Academic journal article Journal of School Health

Bridging the "Med-Ed Gap" for Students with Special Health Care Needs: A Model School Liaison Program

Academic journal article Journal of School Health

Bridging the "Med-Ed Gap" for Students with Special Health Care Needs: A Model School Liaison Program

Article excerpt

Oberg et al[1] suggested in the Journal of School Health that 6 million disabled children may not be receiving needed services at school based on interagency differences in numbers of disabled children reported by the U.S. Dept. of Education and the U.S. Dept. of Health and Human Services' National Health Interview Survey, Child Health Supplement. The author attributed the discrepancies in numbers of disabled children to discordance in the respective agencies' definitions of disability. Regardless of the accuracy or comparability of the disability estimates, the issue raised typifies the long-standing controversy between the medical and education communities concerning the eligibility of children with health-related disabilities for special education services. Education law historically has limited access to special education-related services to those children whose health impairments adversely affected educational performance. Conversely, the medical community has argued that strict eligibility definitions often were discriminatory to children whose health care needs were not being met at school.

Numerous authors postulated that a more integrated approach between the medical and education communities was essential for successful educational programming for the child with chronic illness.[2-6] Collaboration between providers in both communities was recommended, allowing for individualized assessment of the child's needs and enhanced communication among families, health providers, and schools. Unfortunately, the literature suggests that the opposite trend or a broadening of the "med-ed gap" has occurred. Physicians do not routinely participate in collaborative efforts with schools, teachers are poorly trained for this collaborative role, and, as a result, parents often are placed in the less than optimal role of translating complex medical recommendations into educational programming.[2,3,5,7,8]

In 1985, Magrab[5] proposed that a linkage system between the medical and education communities be developed as one way of bridging the med-ed gap. Specifically, a "liaison" special educator having "systematic and regular contact with the classroom teacher and special resource programs" was suggested to better address individual needs of the child. Magrab outlined the role of the special educator on an interdisciplinary team as: assessing the educational needs of chronically ill children, developing linkages between the health and education systems, planning educational programming, and assisting teachers in educational settings to implement appropriate educational programming.[5]

Schools currently are facing the responsibility of planning for inclusion of students with special health care needs (SSHCN) in an environment where diversity best characterizes not only the students themselves, but school faculties and resources as well. Foremost among the issues emerging from the debate over SSHCN in inclusive educational settings are those issues with the potential to affect the health and safety of these students during the school day. Examples include training and monitoring of teachers and assistants who manage chronic health conditions and perform health procedures in the classroom often without health-related knowledge and skills, lack of availability of school nurses on every campus, high nurse-to-student ratios, and skill updates for school nurses performing new procedures or encountering new health technology. Given the potentially negative affect of these issues on the health and safety of SSHCN, a need still exists for establishing interdisciplinary, collaborative linkages between the health and education systems, as described a decade ago by Magrab.[5]



The mission of the School Liaison Program is to promote the optimal inclusion of students with health-related disabilities in educational settings by promoting communication and collaboration among parents, schools, and health providers. …

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