WEDNESDAY, July 27 (HealthDay News) -- Many 'special needs' kids
who struggle with medical, emotional or behavioral issues often
face tough social and academic troubles in school, a new study
Tracking the progress of more than 1,450 students in fourth
through sixth grades from 34 rural schools, U.S. researchers found
that one-third coped with special health care needs such as asthma,
chronic pain, attention deficit-hyperactivity disorder (ADHD),
learning disabilities, or emotional or behavioral problems.
These children, from three large school districts in Maryland
and West Virginia, were also more likely to be bullied or feel
socially isolated in their school, and to be more disruptive in
class, according to the cross-sectional study, published in the
July 25 issue of
"Health affects school performance," noted study co-author Dr. Christopher B. Forrest, a professor of pediatrics at Children's Hospital of Philadelphia. "Special health care needs have manifold effects on school outcomes that increase the likelihood that these kids are not going to successfully transition to adulthood."
For the study, Forrest and his colleagues obtained survey data
from students and their parents, who completed a screening
questionnaire measuring long-term health problems that require
health services or cause functional problems. Children were
classified as having a special health care need if they had a
condition lasting at least 12 months and needed interventions such
as prescription medication, therapy, counseling or other medical,
mental health or educational services.
Additionally, school records were measured for attendance,
grades and standardized achievement test scores.
Forrest said the finding that one of every three students had a
special need was high -- greater than a 2003 national survey
indicating 20 percent of children aged 6 to 17 had such conditions.
But he added that some of the problems stemming from chronic
conditions do tend to peak in the ages he and his team studied.
Boys were twice as likely to have a special health care need as
girls, the study found.
But the overall findings from the study were disheartening,
Forrest said. Kids with special health care needs "have significant
differences in their engagement in school and their school
relationships, as well as academic achievement," he said. "It sets
up a trajectory for these kids that's highly distressing."
The high proportion of low-income families living in the three
districts studied could have contributed to the study results,
Forrest noted, because higher-income schools may have more programs
in place to help kids adjust to special needs before fourth
"It's not a national study," he said. "Some communities may have better resources than others."
James Wendorf, executive director of the National Center for
Learning Disabilities in New York City, praised the study, saying
it "looked at the whole child."
"It certainly clarifies that learning disabilities, once again, are shown to have a demonstrable effect on children's achievement in school," Wendorf said. "We know that students with learning disabilities . . . have very distinct social and emotional challenges that can lead them into difficult situations. We also know many of these things intensify as children grow older."
And because the study used a cross-sectional design, Forrest
said he was unable to rule out reverse causation -- that children
with poor school outcomes may also be more likely to be labeled as
having a special health care need.
Because the problems linked to these special needs can't be
qualified as only health- or education-related, Forrest also
questioned how communities can bring both systems together when
each is funded by a separate stream of finances.
"I also believe it's the kind of challenge we're starting to understand in the 21st century," he said. "We have to look at the child as a whole person . . . and recognize that individuals need health systems and education systems to work together."
The American Academy of Child & Adolescent Psychiatry has
more about school
school services for special needs children.