Assessment of Children with Special Health Care Needs

Assessment of Children with Special Health Care Needs

 

Are students with Chronic or Special Health Care Needs automatically candidates for special education?

In fact, "very often the distribution of intelligence and abilities like hearing and vision among students with health needs is similar to that of the rest of the population.  Students with chronic needs may miss a great deal of school and benefit from a remedial program that includes special education programming.” (Bennett, 2008).

 What assessments are done on a regular basis in Ontario public schools?

With parental permission, dental and vision screening tests are done in schools.  Regular academic testing is done on an on-going basis in the classroom by teachers.  Again, with parental permission, further testing in speech and language, reading, writing and comprehension skills can be done by SERTs and specialized therapists used by the boards. (Speech and Language Therapists, Psychologists, Audiologists, Ophthalmologists and Physicians).  Some of these professionals can do the assessments at the schools and others can be accessed by families at their offices.

How can EAs assist in a child's assessment?

E.A.s who are in close communication with the rest of the school educators can be very helpful in a child's assessment.  By documenting and communicating observations and behaviour, they may see something that others have not noticed.  Understanding the symptoms of various special health care needs can be beneficial to all involved, and can help provide insight into process of the assessment of a child.

Is there one specific method of assessing a child with special health care needs?

No.  There are so many different types of special health care needs and combinations of needs along with the uniqueness of every child and every situation.  Some children have been identified from birth or prior to beginning school, while others result from trauma, accidents or a progressive condition.  Some conditions, like Schizophrenia, do not develop until the later teen years, and other health care needs result from a prior health care issue.  What is most important is the dedication to the well-being of the child and the best educational opportunities they can receive.  Strong communication between educators, parents, therapists, physicians and specialists is essential to provide a child with special health care needs the program that they need to be successful. 

The following is taken from the Ontario Ministry of Education website, highlighting what expectations are in place for teachers when assessing a child and also noting the legislation in the Health Care Act regarding laws of who can perform certain assessments and when parental permission is required:

“Teachers observe the children in their classes every day. They often know when a child is learning or achieving differently from the rest of the class, even in the earliest grades. As soon as a teacher or a parent has a concern regarding a particular student’s progress or behaviour, it is important to begin a data-gathering process. This information will be important should the teacher require the assistance of the in-school team.  Assessment is a continuous, complex process that is an integral part of teaching. It is something the teacher does every day, in a variety of informal and formal ways.

An assessment provides information about:

• a student’s achievement;
• the level of the student’s understanding;
• the effectiveness of a particular teaching technique.

Data from this type of assessment is collected primarily for use in program planning. This data helps teachers to improve student learning and develop programs appropriate to each student’s strengths, interests, needs, and level of functioning. It is as important to identify a student’s strengths as it is to determine needs. A teacher can use a student’s interest in sports, or love of music, or visual memory to help the student overcome weaknesses or insecurities. For example, a student who loves baseball may find it easier to understand some mathematical concepts if they are presented as examples from baseball (e.g., batting averages). When teachers observe students, they record many different aspects of a student’s behaviour and achievement.

In observing the student, teachers may watch for such things as:

• how the student responds to text and non-print alternatives, approaches new tasks, persists with tasks, interacts with others, organizes time and materials, uses language, performs individually and in group activities, and responds to cues (including auditory, visual, and direct and indirect verbal cues);

• how the student responds to the number of people in the immediate area and the behaviour of teachers and support staff, interacts with peers, and responds to authority;

• how the student’s learning is affected by environmental variables such as lighting, sound, temperature, the physical arrangement of the classroom, the time of day, and routines and schedules.

Teachers can gain valuable additional information from parents and others who have worked with the student.  All information gathered about a pupil must be carefully documented and stored in a secure place to ensure that confidentiality is maintained. School board policies regarding the implications of the Municipal Freedom of Information and Protection of Privacy Act must be followed. “(Ontario Ministry of Education, October, 2001).

 

 

It is important when doing any assessment of a child that all rights and privacy acts be followed without exception.

 

 

 Assessing a child with English as a second language presents an additional set of challenges.  Depending upon how much English the child and/or their parents speak and the traditions of that family's culture regarding special health care needs, there can be obstacles into assisting and properly placing a child.  Families that accept a child's health care needs as part of life, may not wish to look for further assessments or aids for their child.  Other families may not understand what is available to them or may be concerned about the financial burden they could face when seeking medical aid.

It is important that educators find ways to make families aware of all their options and guide them to alternatives that suit their personal situation.  All of this needs to be done with a great sensitivity to the stressful nature that health care needs evokes in those involved.

The education assistant plays an important role in the lives of children with special health care needs.  They are often the ones called upon to assist these students in areas that the teacher is not trained in or is comfortable doing.  According to the Special Education Guide for Educators produced by the Ministry of Education, EAs can be very involved in the assessment and placement of a child:

"An educational assessment may consist of formal and informal testing. The assessment may include diagnostic and achievement tests that focus on specific areas of academic achievement. Where school staff are concerned about a student’s achievement, the teacher should inform the student’s parent before such assessments are undertaken. (Depending on the type of assessment, parental consent in writing may be required.)

An educational assessment is required by an IPRC in order to make a decision about identification of a pupil as exceptional or placement of a pupil in a special education program.

Achievement tests provide information about:

• a student’s skills;
• a student’s skills in comparison to his or her peers;
• the need for a change in the student’s program." (Ministry of Education: Guide to Educators, 2001).

 

 

Assessments are not limited to the child themselves, but also to the resources available at a specific school.  It is possible that not everything the child needs can be found in the school they are attending. 

According to the Safe and Caring Schools Act, "System and school leaders need to develop a clear picture of the professional knowledge and abilities school staff bring to the task of supporting all students, particularly students with special health care needs. 

 An assessment of staff capacity will need to consider their:   knowledge about and experience with supporting students with special health care needs; knowledge of and experience with a range of specific strategies for building and maintaining a caring and safe school culture; knowledge and experience of working collaboratively with other members of the school team to support students with special education needs.  System and school leaders also need to identify knowledge and capabilities among parents and community members that they can draw upon in developing a caring and safe school culture and supporting all students. An assessment of parents’ and community members’ capacity will need to identify:  community structures

and resources that can complement a safe school strategy; resources and expertise that parents and community members might contribute to assist in supporting students with special education needs;  existing cooperative relationships with parents and community members and possible ways of expanding them;  existing means for communicating with parents and community members and communication gaps that may need to be bridged." (Safe and Caring Schools Act, 2002).

Lastly, some of the sources that can be used for assessment beyond medical input are:

• Anecdotal notes
• Provincial Report Cards
• Ontario Student Record (OSR)
• Early development instrument (EDI)
• Educational assessments (e.g., EQAO/OSSLT, board/school/teacher assessment tools)
• Professional assessments (e.g., by psychologist, speech and language therapist, occupational    therapist/physiotherapist, audiologist, medical professional, social worker)
• Behaviour log (e.g., ABC chart)
• Functional behaviour assessment (FBA)
• Risk assessment
• Caring and safe school environmental assessments (e.g., cultural audit, action research, school effectiveness survey, Student Success/Learning to 18 indicator data)

Every child is unique and deserving of the best opportunities they can receive, no matter what challenges they face with special health care needs.

 

Resources for Assessment of Special Health Care Needs

 

Bennett, S., Dworet D., Weber K., (2008). Special Education in Ontario Schools. St. Davids,     Ontario: Highland Press.

Holler, David. (2012). Handbook of Children with Special health Care Needs. New York, U.S.A.: Springer Science and Business Media.

Ministry of Children and Youth. (May 2010).  Services for Students with Special Needs / Special Education Needs and the Early Learning Program in Year One, 2010-11. Retrieved from http://cal2.edu.gov.on.ca/may2010/JointADMs_Memo%20ELP_May2010%20eng.pdf

Ontario Ministry of Education. (2002). Caring and Safe Schools in Ontario. Retrieved from http://www.edu.gov.on.ca.

Ontario Ministry of Education. (October, 2001). Special Health Care Needs. Retrieved from http://www.edu.gov.on.ca/eng/general/elemsec/speced/guide/specedpartce.pdf.

The Journal of the American Medical Association. (2005). Chronic Conditions, Functional Limitations, and Special Health Care Needs of School-aged Children Born With Extremely Low-Birth-Weight in the 1990's.  Retrieved from http://jama.jamanetwork.com.

U.S. Department of Health and Human Services. (2004). The National Survey of Children with Special Health Care Needs. Rockville, Maryland. Retrieved from http://mchb.hrsa.gov/chscn/pages/prevalence.html.

Wizner, M. (2008). Children with Exceptionalities in Canadian Classrooms (6th Edition). Toronto, Canada: Prentice Hall.

Submitted by Lee Ann, Andrea, Felesha and Kristina