发育迟缓的学龄儿童获得特殊教育服务外文文献

Contents lists available at ScienceDirect Research in Developmental Disabilities journal homepage Limited access to special education services for school aged children with developmental delay Erica Twardzika Ellen Smitb Bridget Hatfi eldb Michelle C Oddenb Alicia Dixon Ibarrab Megan MacDonaldb aUniversity of Michigan School of Kinesiology 1402 Washington Hts Ann Arbor MI 48109 United States bOregon State University College of Public Health and Human Sciences Corvallis OR 97331 United States A R T I C L E I N F O Number of reviews completed is 2 Keywords Individuals with Disabilities Education Improvement Act Developmental delay Eligibility Enrollment Special education Early intervention A B S T R A C T Background Current policy in Oregon limits eligibility of children diagnosed with developmental delay for school based services Due to eligibility defi nitions children with developmental delay may face additional barriers transitioning from early intervention early childhood special edu cation into school based special education services Aims Examine the relationship between enrollment in school based special education programs given a change in primary disability diagnosis Methods Logistic regression models were fi t for children who enrolled in early intervention early childhood special education services with a primary disability diagnosis of developmental delay and changed primary disability diagnosis before third grade n 5076 Results Odds of enrollment in future special education were greater in children with a change in primary disability diagnosis after the age of fi ve in comparison to children that had a change in primary disability diagnosis before the age of fi ve while adjusting for demographic character istics adjusted odds ratio 2 37 95 CI 1 92 2 92 Conclusion Results suggest that children who are diagnosed with a developmental delay and exit early childhood special education due to maximum age of eligibility are more likely to enroll in special education compared to children without a gap in service access Implications Gaps in service access during early development are associated with the need for supportive services later on in life What this paper adds Current policy in some states restricts the age that children with developmental delay are eligible to receive special education services This manuscript reports on third grade enrollment for children within the state of Oregon who had a diagnosis of devel opmental delay from three to fi ve years of age Findings indicate that restrictive age policy may limit children s access to school based special education services Within the state of Oregon children diagnosed with a developmental delay who exited special education due to restricted age of eligibility reentered special education later on in life Many states have similar eligibility policies and may have similar outcomes for children diagnosed with developmental delay in respect to likelihood of enrollment in third grade special https doi org 10 1016 j ridd 2017 12 008 Received 6 February 2017 Received in revised form 27 November 2017 Accepted 4 December 2017 Components of the current article have been previously presented in August of 2016 as a poster at the National Consortium for Physical Education for Individuals with Disabilities 2016 conference Other components of the research will be presented in November of 2016 as a poster at the American Public Health Association 2016 Annual Meeting and Expo Correspondence author at University of Michigan School of Kinesiology 1402 Washington Hts Ann Arbor MI 48109 2013 United States E mail address ericatwardzik E Twardzik Research in Developmental Disabilities 72 2018 257 264 Available online 08 December 2017 0891 4222 2017 Elsevier Ltd All rights reserved T education given a change in diagnosis after the age of fi ve Future research should examine if this association is observed in other states with similar eligibility criteria If these fi ndings are true throughout the nation it would be benefi cial to extend eligibility of service access for children with developmental delay to nine years if age as allowed in IDEIA This could increase children s like lihood of successful transitions out of IDEA when they no longer need services instead of exiting due to a restricted age range indicated in state legislature 1 Introduction Successful transition into elementary school impacts a child s growth and success during early years and into adolescence Danaher 2011 Giannoni McConnell et al 1998 The transition process from preschool into kindergarten is complex and a number of factors impact the success of the student Rous Hallam Harbin McCormick Rous Hallam McCormick McClelland Acock Oregon Department of Education 2015 Based on state legislation children initially diagnosed with DD in the state of Oregon are evaluated annually to determine eligibility Oregon Department of Education 2015 Beyond the age of fi ve access to school based special education services are only available to children with a new diagnosis beyond DD For example a child diagnosed with a DD at age three might be assessed and diagnosed with autism spectrum disorder at age fi ve which is a disability category that qualifi es a child for school based special education services unlike a diagnosis of DD This change in diagnosis for children with DD is time sensitive in states like Oregon as it results in continued enrollment in IDEIA programs and continuity in special education service access Giannoni McConnell et al 1998 O Connor 2000 Early elementary education marks a child s fi rst experience in formal education Researchers have consistently found an asso ciation between a child s performance in early elementary school and their later academic achievement Day et al 2015 Ensminger Gutman Sameroff McClelland et al 2006 However interventions targeting children birth to fi ve years of age have shown little eff ect on academic outcomes beyond kindergarten Puma et al 2012 Children with DD may not be able to perform at the same level of their peers if supportive services are not accessible during early elementary years Additionally children tend to fl uctuate in and out of special education before third grade while after the third grade likelihood of transitioning out greatly diminishes Jenkins et al 2006 Jenkins et al 2006 estimated that 41 of students who were identifi ed as having a disability before kindergarten transitioned out of special education by grade three However only 26 of students with a disability in grade three transitioned out of special education services until age 19 Jenkins et al 2006 This not only increases the costs to the state to support children throughout primary schooling but also can have a great infl uence on a child s likelihood of success later on in life Aron Hadadian Jenkins et al 2006 There is major support within the state of Oregon to achieve success by third grade with the P 3 initiative where six major institutions have come together to support success of students prenatally through third grade Children s Institute 2017 The emphasis on third grade success is within the sensitive period of brain growth and development in the fi rst 8 years it is deemed that this time period sets the foundation for future success Grantmakers for Education 2010 Hernandez 2011 Whither Opportunity Rising Inequality Schools and Children s Life Chances 2011 Few studies have investigated the third grade special education enrollment characteristics of children who exit special education programs with a DD diagnosis 1 1 Objectives The objective of this study is to determine if the timing of a change in primary disability diagnosis is associated with enrollment in special education at grade three among children who received special education services under a primary diagnosis of DD from three E Twardzik et al Research in Developmental Disabilities 72 2018 257 264 258 to fi ve years of age If a child had a change in diagnosis after the age of fi ve this indicated that the child had an interruption or a gap in the receipt of service access Alternatively children who had a change prior to the age of fi ve were able to continue service access beyond the age of fi ve and did not have a gap in the receipt of services To examine the relationship between the time of diagnosis change and a child s enrollment in third grade special education services a secondary data analysis of Oregon Department of Education ODE state collection fi les was completed It was hypothesized that children who had a change in primary disability diagnosis after the age of fi ve were more likely to be enrolled in third grade special education compared to children who had a change in disability diagnosis before the age of fi ve 2 Methods This retrospective dynamic cohort study outlined in Fig 1 used the ODE state database to determine the relationship between a change from a DD status into a primary disability diagnosis and third grade special education enrollment More specifi cally this relationship was examined through the pathways that children with a DD experience or not a change in diagnosis before the age of fi ve This study determined the proportion of children diagnosed with DD from birth to fi ve years of age that had a change in their primary disability diagnosis and the odds of receiving special education services at grade three The ODE is a federally funded state agency that is responsible for data collections federal reports and public reports for special education in the state of Oregon Schools and school districts have contractual obligations to ensure all children are accounted for within the database All data included children aged birth to fi ve who were enrolled in special education programs from 2009 to 2015 This research study was conducted in accordance with prevailing ethical principles and reviewed and approved by the Institutional Review Board 2 1 Study participants Participants in this study included a subset of children identifi ed within the ODE database from 2009 2015 who had a DD diagnosis between the ages of three to fi ve years The study cohort was dynamic in nature and children could fl uctuate in and out of the cohort depending on their enrollment status in the special education programs In order to be eligible for the study three specifi c criteria were required for a DD diagnosis First the child between the ages of three to fi ve years had a DD of 1 5 standard deviations or more below the mean in two or more developmental areas of a norm referenced test or 2 0 standard deviations or more below the mean in one or more developmental areas of a norm referenced test Developmental areas included cognitive physical commu nication social emotional or adaptive Second the child s disability had an adverse impact on the child s developmental progress Third the child needed early childhood special education services Oregon Department of Education 2015 Finally the child had to experience a change in disability status before grade three and have data in third grade For example a three year old child with data in 2010 would be observed in 2015 as a third grade student However a two year old in 2010 would not be observed as a third grade student within the database and was therefore excluded from analysis In line with these criteria and the purpose of this study children who were previously diagnosed with DD and had no change in eligibility status from ages fi ve to grade three were excluded from these analysis with the assumption that the child was appropriately not receiving services after the age of fi ve Fig 1 The total number of children eligible for the present study was 5076 2 2 Data source Within the ODE database each school district reported all resident children with disabilities who have been identifi ed located and evaluated Thus these children were receiving early intervention or special education from a public or private educational program Data collections occurred on December fi rst of each school year in the state of Oregon and every district was mandated to report this Fig 1 Study design and sample size N 5076 of children enrolled in the current retrospective dynamic cohort study Children were recruited from the state of Oregon from 2009 to 2015 that had a primary disability diagnosis of developmental delay from ages three to fi ve All children eligible had a change in diagnosis from age three through third grade E Twardzik et al Research in Developmental Disabilities 72 2018 257 264 259 information to the state department of education School districts involved in the education of children with disabilities are mon itored by the ODE on a regular basis to ensure compliance with the requirements of the IDEIA Oregon Revised Statutes and Oregon Administrative Rules Monitoring procedures typically included district self assessment data collection analysis and reporting on site visits review of policies and procedures review of the development and implementation of individualized education plans improvement planning and auditing federal fund use 2 3 Dependent variable The primary outcome of interest was enrollment in special education services in third grade Enrollment in special education in third grade was an important time point for two reasons First previous work suggests that third grade is a critical time point where after third grade the likelihood of exiting special education services greatly decreases Second for comparability with other studies investigating early education success which have commonly used a third grade cutoff Delgado et al 2006 McClelland et al 2006 Muschkin Ladd Puma et al 2012 To assess third grade enrollment all children enrolled in special education during the third grade were included within a database From the third grade enrollment database children were matched with those that had a change in diagnosis from DD prior to the third grade Children were considered a match if they had the same unique iden tifi cation number assigned by the state department of education 2 4 Independent variable A variable was created to determine whether a change in primary disability diagnosis for a child occurred before or after fi ve years of age To create this dichotomous variable all children who had a DD from ages three to fi ve years were included in the full database These children were then coded using three categorical variables 0 not enrolled 1 enrolled under DD diagnosis 2 enrolled under other diagnosis to determine enrollment in special education in each individual year up to third grade Note that children older than fi ve years of age could not have a diagnosis of enrolled under DD diagnosis Children who were not enrolled in special education from age six through third grade were excluded from the study Fig 1 The remaining children were assessed for a change in diagnosis before or after the age of fi ve n 5076 A code of enrolled under other diagnosis at age fi ve or younger indicated a change in disability diagnosis before the age of fi ve no gap in services A code of enrolled under other diagnosis after the age of fi ve indicated a change in disability diagnosis after the age of fi ve a gap in services 2 5 Covariates The following demographic variables were evaluated to assess the confounding eff ects of these variables on the main outcome enrollment in special education services gender agency enrollment setting and eligibility age The agency variable was the department responsible for providing services to the child while enrolled in early intervention or school based services and included services accessed within program setting or at a regional center The enrollment setting variable indicated the location where a child received services Enrollment setting classifi cation included access to service within the home hospital or school Eligibility age was calculated using the initial age the child entered special education services in the state of Oregon and the child s birthdate The initial age of eligibility indicated the date that the participant was fi rst determined eligible for enrollment in IDEIA programs with a DD diagnosis All variables were collected by the ODE a federal requirement under IDEIA 2 6 Data analyses Data fi les from the ODE were downloaded and read into STATA 14 1 for Mac 2016 02 16 Frequency counts of all demo graphic information were tested for diff erences between groups using a Pearson chi square test for independence The proportion of children diagnosed with DD number of children diagnosed with DD enrolled in special education programs total number of children enrolled in special education programs was calculated from 2009 to 2015 This was displayed using a scatter plot A nonparametric test for trends across ordered groups developed by Cuzick 1985 was used to determine if this trend was signifi cant STATA command nptrend Descriptive characteristics were presented in both raw counts as well as percentiles and a Pearson chi squared test was used to identify if there were signifi cant diff erences between the children who received a new diagnosis before fi ve and after fi ve Among children who had a gap in the receipt of services summary statistics were calculated to quantify the amount of time the child was not accessible special education services through IDEIA Logistic regression models were fi t to determine the association between a change in diagnosis before or after the age of fi ve and enrollment in special education during third grade The model was built from the most basic model including the independent variable change in primary disability diagnosis before after the age of fi ve and the dependent variable enrollment in special education services at grade three All pre specifi ed covariates were entered in the adjusted model and included in the fi nal model if the covariate signifi cantly contributed The odds of enrollment in special education was obtained from the fi nal