Children with epilepsy in school: Special service usage and assessment practices

Researchers, practitioners and theorists have raised concerns about the special education delivery and classification processes in the United States. The President’s Commission on Excellence in Special Education report (PCESE: 2002) examined these concerns and existing special education research, reports and opinions to develop recommendations for the reauthorization of the Individuals with Disability Act. National Association of School Psychologists Position Statements and other publications support the basic findings of the PCESE report. If enacted as recommended, the proposals will fundamentally change special education classification and service delivery. The changes have the potential to alter in fundamental ways the prevailing school psychology practices in the US. This article: (a) outlines some of the concerns and research that lead to calls for radical special education reform; (b) identifies National Association of School Psychologists (NASP) Position Statements and PCESE findings that respond to identified special education issues and (c) presents information about school-based practices that will likely change if reform actually occurs.

To examine associations between special education, chronic health conditions (CHCs), and college graduation in survivors of childhood cancer and their siblings. Childhood Cancer Survivor Study participants included 23,082 5-year survivors (53.7% male; median [IQR] age at diagnosis, 6 [3-13] years; age at evaluation, 31.0 [24-39] years; treated between 1970 and 1999) and 5,037 siblings (47.7% male; 36.0 [28-44] years at evaluation). Special education use, reasons for special education, CHCs, and college graduation were self-reported. Primary cancer diagnosis and treatment exposures were abstracted from medical records. Comparisons between survivors and siblings were made using chi-square statistics; demographic and treatment factors associated with outcomes were examined using modified Poisson regression models. More survivors reported special education use than siblings (26.5% v 8.6%; relative risk [RR], 2.55 [95% CI, 2.32 to 2.80]). Of those survivors and siblings who had special education services, use was highest between kindergarten and fifth grade (64.4% of survivors and 71.9% of siblings in kindergarten-fifth grade, 14.4% of survivors and 12.5% of siblings in sixth-eighth grade, and 9.2% of survivors and 9.0% of siblings in ninth-12th grade), and primarily attributable to learning and concentration problems. Despite receiving special education, survivors were less likely to graduate college compared with siblings requiring special education (RR, 0.76 [95% CI, 0.66 to 0.88]). Risk for not graduating college included history of CNS tumor (RR, 1.47 [95% CI, 1.40 to 1.55]), cranial irradiation (20-29 Gy, RR, 1.16 [95% CI, 1.09 to 1.25]; 30-49 Gy, RR, 1.37 [95% CI, 1.26 to 1.49]; ≥50 Gy, RR, 1.35 [95% CI, 1.28 to 1.42]), or the presence of a severe, disabling or life-threatening CHC (Common Terminology Criteria for Adverse Events grade 3-4, RR, 1.15 [95% CI, 1.07 to 1.24]). Cognitive problems and CHCs increase risk for not graduating college; these problems are not alleviated by special education.

Chapter 5 - Precision Teaching: Applications in Education and Beyond

Twenty years ago, the educational rights of students with disabilities were dramatically and firmly established in law and practice. Prior to that time, many students were refused enrollment or special educational services. As recently as 1973, at least one million students were denied enrollment in public schools solely on the basis of their disabilities, and at least two million others were not receiving an education appropriate to their needs. Although every state has provided some form of special education throughout this century, these services were largely at the discretion of local school districts. Only since a federal court case in 1972 and the passage of federal legislation in 1975 have all states been mandated to provide a free, appropriate public education to all students with disabilities. Today, as Parrish and Chambers point out in this journal issue, special education for students with disabilities is the largest categorical program in public schools, costing an estimated $32 billion. Since the passage of Public Law 94-142 in 1975 (later retitled the Individuals with Disabilities Education Act, or the IDEA), the number of elementary and secondary students receiving special education has increased from 3.7 million to 4.6 million, increasing also from 8% to 11% of all students in public schools. According to Parrish and Chambers, the population of students eligible for special education is expected to continue to rise. The IDEA governs the educational rights of individuals from birth to age 21, though only students in elementary and secondary school are addressed in this journal issue. The IDEA allowed access to the public schools for many students who had previously been denied enrollment. The IDEA has also been given partial credit for decreasing the rate of institutionalization of individuals with disabilities. Before the IDEA, many parents had the sole responsibility of meeting all the needs of their severely disabled children 24 hours per day; once schools began to provide extensive services to students with severe disabilities, more families were able to avoid institutionalization. Under the IDEA, states and local districts were given a mandate to provide specialized educational programs to students with special needs, and students and parents were given a mechanism for enforcement of their rights. In a 1989 survey, 94% of parents of students with disabilities agreed that services for these students had improved since the implementation of the IDEA. Yet special education today is widely criticized as expensive, ineffective, inadequately coordinated with regular education, and/or culturally biased. The National Association of State Boards of Education has recommended radical reduction in the size of special education. Special education also has its champions, who argue that many students perform better academically and have better self-esteem when provided with special services, often in a separate setting. This analysis addresses five questions concerning special education under the IDEA: (1) Why are so many students considered disabled? (2) What are the educational needs of students with disabilities? (3) How should appropriate, individualized services be funded? (4) Are the IDEA's procedural protections necessary? (5) Can regular education meet the needs of more students?

This handbook provides a concise overview of special education services in countries across the world, using the Article on Education in the United Nations Convention on the Rights of Persons with Disabilities as the analytical frame. The Praeger International Handbook of Special Educationpresents a concise and clear overview of special education services in more than 70 countries across the world using the Article on Education in the United Nations Convention on the Rights of Persons with disabilities as the analytical frame. Each chapter offers information about the country in general, followed by sections on the public education system, the private education system, the special education system, teacher training requirements, and barriers to and promising trends in inclusive and special education. The volumes and chapters are organized by the United Nations Geoscheme, with Volume 1 including an overview of the volumes and chapters on countries in the Americas, Volume 2 addressing countries from Europe and Africa, and Volume 3 focusing on countries in Asia and Oceania. This is the most complete exploration of the delivery of supports and services to children and youth with disabilities across the globe available. The volumes do not compare among or between countries, but rather provide a baseline for understanding current special education practices and their relationship with general education and inclusive practices across the globe. Readers will come away with an in-depth understanding of what is happening with regard to the implementation of special education services and Article 24 of the Convention for the Rights of People with Disabilities. This valuable reference set serves researchers, graduate students, and policymakers in special and general education as well as professionals focused on issues of education worldwide and scholars focused on international special education. As such, this handbook will be an important reference source for university libraries, professional associations, and policy entities.

This study of children with chronic health conditions (CHC) assessed the relationship of demographic and health variables to school achievement and absenteeism. From July 1982 to June 1983 data were collected in 11 subspeciality clinics on 270 children followed at a tertiary care center. Academic performance and days absent for the prior year were obtained from schools. Physicians rated subjects' activity limitation. The CHC group was 61% male, 68% white, mean age 12 years. Children with cystic fibrosis, arthritis, sickle cell disease, hemophilia, and spina bifida averaged the most days absent (>20), while those with chronic lung and cardiac conditions averaged the least (10). Total CHC achievement scores were well below the state average (53rd vs. 63rd percentile). Group scores were highest for general hematology, hemophilia, chronic bowel and lung. Scores were lowest for epilepsy (39th), sickle cell (24th), and spina bifida (21st), and these groups had the highest rates of repeated grades and special services. Overall CHC group achievement was unrelated to school absence. A stepwise regression model related demographic and health variables to log of days absent and achievement scores. Achievement was correlated with socioeconomic status, race, grade failure, and type of CHC (r2=.44; p=.0001) while school absence was mainly related to health variables (activity limitation, number of clinic visits, specific CHC) and female sex (r2=.17; p=.0001). For CHC children, demographic factors were important predictors of academic performance. CHC children of low socioeconomic status were at double jeopardy for poor school achievement.

Bullying experiences and self-reported anxiety about bullying and were compared in 72 elementary and middle school students including 16 in self contained (SC) special education classes, 20 receiving resource or consultation (RC), and 36 matched peers. Individually administered Bully Victimization Scale and School Violence Anxiety Scale scores (Reynolds, 2003) revealed that children with special needs (both SC & RC) tended to report more peer victimization and higher anxiety about school violence than matched peers from the same schools. Placement was not related to self-reported bullying experiences. Students in self-contained classes were significantly more anxious about possible bullying, especially physical, in spite of being in more protected environments. School placement is an important but under-researched issue in assessment and intervention for bullying of students receiving special education services.

Purpose. To develop and test an index of disability severity in a heterogeneous population of preschoolers with disabilities.Method. Using a nationally representative sample of 3104 children receiving special education services in the US, questions from a parent interview were used to develop an index of disability severity consisting of domains of functioning defined by gradients of severity. Regressions were used to examine the association between 15 functional domains and 8 cognitive, social/behavioural, and functional outcomes. Full and abbreviated versions of this disability index were compared. Correlations with proxy measures of disability in this population were used to establish concurrent validity, and the predictive ability of this measure was compared with that of the federally defined disability categories.Results. Of the 15 domains examined, most were significant predictors of at least two outcomes. A shortened index of only six variables was found to be as effective as the longer version in characterising children's level of severity. The index was significantly correlated with intervention variables such as the age at which children began receiving special education or therapy service, r(2802) = −0.22, p ≤ 0.0001, the extent of modification of curriculum materials needed for the child, r(248) = 0.42, p ≤ 0.0001 and the number of services the child received in the school, r(2014) = 0.37, p ≤ 0.0001. Adding severity to special education category significantly increased the amount of variance in outcomes over special education category alone.Conclusions. These results provide evidence for the importance of the construct of severity of disability and its measurement, particularly when conducting research with very young children.

The Individuals with Disabilities Education Act (IDEA) requires public school districts to provide special education and related services to students with disabilities enrolled in private schools. When the private school is a parochial school this issue may be complicated because of the First Amendment's separation of church and state doctrine. Until recently, providing most on-site special education services was prohibited. A recent U.S. Supreme Court decision lifted the ban, and the 1997 amendments to IDEA have helped to clarify a school district's obligation for providing services to parochial school students. In this article the authors summarize and analyze the major court decisions concerned with the provision of special education and related services to parochial school students and discuss their implications for providing on-site special education services at parochial schools. In particular, two questions are addressed: Must private school students with disabilities be provided with the same level of services as their public school peers? Are school districts required to provide parochial school students with on-site special education services?

We evaluated the best-available evidence for the effects of receiving business-as-usual or naturally delivered special education services in K-12 US schools. Our best-evidence synthesis of 44 empirical studies evaluated which outcome domains and disability types have been investigated and whether findings varied by the rigor of the study design and methods. Regression-based studies comparing students with educational disabilities (SWED) to students without disabilities (SWOD) yielded mostly negative associations of receiving special education with academic achievement, behavior, and long-term or other outcomes. In contrast, regression-based studies that contrasted SWED receiving special education to other SWED not receiving special education produced a pattern of estimates similar to quasi-experimental designs that contrast SWED to SWOD. The most rigorous designs utilized quasi-experimental methods that compared SWED receiving special education services with SWED not receiving special education services, and generally reported more positive than negative evidence of receiving special education services across most outcome domains. Future research that utilizes rigorous quasi-experimental methodology and appropriate comparison groups to investigate the effectiveness of special education is needed, particularly for nonachievement outcome domains.

10516 Background: Therapy for medulloblastoma and primitive neuroectodermal tumor has evolved from surgery and adjuvant radiotherapy to risk-adapted multimodal regimens. The impact of these changes in treatment on long-term outcomes remains unknown. Methods: Cumulative incidence of late mortality ( > 5 years from diagnosis), subsequent malignant neoplasms (SMN), chronic health conditions and psychosocial functioning were evaluated among 5-year survivors in CCSS diagnosed between 1970 and 1999. Survivors were stratified according to treatment decade (1970s, 1980s, 1990s) and treatment exposure (surgery + craniospinal irradiation [CSI] ≥30 Gy, no chemotherapy; surgery + CSI ≥30 Gy + chemotherapy [high-risk therapy], surgery + CSI ˂30 Gy + chemotherapy [standard-risk therapy]). Rate ratios (RRs), odds ratios (ORs) and 95% confidence intervals (CIs) were estimated for long-term outcomes among treatment eras and exposure groups using multivariable piecewise-exponential models. Results: Among 1,380 eligible survivors (median [range] age 29 [6-20] years; 21.4 [5-44] years from diagnosis), the 15-year cumulative incidence of all-cause (21.9% 1970s vs. 12.8% 1990s; p = 0.003) and recurrence-related (16.2% vs 9.6%, p = 0.03) late mortality decreased with no reduction in mortality attributable to late effects of therapy including SMN. Among 959 participants, the incidence of SMN did not decrease by era or by treatment group. However, survivors treated in the 1990s had an increased cumulative incidence of severe, life-threatening and fatal health conditions (16.9% 1970s vs 25.4% 1990s; p = 0.03), and were more likely to develop multiple severe or life-threatening health conditions, RR = 2.98 (95% CI, 1.10-8.07). Survivors of standard-risk therapy were less likely to use special education services than high-risk therapy patients, OR = 0.51 (95% CI, 0.33-0.78). Conclusions: Historical changes in therapy have improved 5-year survival, reduced risk of late mortality due to disease recurrence, and reduced special education utilization, at the cost of increased risk for multiple, severe and life-threatening chronic health conditions.

Assessment practices of special need students have been a concern in the educational system of most countries, especially in Nigeria. The aim of this study is to examine the assessment practice of special need students in special education Schools in Zamfara state, Nigeria. The Survey design was adopted for this study. The population of the study comprised all the 55 teachers (special educators) in the two (2) School for Special Education in Zamfara State, which include School for Special Education Gusau and School for Special Education Gummi. School for Special Education Gusau and School for Special Education Gummi have 37 and 18 teachers respectively. Purposive or judgmental sampling technique was used to select all the 55 teachers of special education schools in Zamfara state from whom, we could gain deep insights and understandings of assessment practices in special schools. The instrument used for data collection is a researcher designed questionnaire namely “Special Educators’ Assessment Practice Questionnaire (SEAPQ)”. The Data collected were analyzed using descriptive statistics of Weighted Mean and Standard Deviation. The results showed that the components of student assessment practice conducted among special need students are curriculum-based assessments, intelligence Quotient (IQ), Test screening test, academic achievements, developmental assessments and end-of-grade assessments, and the methods of assessment used are formative assessment, summative assessment, speech therapy evaluation/language scales, developmental scales, diagnostic assessment, standardized test and direct observation. The findings also revealed that special educators’ professional competence in choosing assessment methods appropriate for special need students, administering, scoring, and interpreting of their results and recognizing unethical and inappropriate assessment methods are inadequate. Based on these findings, it was recommended that Special educators should be train on all the components of assessments practices that will benefit special needs students learning outcomes.

Inclusion is usually regarded as the placement of special education students in general education settings. But Mr. Sailor and Ms. Roger present a new vision of integrated education, in which previously specialized adaptations and strategies are used to enhance the learning of all students. AS A FIELD, special education presents an excellent case study of the paradox of differentiation and integration, wherein we seek solutions through increased specialization but, in so doing, we redefine a problem in terms of discrete parts at the expense of the whole. As Thomas Skrtic pointed out more than a decade ago, a large and ever-widening gap exists between the purpose of special education -- to provide needed supports, services, adaptations, and accommodations to students with disabilities in order to preserve and enhance their educational participation in the least restrictive environment -- and its practice.1 And that practice has evolved over three decades into a parallel and highly differentiated educational structure, often with only loosely organized connections to the general education system.2 Having disengaged from general education early on, special education began to undergo a process that, at times, has seemed to mimic cell division. At one point in its ontogeny, the field could list some 30 distinct eligibility categories for special education services (e.g., learning disabilities, behavioral disorders, severe disabilities, autism, and so on).3 Many of these early categories further subdivided, with autism, for example, splitting into a host of subcategories lumped under autism spectrum disorders.4 How has all of this come about? The paradox of differentiation and integration -- with its tensions in practice and contradictions in policy -- offers a reasonable hypothesis. In our efforts to better meet the educational needs of specific identifiable groups, we have promoted differentiation at the expense of integration. If such a policy produced exemplary outcomes, the only remaining questions would concern how to direct scarce resources to meet the needs of a few individuals, and the values underlying special education would no doubt resolve the tension in favor of customization and differentiation. But the positive outcomes don't seem to be there.5 In its early days, special education embraced the diagnostic/prescriptive model characteristic of modern medicine, and disability was viewed as pathology. Psychology, with its partner the test industry, became the gatekeeper for special education. Students referred by teachers and parents were diagnosed in one of the categories of disability and tagged for separate (highly differentiated) treatment. Indeed, special education policy handbooks at the district level came to resemble the Diagnostic and Statistical Manual of the American Psychiatric Association. Then in the 1980s, the U.S. Department of Education began to advance policy reforms designed to slow the growth in the number of special education categorical placements and practices. These initiatives occurred against a backdrop of publications citing positive outcomes from integrated practices and a corresponding barrage of studies associating separate classrooms and pullout practices with negative outcomes.6 The first of these reforms was called the Regular Education Initiative and was designed to stimulate the provision of special education supports and services in general education classrooms. It generated enormous controversy within special education. Indeed, a special issue of the Journal of Learning Disabilities was devoted entirely to an attempt to refute the research underlying the policy.7 Framing the reform of special education policy as general education policy (regular education initiative) failed completely within the community of special education. More recently, federal policy has advanced inclusion as recommended practice and has expended significant funds for training, research, and demonstration purposes. …

Determining the effectiveness of many special education interventions is most difficult because of the practical and ethical limitations associated with assigning participants to a control or non-treated group. Using Longitudinal Study of Australian Children data, this article utilised eight different propensity score analysis methods to determine if a cohort of young primary school children receiving special education services significantly improved their literacy and numeracy skills, social skills and their behaviour, two years after the commencement of the special service, in comparison to a “matched” group of students who did not receive special education support. The children receiving special education support performed statistically significantly less well than the different matched groups across all outcome measures. This result is consistent with the findings from two similar studies in the US and calls into question the effectiveness of special education services for the majority of Australian students with additional needs.

School-based health centers (SBHCs) are associated with numerous positive aspects of student health services. Many schools in the United States (US) do not have transparent policies on chronic health condition (CHC) management. Of particular concern is the underreporting of the delivery of health services in U.S. schools concerning CHC management and its relationship with the presence or absence of a SBHC. Data from the 2020 School Health Profiles (SHP) Survey were examined in New York public secondary schools. Specific health services were reviewed, together with the presence or absence of a SBHC, including daily medication administration, stock rescue medication, case management services, community partners, chronic disease-specific education, and assurance that students with CHCs were enrolled in an insurance program. A significantly greater proportion of schools with a SBHC compared with schools without a SBHC provided: (1) daily medication administration (92.9% vs. 86.5%; p < .001), (2) stock or rescue medication (84.9% vs. 77.4%; p < .001), (3) case management services (83.1% vs. 67.2%; p < .001), (4) disease-specific education for families (63.1% vs. 57.2%; p = .022), (5) student and family connection to community health services (84.2% vs. 76.5%; p < .001), and (6) ensured that a protocol existed whereby students with a CHC were enrolled in an insurance plan if eligible (79.6% vs. 66.8%; p < .001). Findings suggest that data on a national scale include essential facts for states to consider concerning school health policies and practices. Additional research should examine the intricacy of elements connected with school-based health care to understand better the care provided to children with CHCs.