teachers to examine perceptions of team membership practices and effectiveness based on quality indicators of effective intervention team practices as identified in literature. The study indicated the majority of rural schools represented by the teachers surveyed were implementing the team process. The findings identified team practices, such as problem-solving, teacher support, developing interventions, and implementing interventions, as more effective than ineffective. Quantitative results indicated special education teachers reported a higher degree of knowledge of intervention practices and the team process than general education teachers reported. In addition, the special education teachers reported a higher rate of student referrals to the team for intervention than general education teachers reported. The findings suggest the need for rural schools to consider ongoing professional development for both general and special education teachers regarding effective team intervention team practices in order to refine the process.

Identifying Preschool Children for Higher Tiers of Language and Early Literacy Instruction Within a Response to Intervention Framework

Response to Intervention (RTI) or Multi-Tiered Systems of Support (MTSS) is beginning to be implemented in preschool programs to improve outcomes and to reduce the need for special education services. The proportions of children in programs identified as struggling learners through universal screening have important implications for the feasibility of these approaches as well as for the way programs might allocate resources and staff implementing tiered models of intervention. The expected proportions of children who might be identified for higher tiers of instructional support in pre-kindergarten settings are relatively unknown. The proportions of children who would have been identified for higher tiers of instructional language/literacy support when using three different universal screening measures are described. Participants were 659 children participating in the Center for Response to Intervention in Early Childhood (CRTIEC) Tier 1 Study. Results indicated that the proportions of children at Tier 2 and Tier 3 performance levels were higher for children in low-income eligibility programs and varied by program-level characteristics including numbers of English language learners and children with special needs, as well as the universal screening measure used. Implications of these findings suggest the importance of increased focus on early literacy and language in Tier 1 instruction in programs serving high proportions of children at risk as a means of preventing reading failure in future years.

Toward Improved Accuracy: A Response to Kauffman and Badar

The number of children estimated to suffer mental health disorders, and therefore, creating the need for special education services for children with emotional and behavioral disorders (EBD), is between 5% and 25% of children under the age of 18 (Brauner & Stephens, 2006). Admittedly, not all children with EBD have been identified and served, but many children have been identified as eligible for special education services as part of IDEIA regulation. Children identified with EBD are eligible for a variety of special education services. These services may be applied to interventions (or treatments, in mental health terminology) delivered in a regular classroom (e.g., supplementary aids and services, positive behavior intervention plans), while other services may require selfcontained or pullout programming for all or part of the school day. Regardless of the method, the goal of special education is to improve the academic, behavioral, and emotional outcomes for children identified with EBD.Although the goal of special education is improved child outcomes, we agree with the conclusion of Kauffman and Badar (2013) that parents and children may be influenced by social stigma associated with the classification, which may cause families to neglect or even decline special education services. In an attempt to increase special education participation by lessening the stigma associated with EBD identification, Kauffman and Badar offer four suggestions aimed at changing the public perception of special education services including: (a) discussing with stakeholders (e.g., parents, children) differences in behavior resulting from treatment in clear, understandable terms; (b) recognizing the reality of such differences due to treatment and its impact on students' learning; (c) emphasizing to stakeholders the benefits of special education; and (d) working to implement specialized instructional interventions (or treatments) as intended and planned.We support these recommendations as eminently practical and because they are based on sound judgment and experience. These suggestions may help to reduce some stigma in individual cases. Our concern is that they address some of the indicators of stigma but not the underlying causes. They are, therefore, not likely to address the issue of stigma and its impact on children, families, and the discipline of special education more broadly. Thus, stigma is likely to remain because the causes have not been adequately addressed. And, like a disease, the symptoms, or stigma is likely to worsen; rendering the four recommendations of Kauffman and Badar increasingly less effective with time.The stigma problem associated with EBD is daunting. Accordingly, we suggest that the boldness required to address it should be commensurate with the ubiquity of concerns about special education reflected in the popular and professional media. Returning to the disease metaphor, invasive and uncomfortable treatments are now required to salvage the patient, which in this case is the special education enterprise for EBD.At the time of this writing (January 8, 2014) for example, a cover letter was released by the United States Secretary of Education Arnie Duncan, for a report calling on schools to reconsider and refrain from the widespread application of harsh disciplinary practices in schools (U.S. Department of Education, 2014). It included the following quote:Although students who receive special education services represent 12 percent of students in the country, they make up 19 percent of students suspended in school, 20 percent of students receiving out-of-school suspension once, 25 percent of students receiving multiple out-of-school suspensions, 19 percent of students expelled, 23 percent of students referred to law enforcement, and 23 percent of students receiving a school-related arrest, (p. i)The scientific literature on EBD-including works published by well-regarded special education researchers in this journal-is also replete with nonsupportive conclusions about special education participation. …

The role of supportive housing in homeless children's well-being: An investigation of child welfare and educational outcomes

Research has demonstrated that homeless children have disproportionate negative academic experiences, including absenteeism, high rates of mobility, grade repetition, and the need for special education services, which may all contribute to poor academic performance. Homeless children are also more exposed to violence and social isolation due to their often dangerous living environments, past histories of victimization, and trauma experienced by their mothers. The main purpose of this study was to investigate the impact of family supportive housing service receipt on children's well-being, including the academic functioning and child protection involvement of homeless children. A total of 183 children's supportive housing records were sequentially linked to data from the Minnesota Departments of Education and Human Services, including the Minnesota Automated Reporting Student System, MCA-II database, and Social Services Information System through Minn-LInK. Generalized Estimating Equation analysis was implemented to examine the three-year longitudinal role of supportive housing for homeless children's educational and child protection outcomes. Significantly positive effects of recipients of supportive housing services were found in school mobility, school attendance, and math achievement. The proportion of children with child protection involvement for the supportive housing group sharply decreased over time. Recommendations for policy and future research are made; study limitations are addressed.

Low Birth Weight, Preschool Education, and School Remediation.

Studies have documented a strong relationship between low birth weight status and adverse child outcomes such as poor school performance and need for special education services. Following a cohort of over 1,300 low-income and predominately African American children in the Chicago Longitudinal Study we investigated whether birth weight and family socio-economic risk measured at the time of the child's birth predicts placement into special education classes or grade retention in elementary school. Contrary to previous research, we found that low birth weight (< 5 ½ pounds) does not predict special education placement. Rather, these children (especially boys) were more likely to be retained in grade as an alternative approach to addressing poor school performance. Family socio-economic risk at birth was a significant predictor of the need for remedial services. We also assessed whether a high-quality preschool program offered at ages 3 and 4 can reduce the negative effects of low family SES and birth weight on the need for special education and grade retention. Preschool participation in the Child-Parent Centers was found to reduce the likelihood of school remediation. The effects of preschool were greater for children from families with higher levels of socio-economic disadvantage. The beneficial effects of preschool on special education placement were also larger for boys than girls.

A population‐based study of the recurrence of developmental disabilities – Metropolitan Atlanta Developmental Disabilities Surveillance Program, 1991–94

Serious developmental disabilities (DD) are quite common and affect approximately 2% of all school-aged children. The impact of DDs with respect to the need for special education services, medical care and the demand on family members can be enormous. While this impact can be magnified for families with more than one child with a DD, little is known regarding the epidemiology of recurrence of DDs. When the cause of a DD is unknown, genetic counsellors rely on recurrence risk estimates which for DDs are over 10 years old. The objectives of our study were to: (1) assess the contribution of recurrent cases to the prevalence of DDs; (2) provide current, population-based recurrence risk estimates; and (3) examine characteristics of the first affected child as predictors of recurrence. Two population-based data sources were used to identify all children born to the same mother during the period 1981-91 in the five-county metropolitan Atlanta area with at least one of four DDs: mental retardation (MR), cerebral palsy, hearing loss, or vision impairment. Recurrence risk estimates for these DDs ranged from 3% to 7% and were many times higher than the background prevalences. The risk of recurrence of DDs was greatest for MR - approximately eight times greater than the baseline MR prevalence. Isolated mild MR (IQ 50-70) was highly concordant between siblings with MR. Sex, race, and birthweight of the index child, maternal education, and maternal age were not significantly associated with recurrence risk. Further research is needed to investigate the roles of genetic and environmental factors on the recurrence of DDs, particularly isolated mild MR.

The Effects of African American Movement Styles on Teachers' Perceptions and Reactions

This study examined teachers' perceptions of African American males' aggression and achievement and the need for special education services based on African American students' cultural movement styles (i.e., walking). The participants, 136 middle school teachers, viewed a videotape and completed a questionnaire. To study interaction effects between student ethnicity and student movement and teachers' ratings of student achievement, aggression, and need for special education, a completely randomized factorial analysis of variance was employed. The results indicated that the teachers perceived students with African American culture—related movement styles as lower in achievement, higher in aggression, and more likely to need special education services than students with standard movement styles. Implications for research are discussed.

Homeless Children in Emergency Shelters: Need for Prereferral Intervention and Potential Eligibility for Special Education

The purpose of this study was to describe the level of need for special education services for probable behavioral disorders (BD), learning disabilities (ID), and mental retardation (MR) among school-age homeless children living in shelters. Children living in emergency homeless shelters face the dual challenge of being at risk for BD and learning problems while having limited access to special education programs. From a county-wide sample of 18 out of 22 emergency homeless shelters in Los Angeles, 118 homeless parents were interviewed, and 169 children were tested for BD, LD, and MR using standardized screening instruments. Almost one half of sheltered homeless children (46%) screened positive for at least one disability requiring special education services, with BD being the most prominent (30%). Procedures to identify early need for special education services should be adapted to accommodate the transiency of school-age children living in homeless shelters.

Sheltered homeless children: their eligibility and unmet need for special education evaluations.

This study described the proportion of sheltered homeless children in Los Angeles, Calif, who were eligible for special education evaluations because of a probable behavioral disorder, learning disability, or mental retardation, and to explore their level of unmet need for special education services. This was a cross-sectional study of 118 parents and 169 children aged 6 through 12 years living in 18 emergency homeless family shelters in Los Angeles County, California. Parents and children were interviewed with standardized mental health and academic skill measures in English and Spanish. Almost half (45%) of the children met criteria for a special education evaluation, yet less than one quarter (22%) had ever received special education testing or placement. The main point of contact for children with behavioral disorders and learning problems was the general health care sector. School-aged sheltered homeless children have a high level of unmet need for special education evaluations, the first step toward accessing special education programs. Interventions for homeless children should include integration of services across special education, general health care, and housing service sectors.

Efficacy of an early intervention education program for moderately handicapped infants

This paper focuses on the evaluation of special education services for handicapped infants. The research question posed is whether early intervention programming results in reduced need for specialized services when children are age-eligible for elementary school. The primary focus of the paper is the development of a predictive model which may be useful in assessing the efficacy of early intervention services. The predictive model is applied using longitudinal data from a small sample of moderately handicapped infants. The preliminary findings support the contention that earlier intervention results in a lessened need for special education services in subsequent years. The paper also discusses the benefit-cost issues related to the efficacy question under investigation.

Identification of special education needs with the Personality Inventory for Children (PIC): A hierarchical classification model.

Psychologists who test children for possible special education placement are obliged to incorporate parental input into the assessment process. This investigation studied the utility of a multidimensional, parent-informant questionnaire, the Personality Inventory for Children (PIC), as a screening measure for the need for special education services. PIC profiles from children in regular classrooms and classrooms for the learning disabled, emotionally impaired, and mentally impaired were used in discriminant function analyses to develop a set of hierarchical classification rules. Results of analyses within both a derivation and a replication sample indicated reasonably high correct classification rates for these rules. Also, results within a third sample of AfricanAmerican and White children matched for IQ suggested absence of classification bias by race. Implications of these results for use of the PIC in school assessments are discussed. Federal guidelines that define the basic categories of special education services (e.g., PL 94-142, Federal Register, 1977) specify that parental input must be considered in the placement of children. School psychologists and other assessment practitioners who evaluate referred children are thus obliged to gather parental observations about child adjustment that are relevant to the determination of the need for remedial services. Objective questionnaires are a common means to systematicall y gather parental observations (e.g., Lachar, 1993), which typically represent parental concerns across several adjustment domains with reports in each domain normed by child age and gender. Examples of parent-inform ant questionnaires with good psychometric properties that are widely used in school and child clinical evaluations include the recently revised Child Behavior Checklist (Achenbach, 1991) and the Personality Inventory for Children (PIC; Wirt, Lachar, Klinedinst, & Seat, 1984), the subject of this article. The PIC has characteristics that may be advantageous for its use in school settings. For example, the age range of the normative sample for the PIC spans the preschool, elementary, and high-school years and it has scales that reflect child cognitivedevelopmental status as well as emotional-behavioral adjustment. PIC profile scales (e.g., Lachar & Gdowski, 1979) and profile patterns (e.g., Kline, Lachar, & Gdowski, 1992) can be interpreted using empirically based guidelines. Finally, the research literature about the validity of the PIC in school assessments is relatively large, which we briefly summarize here. Scores from PIC scales constructed as measures of child cognitive-scholastic functioning (e.g., Achievement, Intellectual Screening, and Development) correlate about —.60 to —.40 with

The Computational Analysis of English: A Corpus-Based Approach

specifically on the difficulty of recognizing learning versus language difficulties, that is, how to identify a nonnative-speaking child's need for special education services. They propose a model that administrators can employ that minimizes bias. In a similar vein, the next chapter, by Jeffery Braden and Sandra Fradd, suggests ways that administrators can anticipate difficulties and intervene before such referrals are necessary. William Tikunoff, in the eighth chapter, focuses on instructional leadership. He discusses the characteristics of an effective principal and targets specific areas, such as effective time management. The final chapter, by Beatrice Ward, addresses the greatest resource of any educational institution: the teachers. She describes the clinical approach to teacher development and how it can be implemented. Overall, this book fills a need for basic, factual information about legal requirements, program types, and effective instructional and leadership strategies with respect to the LEP population. Furthermore, it provides guidance on the complex issue of special education for LEP students, particularly the referral process. An additional chapter exploring different models for assessment and program design for these students would have provided depth and balance. Although there is necessarily some overlap between the chapters, it is reinforcing, not repetitive. In addition to being extremely useful to administrators, this book would be of value to school personnel such as psychologists, special education consultants, LEP consultants, instructors-in short, for anyone committed to the design and delivery of effective instructional programs for LEP students.