Involvement of Students With Severe Disabilities in Specialized Health Care Procedures

Abstract

A recommended practice in the field of severe disabilities is involving students in their specialized health care procedures; however, little is known about how this practice is occurring in schools. The purpose of this qualitative multiple-case study was to understand how secondary-age students with severe disabilities are involved in their specialized health care at school. Purposeful sampling resulted in nine cases and a total of 41 participants. A case comprised a secondary-age focus student and the student’s parent(s), special education teacher, school nurse, and classroom nurse or paraprofessional. Data sources were observations, interviews, and document reviews. The researchers analyzed the data using an iterative inductive coding approach for each individual case to identify patterns in the data followed by a cross-case synthesis using visual matrices to identify salient themes across cases. This process resulted in four themes depicting how students were involved in their specialized health care at school, which were (a) partially participating, (b) interacting with adults, (c) engaging in risky behaviors, and (d) passively participating. The findings from this study highlight a need for improved attention to the promotion of self-care in specialized health care for this population.

Beliefs About Secondary-Age Students with Extensive Support Needs Participating in Their Health Care at School

“…Current intervention research that examines strategies and outcomes for teaching youth involvement in SHCPs, including partial participation, has primarily been conducted in hospital, clinical, and home-based settings (Ballard & Dymond, 2019). Although involving students in their SHCPs at school is a recommended practice in the field of special education, there are no recent intervention studies conducted in school settings.…”

“…The first author collected data through in-person individual interviews. Interviews were conducted following multiple observations, post-observation interviews, and document reviews as part of a larger study (see Ballard & Dymond, 2019). These data collection procedures provided multiple opportunities to establish rapport with participants prior to interviewing them as well as preliminary insights into the particularities of individual cases.…”

Placement of Students with Severe Disabilities Who Have Complex Health Care Needs in General Education Classes

“…The same response has been observed about students who also have complex health care needs. As Ballard and Dymond (2019) noted,In the past, the medical model (a deficit-based approach) informed educational service delivery for students with severe disabilities and SHCP [specialized health care procedures] . .…”