Abstract
School success predicts many pathways for health and well-being across the life span. Factors promoting or potentially impeding
school success are critical to understand for all children and for children with special health care needs (CSHCN), whose
life course trajectories are already impacted by their chronic health problems. The 2007 National Survey of Children’s Health
was used (1) to estimate national and state prevalence and within and across states disparities in factors promoting school
success (engagement, participation, safety) or potentially impeding success (missing school, grade repetition, school identified
problems) for all children and CSHCN and (2) to evaluate associations with CSHCN service need complexity and presence of emotional,
behavioral or developmental problems (EBD) as well as with school case management policies in states. Among school age children,
60 % experienced all three factors promoting school success (49.3–73.8 % across states), dropping to 51.3 % for CSHCN (39.4–64.7 %
across states) and to 36.2 % for the 40 % of all CSHCN who have both more complex service needs and EBD. CSHCN were more likely
to experience factors potentially impeding school success. After accounting for child factors, CSHCN living in states requiring
case management in schools for children with disabilities were less likely to experience grade repetition (OR 0.65). Within-state
disparities between non-CSHCN and CSHCN varied across states. Threats to school success for US children are pervasive and
are especially pronounced for CSHCN with more complex needs and EBD. Findings support broad, non-condition specific efforts
to promote school success for CSHCN and consideration of state school policies, such as case management.
school success are critical to understand for all children and for children with special health care needs (CSHCN), whose
life course trajectories are already impacted by their chronic health problems. The 2007 National Survey of Children’s Health
was used (1) to estimate national and state prevalence and within and across states disparities in factors promoting school
success (engagement, participation, safety) or potentially impeding success (missing school, grade repetition, school identified
problems) for all children and CSHCN and (2) to evaluate associations with CSHCN service need complexity and presence of emotional,
behavioral or developmental problems (EBD) as well as with school case management policies in states. Among school age children,
60 % experienced all three factors promoting school success (49.3–73.8 % across states), dropping to 51.3 % for CSHCN (39.4–64.7 %
across states) and to 36.2 % for the 40 % of all CSHCN who have both more complex service needs and EBD. CSHCN were more likely
to experience factors potentially impeding school success. After accounting for child factors, CSHCN living in states requiring
case management in schools for children with disabilities were less likely to experience grade repetition (OR 0.65). Within-state
disparities between non-CSHCN and CSHCN varied across states. Threats to school success for US children are pervasive and
are especially pronounced for CSHCN with more complex needs and EBD. Findings support broad, non-condition specific efforts
to promote school success for CSHCN and consideration of state school policies, such as case management.
- Content Type Journal Article
- Pages 1-9
- DOI 10.1007/s10995-012-0993-z
- Authors
- Christina Bethell, Department of Pediatrics, School of Medicine, Oregon Health and Science University, 707 SW Gaines Avenue, CDRC-P, Portland, OR 97239, USA
- Christopher B. Forrest, Department of Pediatrics, The Children’s Hospital of Pennsylvania, Philadelphia, PA, USA
- Scott Stumbo, Child and Adolescent Health Measurement Initiative, Oregon Health and Science University, Portland, OR, USA
- Narangerel Gombojav, Child and Adolescent Health Measurement Initiative, Oregon Health and Science University, Portland, OR, USA
- Adam Carle, Cinncinati Children’s Hospital Medical Center, Cincinnati, OH, USA
- Charles E. Irwin, Phillip R. Lee Institute for Health Policy Studies, University of California, San Francisco, San Francisco, CA, USA
- Journal Maternal and Child Health Journal
- Online ISSN 1573-6628
- Print ISSN 1092-7875