Part 1: Meeting The Challenge of Disrupted AttendanceFor
most students, missing a few days does not affect their school work or
estrange them from friends. However, for students with asthma,
allergies, migraines, chemical injury and other environmental
illnesses, cancer, chronic fatigue immune dysfunction syndrome, severe
injuries, prolonged illnesses and other chronic health conditions,
keeping up with school work and keeping in touch with teachers and
peers can sometimes be a real challenge.
Part 2: A Section 504 Planning Team Agenda to Provide Academic & Social ContinuityStudents
who are missing school because of health conditions need to know that
schools may be violating their civil rights under Section 504 and the
ADA if:
- staff create or ignore
conditions that make healthy children sick or sick children sicker,
such as poor ventilation, moldy carpets, furry animals, renovation
activity, toxic chemicals or other sources of contamination that are
barriers to attendance or that handicap their performance or ability to
participate.
- school policies deny
instructional support or limit instructional services to a certain
numbers of hours per week or to after school hours.
- teachers penalize a student for missed class time due to health problems.
- students do not receive the continuity and quality of instruction necessary to maintain academic progress.
Part 3: Chutes & Ladders: Meeting the Needs of Students with Chronic Health ConditionsGUIDING
PRINCIPLE: "The singular purpose for determining that a student has a
disability is to increase the educational opportunities available to
that student so that he/she progresses through school. The
responsibility of the evaluation team is to ensure that each student
receives the most appropriate educational program in the Least
Restrictive Environment..." Educating the Whole Student, MA Dept. of
Education, September, 1992
See below: Characteristics of a Good Teacher-Student Match For a Student at High Risk for Missing SchoolSee below: The Administrative and Educational Advantages of Good Distant Learning Packages
* * * * * * * * * * * * * * * *
I
specialize in educational planning for students with chronic health
conditions. I know that supportive policies, good resources and good
planning can protect health, prevent crises, and reduce the toll of
prolonged or intermittent absences on a child's health, education and
self-esteem.
* * *
The information presented in this article is for educational purposes
and does not substitute for the professional advice of your lawyer or
physician.
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Characteristics of a Good Teacher-Student Match for a Student at High Risk for Missing School (Web version 01/2005)
Students
with an injury or a chronic or re-occurring health condition may have
frequent, repeated, intermittent, and extended periods of disrupted
attendance and impaired functioning. They are at high risk of being
left out and left behind. This checklist identifies the teacher
characteristics and practices that are most supportive and protective
for students at risk for missing school, who have a history of missing
school and who are re-entering school after an injury or illness.
Schools and parents can use this list to design an IEP or S. 504 plan.
The Teacher
___ Is experienced. (Has taught the course before)
___ Is extremely well organized.
___ Follows a course syllabus.
___ Has explicit written goals and objectives for course.
___ Can be relied on to follow a predictable calendar of activities and assignments.
___ Uses a basic standard text.
___ Posts the course syllabus, class calendar, study guides and assignments on a class website.
___
Has student names, phone numbers and email addresses available to all
students and encourages students to use each other as resources (study
buddies, cooperative learning groups, study teams, etc.).
___ Uses a cooperative vs. a competitive goal structure.
___ Makes all texts, supplemental materials and resources available at start of course.
___ Encourages take-home exams.
___ Uses email to communicate.
___ Is computer literate.
___ Is knowledgeable about learning resources on the web.
___ Is willing to talk on phone with students.
___ Accepts assignments, papers and projects online.
___ Teaches note-taking skills; Uses course note-takers.
___ Encourages students to share lecture and discussion notes.
___ Encourages ìwriting across the curriculum.
___ Accepts phone links or video camera in classroom.
___ Evaluates tests and assignments promptly.
___ Is knowledgeable about student resources within the school and the community.
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Administrative And Educational Advantages of Good Distant Learning Packages (Web version 01/2005)
1. They provide explicit, self-contained, sequential, comprehensive curriculum. (Provides access to general curriculum.)
2. They provide explicit structure, expectations and learning objectives.
3. The include all necessary resources and are student-driven, self-paced and can be used for accelerated learning.
4.
They provide an asynchronous system for variations in student's health,
functioning and schedule. Help is available at all times. Ensures
continuity.
5. They eliminates the
double pressure of "keeping up" and "making up" for a student with a
history of missing school and acquiring educational deficits.
6.
They provide unit reviews that allow students to identify knowledge or
skill deficiencies. Students gain mastery of concepts and skills so
they develop the proficiencies and pre-requisites needed for future
academic challenges.
7. The courses
are accredited in many states and are recognized as equivalent to
school courses and are aligned with state curriculum frameworks.
8. They allow students to avoid the frustrations, inadequacies and inefficiencies of tutoring.
9. They provide evaluation and feedback by certified teachers.
10.
They manage educational documentation and administrative paperwork.
Provides records and reports grades and credit status to school.
11. Mobility provides student access anywhere there is a computer connected to the internet, at home or school.
12.
Online learning gives students experience with distance education
opportunities, taking advantage of other programs that offer advanced
degrees and corporate training.
13. Low Cost
[The
information presented in this article is for educational purposes and
does not substitute for the professional advice of your lawyer or
physician.]
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All Healthy Kids
materials are reviewed and revised in response to comments and
suggestions from the professionals and parents who use them. Your
feedback increases the usefulness of these items to others. I'd be
especially glad to hear about problems that you have solved or policies
or practices that Healthy Kids information has influenced. I look
forward to hearing from you. healthykids@rcn.com
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Missing School Advocacy Kit v.2009
Are you or someone you know missing school?
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Part 1: Meeting The Challenge Of Disrupted Attendance (Web version 01/2005)
WHO IS MISSING SCHOOL?
Students
with chronic health conditions, acute health problems or traumatic
injuries may be at home or in the hospital for frequent, prolonged or
reoccurring periods of time. Their medical evaluations, treatments or
rehabilitation can contribute to additional periods of disrupted
attendance as well as limited stamina or alertness. Pain or the side
effects of medication may impose unpredictable episodes of weakness or
limited functioning. Students may miss some or most of the school day,
or be hospitalized or in recovery for unpredictable lengths of time.
There
are also students whose special interests (performing arts, sports) or
professional commitments create schedule conflicts with school hours.
Other students miss school, or suffer stress, fatigue and distraction
because family circumstances involve them in the personal care of
family members with disabilities or require them to work for necessary
income. Students may miss school while grieving the loss of a family
member, during pregnancy or because child care is unreliable.
In
many areas of the country, students face geographic or transportation
barriers to regular attendance, especially during extreme weather
conditions. Some students miss school to accompany parents on business
travel. A large number of students miss instructional time in regular
classes because special education services and 'pull-out' therapies are
scheduled during regular class time with no planning for filling in the
gaps in regular instruction.
THE PROBLEM: EDUCATIONAL DEPRIVATION
Lost class time, at any age and for any reason, can impose an acute as well as a cumulative handicap on students.
LEFT
OUT AND LEFT BEHIND. Students who miss school because of health
conditions can also suffer secondary educational losses unrelated to
their academic ability. The school may impose grading or promotion
penalties for missed time or missed "work." Students experience
education neglect when a school records missed school time as an
'excused' absence but provides no instructional services or support. An
additional hardship is imposed when teachers demand that students do
assigned 'work' or take tests in spite of missing instruction. School
officials may also misclassify or misinterpret absences as truancy,
criminalizing the problem.
ADVOCACY NOTE
US
Department of Education regulations implementing Section 504 of the
Rehabilitation Act of 1973 require schools to provide a free and
appropriate public education to students with disabilities regardless
of the nature or severity of their disability.
The
provision of an appropriate education is the provision of regular or
special education and related aids and services that are designed to
meet the individual educational needs of the person with a disability
as adequately as the needs of non-disabled persons are met.
In
1994, Department of Education - Office for Civil Rights, Region 1,
found Boston Public Schools in violation of Section 504 for the policy
and practice of arbitrarily limiting instructional services to a set
maximum number of hours per week, limiting home services to after
school hours, failing to provide continuity and coordination of
services, and failing to respond to complaints of insufficiency of
services.
BAD PRACTICE
Although
it violates the student's rights under educational and civil rights
laws, many school policies or customs arbitrarily limit instructional
services without first considering the extent of the individual
student's needs. Schools may inappropriately prohibit a student's
participation in extra curricular activities or school programs.
Many
schools impose arbitrary waiting periods before recognizing a student's
'eligibility' for services and then it is usually too little, too late.
Students then suffer the double problem of trying to make up and keep
up with ongoing class demands.
TUTORING = INSUFFICIENT SERVICES
Tutoring
is the most commonly used assistance option. However, it is often
provided reluctantly, and it is costly and generally ineffective. When
teachers do not provide for continuity of instruction and for a reentry
plan that would facilitate the student's reintegration, it
significantly diminishes the value of attendance.
The
most common complaints about tutoring include the lack of tutor-teacher
communication, the lack of structured plans or learning objectives,
unqualified tutors, inadequate instructional time and no meaningful
evaluation. No wonder that many students feel left out and left behind.
GOOD PRACTICES
Schools
can protect students' educational progress and save funds wasted on
inappropriate and ineffective 'tutoring' by developing supportive
proactive policies, identifying appropriate resources, and by enhancing
teachers' communication, planning and documentation systems.
Students who miss class time need:
1) explicit goals and learning objectives,
2) structured study guides that preview and review lessons, and
3) reliable communication about activities and events they have missed.
Supportive
policies, good resources and good planning can reduce the toll of
prolonged or intermittent absences on a student's health, education and
self-esteem.
GOOD PLANNING
Developing
a formal written plan to protect students against gaps in learning
makes good educational sense. It is the right thing to do and the
legally appropriate thing to do.
A written plan clarifies needs and provides guidelines for immediate and long-term support.
A
good plan enhances the staff's professional repertoire, supports
multidisciplinary teamwork, and fully exploits today's enriched menu of
multiple instructional delivery options and assessment tools including
multimedia, communications and computer technology and community
resources.
EVERYONE NEEDS A LITTLE HELP SOMETIME
A
school can enhance education for all students by evaluating and
redesigning its student support systems. For example, a school may
expand its student service program to engage high school and middle
school students in academic assistance projects within and across
grades with students in and out of school. A school district may take
advantage of new community technology and networks to include library
resources or to involve the extended community as mentors and
instructional aides.
________________________________________________________
Part 2: A Section 504 Planning Team Agenda to Provide Academic & Social Continuity (Web version 01/2005)
The
S. 504 Plan is a formal written agreement for a student that is
developed by the school staff working in partnership with the student's
parents and health care providers (and the student). The goal of the
plan is to identify barriers to education for a student at risk for
disrupted attendance and to provide the instructional resources and
services that enable the student to make meaningful educational
progress.
ROLES AND RESPONSIBILITIES
School Nurse
- Identify student with a pattern of or at risk for disrupted attendance.
- Obtain
documentation from student's physicians, therapists and other
specialists. (Health professions should anticipate the student's need
for documentation. Avoid all or nothing short cuts: Physicians may need
information on flexible program options.)
- Consult on school environmental safeguards and modifications.
- Design and monitors student's individual school health care plan.
- Provide teacher and peer education, family and student support.
Counselor/Advisor/Liaison
- Develop student profile including a) performance history, b) attendance history; c) learning needs.
- Maintain student educational record.
- Flag pattern of absences
- Arrange for educational evaluations of student's needs.
- Coordinate plan.
- Plan timely communication and information exchange, opportunities for social continuity (peer tutors, peer editors, study buddies...)
Principal
- Initiate and supervises student's plan.
- Identify planning team and roles, tasks and responsibilities.
- Convene the planning team meeting.
- Ensure state curriculum frameworks or standards are available to team.
- Provide home instructors/Mentors
- Provide primary or supplementary instructional support. Must be qualified in the subject area he or she is responsible for.
Teacher(s)
- Provide
instructional framework and goals for learning program unless delegated
to department chair, alternative educational service or program.
- Promote distant learning and communication opportunities.
- Facilitate student-student communication.
Department Heads
- Provide curricular guidelines and program quality assurance.
- Consult with curriculum specialist/educational media specialist
- Provide information for adapted or alternative methodology and technology, multimedia resources and audio/visual programs.
- Consult with teachers on instructional resources and materials, assignments and evaluation criteria.
Parents
- Provide information for student profile.
- Provide emotional support for student.
- Provide feedback to liaison and staff on appropriateness and effectiveness of program, resources and services.
Student
- Express needs.
- Express preferences and interests.
Circle of friends
- Brainstorm ways to maintain communication and connections
STEP ONE
Conduct a Needs Assessment: Identify studentís functional abilities and constraints.
Consider:
- Computer skills
- Documentation skills (footnotes, bibliographies, etc.)
- Key boarding
- Lab skills
- Memory strategies
- Note taking skills
- Organizational skills
- Proofreading and editing skills (punctuation, word usage, spelling, grammar)
- Reading level
- Research skills
- Test taking strategies
- Use of reference materials
- Writing process
Consider:
- ability to concentrate
- alertness
- appetite, thirst
- attention
- behavior
- coordination and balance
- fine motor/gross motor control
- time demands of treatment, rehabilitation plan
- energy demands of treatment
- rehabilitation plan
- effects of medication
- memory
- moods
- need for review, reinforcement
- sleep patterns
- strength or stamina
- temperament
STEP TWO
Identify
educational goals and objectives for all subject areas. (Reference
state frameworks, course syllabi, learning objectives, study guides,
reading lists, and lesson plans.)
Consider
modifications and related services: What modifications to schedule or
location would enable student to maximize participation or attendance?
What instructional resources and assistive technology match curricular goals and studentsí needs?
What criteria should be used to select materials?
The
use of multimedia resources and computer and communications technology
can provide a flexible appropriate program. Web-based local, national
and global learning communities and online mentors, teachers, peers and
coaches can establish tele-learning and www systems that enhance and
enrich independent learning opportunities as well as collaborative
learning.
Arrange for students at risk for disrupted attendance to have duplicate texts and course materials at home.
Arrange for flexible expectations, alternative formats for materials, evaluations.
Provide modified assignments. (Vary length and format for variable levels of effort or attention.)
Arrange for reduced class load and /or part-time/flex-time attendance.
Arrange for sequential vs. simultaneous scheduling of courses.
Cluster courses or rooms to reduce travel time between classes.
Plan rest areas or rest times (both private/social areas).
Provide elevator pass.
Schedule frequent breaks as needed.
Arrange transportation to school, extra curricular activities and events
Evaluate and improve environmental conditions at school.
Ensure
adequate ventilation, eliminate or reduce odors, mold, chemicals,
construction activity, pesticide applications, and animals.
Adapt physical education/fitness programs; Provide physical/occupational therapy at school.
Consider extended year program options.
Other_________________________
STEP THREE
Select
appropriate methodology and instructional resources: media resources
and auxiliary services, aids and modifications for both in-school and
home instruction.
Audio tapes of classes
Books on tape
Class note takers
Computer programs
Computers
Correspondence courses
Discussion and study guides
Distant learning programs
Educational Videos
Home education/tutorials
Independent study program
Library study groups
Magazines
Museum kits
On line activities/Email
Phone consult
Reading lists
Reference books
Speaker phone hookup
Study buddies
Teacher home visit
Text books
Trained peer tutors
Tutors (certified teachers)
Video tapes of classes
Other
STEP FOUR
Agree
on appropriate evaluation criteria and assessment strategies
(portfolio, interviews, tests, projects, journals, reports -- written,
oral, etc.)
STEP FIVE
Agree on a communication system for feedback and problem solving ñ fax, voice mail, email, etc.
STEP SIX
Plan for re-entry and transitions. The more a student communicates with teachers and classmates, the easier the re-entry.
STEP SEVEN
Facilitate
social opportunities as well as academic support. (Study buddies,
email, phone pals, pen pals, school websites, bulletin boards, home
visits, extra curricular activities).
Provide
student with all classroom and school newsletters, notices, memorandum,
and program flyers. Provide timely notice of classroom/school events,
extracurricular activities, programs, visitors, trips, parties, etc.
Encourage participation in special events and extra-curricular
activities.
STEP EIGHT
Evaluate and redesign plan to meet student's changing needs.
_______________________________________________________
Part 3: Chutes & Ladders: Meeting the Needs of Students With Chronic Health Conditions (Web version 01/2005)
For
students with a chronic health condition, school can become like a
Chutes and Ladders game with many more chutes than ladders. No matter
what the degree or severity of a student's medical condition, he or she
will have more absences than their classmates. Thus he or she will face
many challenges and setbacks trying to keep up at school.
In
general, the student's health condition and medical management needs
create significant obstacles to school attendance and academic and
social continuity.
The school's
willingness and ability to protect a student's health and education can
have a significant impact on the student's social, emotional, and
educational well-being. Schools that understand the needs of health
impaired students know that these students require some extra thought
and planning and strong school-family partnerships to coordinate their
health and educational needs.
On the
other hand, a teacher's inappropriate expectations and inflexible
demands can cause many additional hardships, can inflict extreme
distress on the students and their families, and create acute and
cumulative educational disadvantages.
Recommended Reading: Missing School Time? Filling the Gaps. 1992. Ellie Goldberg, M.Ed.
B A C K G R O U N D (adapted from James Perrin, MD, Michael Weitzman, MD)
10
- 20 % of children under 17 have some type of chronic health condition
(asthma, diabetes, seizure disorders, cystic fibrosis, sickle cell
anemia, liver or heart defects, etc.) Less than 2% of children have a
severe health impairment.
Rates of chronic illness have increased in the past twenty years.
Despite
differences among specific illnesses or their severity, the issues
faced by families relate to the chronicity of a condition.
And
despite the differences among illnesses or their severity, students
face common barriers to education and health management at school that
place them at high risk of not functioning to their fullest potential.
CHALLENGES OF CHRONIC HEALTH CONDITION(S) AND DISABILITY
- Unpredictable variations in functioning (stamina and alertness).
- Swings in moods and cognitive function because of condition, fatigue and/or medication.
- Frequent and time-consuming medical evaluations, treatments.
- Altered routines (eating, sleeping, work time, recreational activities, free time).
- Fatigue
- Anxiety
- Diminished Self Esteem
- Developmental stress intensified
- Hidden Handicaps
- Out of sync with peers
- Peer acceptance/socialization skills at risk
MEDICATION
- Debilitating Side Effects
- Over dosing, Under dosing, Frequent changes in medication
DEMANDS OF MEDICAL MONITORING
- Frequent disruptions of daily activities
- Constant adjustment to changes in patterns of daily life (eating, activity levels, etc.)
- Frequent physician visits during school day
MISSED SCHOOL TIME
- Disrupted attendance
- Disrupted relationships (student-student, student-teacher)
- Missed instruction results in cumulative academic deficits
- Lack of skills development, cognitive strategies and prerequisites to make progress
- Lack
of context results in not knowing what is expected, can't understand
assignment objectives, doesn't understands standards for acceptable or
good performance, hyper vigilance (misinterpreted as ADHD)
- Lack of communication and curricular support diminishes value of school attendance.
- Lack of meaningful evaluations.
- Unfair grading and credit penalties.
- Social inhibitions developed from loss of social relationships and contacts.
- Depression related to being left out and left behind with no hope for catching up.
- Truancy actions against student
DOMINANCE OF PROBLEM ORIENTED DISCUSSIONS
- Pessimism, Negative focus
- Impaired self esteem
- Communication problems
- Competition between academic and social needs
- Difficulty making up and keeping up with class
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