-Investigative Report-
By: Dr. R. Peralta
What is already known?
Racial and ethnic minority children are at a disadvantage due to higher rates of health conditions and underutilization of health services. We know less about whether Black, Hispanic, and Multiracial children with health conditions also underutilize school services related to health and learning.
What does this study add?
We found that Black, Hispanic, and Multiracial students are more likely to have an IEP plan in place when they had greater family resources, neighborhood resources, more comorbid health conditions, when their health condition was more severe, and when they had unmet health care needs compared to white children. We applied the Andersen Behavioral Model to predict whether students had access to school-based services under an IEP plan.
Black and Hispanic children and children living in low income families bear a greater burden of chronic health conditions compared to their wealthier White counterparts. For example, Puerto Rican American children Americans have an asthma rate that is double (13 %) that of white children (7 %).
Black and Hispanic children have higher rates of type 2 diabetes (16 per 100,000 and 19 per 100,000 respectively) compared to White children (6 per 100,000). Black and Hispanic children have a greater propensity toward obesity with 24 % of Black youth, 23 % of Hispanic youth being obese compared to 13 % of White youth.
Compared to Whites, Black and Hispanic children and adolescents are also less likely to utilize health care services, tend to underutilize health services and have greater unmet needs for health care. For those children with special health care needs, minorities are more likely than Whites to be without a usual source of care and have greater unmet healthcare needs. Such health disparities persist through adolescence into adulthood causing long term difficulties.
One of the most important areas of a child’s life is school, where children and adolescents spend 6–8 hours per day. Children may face barriers to learning due to the impact of their health condition. These barriers might be felt more strongly among racial and ethnic minority students due to their higher rates of health conditions and unmet healthcare needs compared to Whites.
Racial and ethnic minority students already experience lower rates of school success across most measures and having one or more health conditions adds to their educational challenges. Health is an important causal mechanism through which race/ethnicity and socioeconomic factors impact school success.
Federal law mandates that public schools provide educational services to children under the Individuals with Disabilities Education Act (IDEA) of 2004 if they meet the following criteria; (a) have a mental or physical impairment that affects performance in a general education setting; (b) the impairment is persistent and substantially limiting to education; and (c) the impairment impacts major life activities.
Children access special school services, such as educational goal setting, identification of supplementary aids, and special needs accommodations, as part of individualized educational programs (IEP) designed to meet their individual learning needs.
Nationally, 13 % of school children with disabilities have an IEP plan in place to receive educational services specific to promoting health and learning. It is assumed that utilization of these IEP services will reduce disparities in school outcomes for disadvantaged students with health conditions, yet there is currently little known about the characteristics of the children (including race, ethnicity, sex or health conditions) that have an IEP plan in place to receive services in the schools.
This investigative report examines the extent to which children with health conditions have an IEP plan in place by drawing on a national secondary dataset, the National Survey of Children’s Health.
We look to the Anderson Behavioral Model to understand predictors of having an IEP plan in place for children with health conditions, as it is widely used by researchers interested in understanding the influences on health service use.
Having an IEP plan in place serves as the gateway to health service utilization; a student must first have an IEP plan before they can access the special education services under the plan. The Behavioral Model identifies three factors that influence whether a service is utilized which include; predisposing factors, enabling factors, and need factors.
References
Ackerman, B. (2012). G.U.I.D.E. to differentiated instruction for Christian educators. Lynchburg, VA: Liberty University Press.
Gibb, G. S., & Dyches, T. T. (2016). IEPs: Writing quality individualized education programs (3rd ed.). Upper Saddle River, NJ: Pearson.
Kenyon, E., Beail, N., & Jackson, T. (2014). Learning disability: Experience of diagnosis. British Journal of Learning Disabilities, 42(4), 257-63. doi:10.1111/bld.12054
Kirk, S., Gallagher, J., & Coleman, M. (2015). Educating exceptional children (14th ed.). Stamford, CT: Cengage.
Van Brummelen, H. (2009). Walking with God in the classroom: Christian approaches to learning and teaching (3rd ed.). Colorado Springs, CO.
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