School Outcomes of Children With Special Health Care Needs

Abstract

WHAT'S KNOWN ON THIS SUBJECT:Using a noncategorical approach to identifying children with special health care needs, previous research has shown that these individuals are at increased risk for poor health and high health care resource use. WHAT THIS STUDY ADDS:Children who screen positive for a special health care need because of functional limitations or behavioral health problems are at risk for low student engagement, disruptive behaviors, poor grades, and belowaverage performance on standardized achievement tests. abstract OBJECTIVE: To examine the associations between having a special health care need and school outcomes measured as attendance, student engagement, behavioral threats to achievement, and academic achievement. PARTICIPANTS AND METHODS:A total of 1457 children in the fourth through sixth grades from 34 schools in 3 school districts and their parents provided survey data; parents completed the Children With Special Health Care Needs Screener. School records were abstracted for attendance, grades, and standardized achievement test scores. RESULTS:Across 34 schools, 33% of children screened positive for special health care needs. After adjusting for sociodemographic and school effects, children with special health care needs had lower motivation to do well in school, more disruptive behaviors, and more frequent experiences as a bully victim. They experienced significantly lower academic achievement, as measured by grades, standardized testing, and parental-assessed academic performance. These findings were observed for children who qualified as having a special health care need because they had functional limitations attributed to a chronic illness or a behavioral health problem but not for those who qualified only because they took prescription medications. CONCLUSIONS:Specific subgroups of children with special health care needs are at increased risk for poor school outcomes. Health and school professionals will need to collaborate to identify these children early, intervene with appropriate medical and educational services, and monitor long-term outcomes.

Adverse Childhood Experiences of Low-Income Urban Youth

“…All of these exposures were frequently cited by our participants and have been shown in other studies to contribute to poor health outcomes. [75][76][77][78][79][80][81][82][83] Experiences such as harsh parenting, which negatively affect child well-being but may not be perceived as stressors, also should be considered. However, before including any of these measures in any formal ACE assessment, more research must be done to examine the relative contribution of these additional experiences to health outcomes.…”

Supply and Utilization of Pediatric Subspecialists in the United States

“…However, these analyses were limited due to the large number of children with multiple chronic diagnoses and the lack of subspecialty-specificutilizationordiseasespecific outcomes. Future work examining disease-specific utilization and outcomes among children with specific diagnoses 17 or health needs 44 may be valuable in identifying consequences of variation in subspecialty access that are not apparent in our current analysis.…”

Pediatric Hospital School Programming: An Examination of Educational Services for Students who are Hospitalized

“…Self-confidence and achievement motivation are undermined. (p. 395) These effects are frequently exacerbated by learning difficulties, as children with chronic medical conditions or special health care needs endure multiple short-term and long-term issues that adversely affect their ability to learn (Filce & LaVergne, 2015;Forrest, Bevans, Riley, Crespo, & Louis, 2011). According to Clay (2004), approximately 20% of children have a chronic illness and, for at least one-third of these, the illness is significant enough to negatively impact normal educational progress.…”