No abstract

Recently there have been several follow-up studies of students who have exited special education programs (Hasazi, Gordon, & Roe, 1985; Mithaug, Horiuchi, & Fanning, 1985). These studies raise an interesting question: How well have special education programs prepared the youth they were designed to serve? This study reviews findings concerning the postschool adjustment of 160 students who were labeled behaviorally disordered at graduation from public school in the state of Washington between 1978 and 1986.

Follow-up studies examining the outcomes for children and youth with learning disabilities who attended special education have appeared in the literature for decades. As American society becomes more technologically advanced and competitive, postsecondary school opportunities and subsequent employment choices that are meaningful and provide a livable wage teeter out of the reach of young people with learning disabilities. Follow-up study investigators seek to understand how to better prepare youth to meet these challenges by studying their long-term outcomes. The authors review data from 13 frequently referenced follow-up studies regarding postschool outcomes, postsecondary education, and employment, with attention to gender differences, for youth with learning disabilities who were served by and graduated from special education programs nationwide. They take a critical look at contradictions in the findings and discuss five methodological issues that seem to influence the conduct and interpretation of follow-up studies: aggregating data across disability categories; combining data on graduates who have been out of school for unequal periods of time; ignoring the issues of missing data, participant attrition, and incomplete data sets; combining data from different informants; and using nonequivalent databases to make comparisons to a population with no disabilities. The authors provide recommendations for conducting follow-up research on the long-term quality of life of children and youth with disabilities and their families.

Despite the prevalence of disabilities among persons living in rural areas, scarce data exist on their health care needs. While rural residents generally experience barriers to access to primary health care, these problems are further exacerbated for people with disabilities. This article summarizes findings from the published literature on access to primary health care among people with disabilities living in rural locations. A comprehensive computerized literature search turned up 86 articles meeting the study criteria, focused on the following rural populations affected by disabilities: children and adolescents, working-age adults, the elderly the mentally ill, and people with AIDS. For each of these populations, substantial problems in accessing appropriate health care have been documented. The literature consistently emphasizes the failure of local health care systems in nonmetropolitan areas to adequately address the complex medical and related needs of individuals with disabilities. In the absence of specialized expertise, facilities, and primary care providers trained specifically to care for disabled persons, local programs rely heavily on the use of indigenous paraprofessionals and alternative models of care. Further research is needed to identify and test the efficacy of innovative service delivery strategies to improve health care access for this population.