School‐based tertiary and targeted interventions for students with chronic medical conditions: Examples from type 1 diabetes mellitus and epilepsy

Abstract

Approximately 15% of children experience a significant illness prior to age 18 years. For many of them, school absenteeism, substandard academic performance, and social problems ensue. When disorders affect the central nervous system, some suffer global developmental delays or selective neuropsychological deficits. As health service providers, school psychologists understand both the educational process and the ways in which childhood illnesses can impact it. This article argues that school psychologists' breadth of knowledge enables consultation with teachers about health-related classroom accommodations and communication between medical professionals and educators. Epilepsy and type 1 diabetes mellitus are two conditions associated with a risk of school problems. Using these two disorders as examples, this article outlines roles for school psychologists and provides specific guidance about how they can promote success among all students with chronic illnesses. C 2007 Wiley Periodicals, Inc.The first decade of the 21st century may be a turning point in school psychologists' practice due to the 2004 reauthorization of the Individuals with Disabilities Education Act (PL 108-446), which now encourages consultative services when students present with learning problems. As a result, gatekeeping-associated psychoeducational testing, sometimes equated with perfunctory IQ testing, may be greatly diminished by new guidelines for specific learning disability determination. If these legislative changes extend to practice, school psychologists may have more flexibility to consider practice alternatives. Division 16 of the American Psychological Association and the National Association of School Psychologists have advocated for health promotion for all students and focused consultation for the relatively few with documented illness (American Psychological Association, Division 16, 1998;Ysseldyke et al., 2006). This article concerns the second task-how to help students with recognized health problems and, in doing so, forge new and expanded ways to practice.School psychologists' concern with health-related issues is expanding. A literature search, which reviewed studies published in leading school psychology journals over a 21-year period, found that the publication of health-related articles has significantly increased (Wodrich & Schmitt, 2003). Furthermore, diverse health disorders (e.g., asthma, cancer, diabetes, epilepsy) are now addressed in these journals. Empirical information now appears regarding routine psychological practices that encompass health issues. For example, Carlson, Demaray, and Hunter-Oehmke (2006) found that 62% of school psychologists surveyed said that they collaborate with health care professionals in psychotropic medication trials. In another practitioner survey, Wodrich and Spencer (in press) found that more than 95% of school psychologists were currently involved in identifying students for other health impairment (OHI) services, including those with epilepsy, asthma, diabetes, and cancer.Frequen...

School Experiences of an Adolescent with Medical Complexities Involving Incontinence

“…Some absences were attributed to fear of accidents at school or even fabricated by the student to avoid attendance. The literature suggests that children with chronic illness miss more school than do their peers without illnesses (Caldwell et al, 1997;Sato et al, 2007;Shapiro et al, 1995;Wodrich & Cunningham, 2008). During initial interviews, Emily and her mother reported that Emily might miss anywhere from 1-3 days of school each week if she was not feeling well.…”

“…The lack of a viable educational support plan and specific plans for frequent home-school communication resulted in what everyone agreed to be academic underachievement for Emily. There is much support in the literature (both professional guidelines and research) for formal supports at school (American School Health Association, 2002;Best, 2005;Clay, 2004;Filce & LaVergne, 2011;National Association of School Nurses, 2013;Shapiro et al, 1995) as these children are at risk for underachievement (Best, 2005;Clay, 2004;Wodrich & Cunningham, 2008). The lack of awareness of Emily's 504 Plan, the low level of individualization in this plan, the ambiguity of processes and responsibilities, and an overall absence of regular communication all contributed to Emily's lackluster performance at school.…”

“…When a child has a chronic illness that manifests in incontinence, the physical impact of illness often necessitates absences from school for hospitalizations, treatments, therapies, and recovery time. While studies have shown students with chronic illness miss school more frequently than their peers (Caldwell et al, 1997;Sato et al, 2007;Shapiro et al, 1995;Wodrich & Cunningham, 2008), little has been reported regarding absenteeism for children with incontinence related to VACTERL association. Filce and LaVergne's study (2011) showed a significantly higher absenteeism rate for children with bowel and/or bladder dysfunction (22.5% missed more than 11 days per year) as compared to the general population (6%) (Bloom, Cohen, & Freeman, 2011).…”

“…School attendance is a strong predictor of academic achievement for students in general (Balfanz & Byrnes, 2012;Carroll, 2010) and for students with chronic illnesses in particular (Caldwell et al, 1997;Sato et al, 2007;Wodrich & Cunningham, 2008). When a child has a chronic illness that manifests in incontinence, the physical impact of illness often necessitates absences from school for hospitalizations, treatments, therapies, and recovery time.…”

Accommodating Students with Epilepsy or Seizure Disorders: Effective Strategies for Teachers

“…Social consequences associated with epilepsy include fear of negative perception if others are aware of the diagnosis, difficulty making new friends (Baker et al, 2008), emotional problems, mental health problems, and low self-esteem (Miller, Palermo, & Grewe, 2003). Academic achievement can also be significantly impacted by many aspects of epilepsy including seizure activity, coexisting cognitive deficits, side effects of anti-epileptic drugs (Wodrich & Cunningham, 2008), absenteeism, peer acceptance, and teacher understanding and expectations (Reilly & Ballantine, 2011). Academic difficulties are frequently observed in the areas of mathematics, spelling, reading comprehension, and word recognition (Black & Hynd, 1995), with some children with epilepsy experiencing difficulties across all academic areas (Reilly & Ballantine, 2011).…”