ABSTRACT
A successful school experience is critical to the development of all children, particularly in the areas of academic achievement, regular school attendance, and social competency. Vulnerabilities in achieving each of these three goals have been documented among students with special health care needs (SSHCN), and ascribed to the influence of their health-related disabilities. Despite recognition of these vulnerabilities, barriers still exist to successful integration of SSHCN into educational settings. A key barrier to successful integration involves poor linkages between the health and education systems. This article describes a model linkage system--the School Liaison Program at Texas Children's Hospital, developed as a U.S. Dept. of Health and Human Services Maternal and Child Health Bureau Special Project of Regional and National Significance. The program provides educational liaison services between the largest pediatric hospital in the United States and school districts in the fourth largest city. A description of the linkage system emphasizes interdisciplinary staffing by both special educators and health providers. The model for educational liaison service delivery presented includes the elements of eligibility, assessment of the educational implications of illness, plan development and referral, involvement in educational placement, and monitoring. Resources for integrating SSHCN into educational settings are suggested.
Subject(s)
Disabled Persons/education , Education, Special/methods , Interinstitutional Relations , Program Development , School Health Services/organization & administration , Adolescent , Adult , Child , Child, Preschool , Communication , Continuity of Patient Care , Delivery of Health Care/methods , Disability Evaluation , Female , Financial Support , Humans , Infant , Male , Patient Care Team , Program Evaluation , Rheumatic Diseases/rehabilitation , Spinal Dysraphism/rehabilitation , TexasABSTRACT
A statewide survey of 2,875 Texas public school nurses was conducted to determine the characteristics, needs, and involvement of nurses in the health and education management of students with special health care needs (SSHCN). The 1,574 survey respondents (response rate = 55%) were primarily registered nurses (84%) with a mean of 8.6 years (SD = 7.1) of experience in the school setting. Respondents served 1.5 school campuses on average; the mean nurse-to-student ratio per campus was 1:728 (SD = 518). Respondents identified 106,650 SSHCN (6% of total enrollment). Asthma (47%), attention deficit disorder (26%), and seizure disorders (8%) were the most prevalent conditions encountered among SSHCN. Medication administration (54%), diapering (12%), and inhalation respiratory treatments (11%) were the most common of 48,569 health procedures delivered daily to SSHCN by nurses, clerical staff, assistants, and teachers. Parents were identified as the primary source of both child-specific health (70%) and training (68%) information in the school setting. Although nurses, of all school personnel, are likely best able to speak to the impact of a child's health impairment and needed school services, only 32% of respondents reported routine participation in special education eligibility evaluations and only 18% reported routine attendance at special education meetings for SSHCN. Moreover, 84% and 92%, respectively, reported discomfort at participating in special education eligibility evaluations and attending special education meetings.
Subject(s)
Child, Exceptional , Health Services Needs and Demand , School Nursing/organization & administration , Adolescent , Asthma/nursing , Attention Deficit Disorder with Hyperactivity/nursing , Child , Education, Special/organization & administration , Humans , School Health Services/organization & administration , Surveys and Questionnaires , TexasABSTRACT
Children with special health care needs pose many challenges for community-based providers. Programs such as school, child care, and Head Start provide services to children that previously would have been delivered in hospitals or at home. The need for a system of care to assure safe, quality services for these children is paramount. While health procedure manuals for schools have been developed, few recommendations address the actual training of providers or the trainers of providers. This article describes a system of training which includes steps in managing the care of children with special health care needs, levels of training, and expected competencies for the care providers of children with special health care needs.
