THE HEALTH OF YOUNG ADULTS WITH DISABILITIES IN THE UNITED STATES: THE COLLECTIVE ROLES OF RISK FACTORS IN SOCIAL ECOLOGIC FRAMEWORK

Background: Over the last few decades, the prevalence of young adults with disabilities (YAD) has steadily risen as a result of advances in medicine, clinical treatment, and biomedical technologythat enhanced their survival into adulthood. Despite investments in services, family supports, and insurance, they experience poor health status and barriers to successful transition into adulthood. Objectives: We investigated the collective roles of multi-faceted factors at intrapersonal, interpersonal and community levels within the social ecological framework on health related outcome including self-rated health (SRH) of YAD. The three specific aims are: 1) to examine sociodemographic differences and health insurance coverage in adolescence; 2) to investigate the role of social skills in relationships with family and peers developed in adolescence; and 3) to collectively explore the association of sociodemographic characteristics, social skills, and community participation in adolescence on SRH. Methods: Using longitudinal data (N=5,020) from the National Longitudinal Transition Study (NLTS2), we conducted multivariate logistic regression analyses to understand the association between insurance status as well as social skills in adolescence and YAD’s health related outcomes. Structural equation modeling (SEM) assessed the confluence of multi-faceted factors from the social ecological model that link to health in early adulthood. Results: Compared with YAD who had private insurance, YAD who had public health insurance in adolescence are at higher odds of experiencing poorer health related outcomes in self-rated health [adjusted odds ratio (aOR=2.89, 95% confidence interval (CI): 1.16, 7.23), problems with health (aOR=2.60, 95%CI: 1.26, 5.35), and missing social activities due to health problems (aOR=2.86, 95%CI: 1.39, 5.85). At the interpersonal level, overall social skills developed through relationship with family and peers in adolescence do not appear to have association with health related outcomes in early adulthood. Finally, at the community level, community participation in adolescence does not have an association with SRH in early adulthood. Conclusions: Having public health insurance coverage does not equate to good health. YAD need additional supports to achieve positive health outcomes. The findings in social skills and community participation suggest other potential factors may be at play for health related outcomes for YAD and the need for further investigation.

TEACHERS’ ATTITUDES TOWARD INCLUSION OF CHILDREN WITH DISABILITIES IN RURAL EL SALVADOR

The attitude of school teachers toward inclusion of children with disabilities is an important factor in the successful implementation of a national inclusion program. With the universal pressure to provide education for all and international recognition of the importance of meeting the needs of diverse populations, inclusive education has become important to governments around the world. El Salvador’s Ministry of Education seeks to establish inclusion as an integral part of their struggle to meet the needs of children across the country, but this is a difficult process, especially for a country with limited resources which still struggles to meet international expectations of educational access and quality. Teacher attitude is an important factor in the success of inclusion programs and can be investigated in relation to various factors which may affect teachers’ classroom practice. While these factors have been investigated in multiple countries, there is a need for more knowledge of the present situation in developing countries and especially in schools across the rural areas of El Salvador to meet the needs of the diverse learners in that country. My research was a mixed methods case study of the rural schools of one municipality, using a published survey and interviews with teachers to investigate their attitudes regarding inclusion. This research was the first investigation of teachers’ attitudes toward inclusion in rural El Salvador and explored the needs and challenges which exist in creating inclusive schools across this country. The findings of this study revealed the following important themes. Some children with disabilities are not in school and those with mild disabilities are not always getting needed services. Teachers agreed with the philosophy of inclusion, but believed that some children with disabilities would receive a better education in special schools. They were not concerned about classroom management. Teachers desired more training on disability and inclusion. They believed that a lack of resources, including materials and personnel, was a major barrier to inclusion. Teachers’ attitudes were consistent regardless of family and professional experience with disability or amount of inclusion training. They were concerned about the role of family support for children with disabilities.

A longitudinal analysis of disproportionality in statewide exclusionary discipline of students with disabilities

The study examined the state-by-state changes in the rates of exclusionary discipline of students with disabilities compared to their non-disabled peers. Historically, students with disabilities have been excluded at rates that are out of proportion with their population. This study used state discipline to investigate the current status of disproportional exclusion of students with disabilities and if there are any regional trends in the discipline of students receiving special education services. Results indicate that in both the 2009-2010 and 2011-2012 school years, there were significant differences between the rates at which students with and without disabilities were disciplined. Students with disabilities were suspended at higher rates during both school years and expelled at higher rates during the 2011-2012 school year. Results also suggest that rates of suspensions and expulsions continue to be high, particularly for students with disabilities. Findings may help states and schools develop policies that promote fair discipline of students with disabilities.

CHARACTERISTICS OF PRIVATE HIGH SCHOOLS FOR STUDENTS WITH EMOTIONAL DISABILITIES AND PERCEPTIONS OF THEIR PUBLIC SCHOOL CASE MANAGERS

Placement of students with disabilities in private special-education schools remains costly and controversial. This is particularly concerning, given the lack of research on the characteristics and quality of these restrictive settings. The purpose of this study was to identify the academic and vocational course offerings and behavioral supports provided in private special-education schools the serve high school students with emotional disabilities (ED). Second, the research examined the perceptions of the quality of services in these setting from the perspectives of public school case managers. Using a mixed-method design to collect data, 9 administrative heads of private special-education schools were surveyed, and 7 public school case managers were interviewed. Results indicated that (a) private special-education schools offer the basic academic core courses needed to meet graduation requirements, (b) vocational options for students enrolled in these schools are quite limited, (c) these schools provide a variety of behavioral interventions and supports, and (d) case managers are concerned with the lack of academic rigor and inconsistent programming at these schools but applauded the notion that students with ED are exiting with a high school diploma. Findings from this study may have policy implications for improving and developing programming options for high school students with ED.