Strong evidence supports the existence of Health Barriers to Learning (HBLs)—health conditions that when untreated or unmanaged can interfere with a child’s ability to learn and succeed in school. These HBLs include vision and hearing deficits, uncontrolled asthma, mental and behavioral problems, dental pain, persistent hunger, and the effects of lead exposure. However, 19% of US children aged 6 to 11 did not receive their annual checkup in the past year. School requirements for health screenings can help identify children with HBLs. This study explores which states require health screening for children in elementary school, and the extent to which the 7 HBLs are included.MethodsInvestigators reviewed websites of state departments of health and education, and legislation for all 50 states and DC. For states with mandated screenings and a required form, investigators applied structured analysis to assess HBL inclusion.ResultsNo state mandated that schools require screening for all 7 HBLs. Less than half (49%) required comprehensive school health examinations and only 12 states plus DC required a specific form. Of these, 12 of the forms required documentation of vision screening, 11 of hearing screening, and 12 of dental screening. Ten forms asked about asthma and 9 required documentation of lead testing. Seven asked about general well-being, emotional problems, or mental health. None addressed hunger. When including states without comprehensive school health examination requirements, the most commonly required HBL screenings were for vision (80% of states; includes DC), hearing (75% of states; includes DC) and dental (24% of state; includes DC).ConclusionThe lack of state mandated requirements for regular student health screening represents a missed opportunity to identify children with HBLs. Without state mandates, accompanying comprehensive forms, and protocols, children continue to be at risk of untreated health conditions that can undermine their success in school.

This article summarizes the results from a 2013 online survey with 408 principals and assistant principals in New York City public elementary and middle schools. The survey assessed three primary areas: health issues in the school, health issues perceived as barriers to learning for affected students, and resources needed to address these barriers. Eighteen of the 22 health conditions listed in the survey were considered a moderate or serious issue within their schools by at least 10% of respondents. All 22 of the health issues were perceived as a barrier to learning by between 12% and 87% of the respondents. Representatives from schools that serve a higher percentage of low-income students reported significantly higher levels of concern about the extent of health issues and their impact on learning. Respondents most often said they need linkages with organizations that can provide additional services and resources at the school, especially for mental health.

This study describes patterns of youth functioning at intake and 6 months into services in systems of care and change in functioning profiles. Participants included 2,826 males and 1,335 females aged 5 to 18 at intake. Functional impairment was assessed at intake and 6 months. Latent class analysis was used to classify youth based on their functional impairment profiles, and latent class transition analysis was used to examine the conditional probabilities of transitions in class membership between intake and 6 months. Males and females enter services with distinct patterns of functional impairment. The majority of youth remained in their respective profiles. Transitions tended to be from a higher to a lower impairment class. Importantly, a small group of males and females transitioned from a low to a higher impairment class. Providers should note that gender differences existed in the nature of change in class membership over time.