Child health care and "the new morbidity": toward a model for the linkage of private medical practice and the public schools

A renewed, and somewhat overdue, emphasis on programs for children has become a widespread concern of the health and human services fields. This paper addresses the problems and potentials of achieving a greater degree of coordination of the child-oriented human services through an examination of the response and the interaction of the (largely private) medical care and the (largely public) educational systems with respect to the special situation of children with learning-related handicapping conditions. The perspectives and particular interests of each of these complex systems are described along with their special role in the detection, assessment, and intervention with regard to children with learning-related problems. A description is provided of the process through which children are placed in educational programs that give special recognition to their learning difficulties. Particular note is taken of those places where medical care providers can have an effective influence on the educational placement of the child. The paper concludes with four recommendations that should help to insure the interaction of child health and educational services for children with learning-related handicapping conditions.

US Court of Appeals decision regarding Armstrong v. Kline: the 180 day rule

On June 21, 1979, Judge Clarence C. Newcomer, of the United States District Court for the Eastern District of Pennsylvania, issued his decision and Order in the case of Armstrong v. Kline. Judge Newcomer held that the undisputed policy and practice of the Pennsylvania Department of Education of refusing to provide or fund the provision of a program of special education and related services in excess of 180 days per year to any handicapped student was in violation of Public Law 94-142. Also held to be in violation of the law was the Department's companion policy of instructing all hearing officers who preside at special education due process hearings that they were without the power to order or approve any educational programs exceeding 180 days per year. On July 15, 1980, the Appellate Court upheld the District Court in three separate opinions. This article describes the decision of the District Court, explains how the reasoning of the Appellate Court differs, and points out some of the implications of the Appellate Court's holding.

Early childhood education for the handicapped in the 1980's: recommendations

The author interviewed 13 specialists in early childhood education for the handicapped as to their opinions regarding and hopes for the field in the next decade. These interviews are analyzed and the results presented as a series of obtainable goals for the 1980's. The recommendations vary from suggestions for modification of training in universities and colleges to the establishment of family centers.

180 day barrier: issues and concerns

Legal and educational issues related to year-round education for handicapped individuals are discussed. A review of legal developments supporting 12 month education and an historical exploration of the goals of compulsory schooling demonstrate the inherent conflict between providing a free appropriate education to all handicapped children and the existence of the 180 day rule. Additional arguments in support of year-round schooling are based on the concerns of parents and teachers, as well as the apparent methodological advantages to avoiding lengthy breaks in programing for the severely handicapped children. Finally, it is suggested that the concept of year-round schooling is not inconsistent with the goals of mainstreaming and the need of severely handicapped individuals to have the opportunity to generalize learned skills.

Issues in the implementation of extended school year programs for handicapped students

For some severely and profoundly handicapped children who have a regression-recoupment disability, the lengthy interruption in school programing during the summer months poses serious obstacles to learning. As a result of court decisions in Armstrong v. Kline and Battle v. Commonwealth, the public schools now have an obligation to identify these children and to provide programs suited to their needs. School personnel are urged to take the initiative in developing quality extended school year programs that accommodate the need for clear eligibility criteria based on valid and reliable student performance data, reducing the number of students in need through effective instruction and parent/home involvement; exploring the use of alternative service models; identifying funding mechanisms for extended year programs; and operating programs cost effectively.

An approach to preventive intervention in child psychiatry

A conceptual model for primary prevention is proposed. Its five elements are (1) Risk Factors that increase the likelihood of (2) eventual Mental Disorder contingent upon (3) intervening psychological stresses that promote Crises, which the individual may master more or less effectively dependent on (4) his current psychological Competence and (5) the powerful influence of Social Supports. The paper summarizes recent preventive intervention efforts and evaluative studies that focus on these elements in seeking to reduce psychiatric disorders in child populations: reduction of risk factors through mental health consultation and collaboration by mental health clinicians with child care workers and administrators; improvement of competence in children t risk by special educational programs with children and their parents that seek to enhance their cognitive and emotional programs with children and their parents that seek to enhance their cognitive and emotional problem-solving and coping skills; crisis intervention for children and their families by anticipatory guidance and preventive intervention; and fostering protective social supports by convening supportive groups for persons in need, and organizing mutual help groups, both of which seek to provide individuals under stress with help with emotional reequilibrium and cognitive guidance to compensate for capacities that are usually temporalily eroded by the upheaval of crisis.

Problems of the communicatively disadvantaged. An overview

The article traces the attitude of various cultures through the centuries toward the hearing and speech handicapped. It outlines the early efforts to develop rehabilitative techniques for such handicaps, and describes a number of the pioneers in the field of education for the "deaf and dumb." The emergence of the opposing philosophies for training the hearing handicapped, the oral school and the signing school, and the influence these two had on the development of education for the deaf is described. The part played by basic research and the development of new instrumentation during the past 50 years in the solution of many of the problems of disordered communication is reviewed. Finally, the philosophic aims are described that led to the establishment of the Boys Town Institute for communicatively handicapped children.

[The changing situation of the school for the physically disabled owing to the rising numbers of most severely and multiply disabled pupils (author's transl)]

The author outlines a group of disabled who are suggested to be inadequately covered by the usual targets of rehabilitation (reintegration in the labour market, independence in the activities of daily living, starting a family--in short: "normality"), because of the presence of severe and extensive disabilities or disability combinations. Starting from an analysis of the living situation these children are facing in their childhood, and a projection on the living situations to be expected in adulthood, the essential principles of an educational concept are developed which, at the price of departure from established educational ideas, is intended, ideally, to enable the course of education to be adjusted to the living situation of the individual. These individualised programmes must be based on an established right to being different, and insistence on the inalienability of equal value and equal rights as a task of education in the schools for the physically disabled.

Where special education for disturbed children is going: a personal view

Public Law 94-142 is likely to result in suppression rather than expansion of services to mildly disturbed students because of problems in the definition of emotional disturbance and the requirement of service for all children identified. A legal, bureaucratic approach to the problem of behavioral deviance is of questionable wisdom. The direction the field is taking is largely determined by forces external to special education. Special educators might increase their level of success by giving greater attention to more basic issues than they have in the past.