Sheri A. Marino, MA, CCC-SLP
December 20, 2017
A recent survey of early childhood teachers asked “What is your greatest concern?” The majority of teachers reported “Managing challenging behaviors in our classroom,” according to Mary Ann Hansen, the director of First 5 Humboldt, a county-based commission in California which provides programs for children under age 5. She went on to say “We hear this over and over again, that teachers are struggling.” Sadly, many students are also struggling as their needs are unable to be met in a classroom environment that lacks support, proper teacher training, and the funding necessary to provide a quality education which addresses their varying needs.
With an increasing number of children requiring special education services in the schools, significant demands are being placed on both special and regular education teachers. Learners with differing educational, behavioral, and medical needs are both financially and emotionally challenging for both their school districts and teachers alike. School budgets are being depleted rapidly as districts attempt to provide a free and appropriate education (FAPE) for all, especially when Individualized Education Plans (IEP) require extensive special services including speech, physical, occupational therapy, nursing, counseling, behavioral services, in-class support, and personal aides.
Providing for the many needs of children classified in special education costs our nation an estimated $50 billion annually, and that number is likely outdated as it is based on data from the 1999-2000 SEED study, which doesn’t reflect the rise in students requiring special education since 2000.
The average annual cost for a general education student is $7,552, while the average cost per special education student is $16,921. However, approximately 330,000 students with exceptionally high-needs cost their districts $100,000 or more on an annual basis.
Students identified with one of 13 disabilities listed under the Individuals with Disabilities Education Act (IDEA) are classified in school and provided with an IEP identifying learning goals, necessary accommodations, and describes the special services to be provided by the school, free of charge to the families. Students who do not qualify for an IEP may receive a 504 plan. This plan may provide specific accommodations, supports, or services for a child with any disability which can include learning or attention issues. It has a broader definition of a disability, but it does not have to be a written document.
The number of students ages 6-21 with disabilities rose to 5.83 million by fall 2014. Chronic health issues such as epilepsy, mental health disorder, attention deficit hyperactivity disorder (ADHD), and mobility impairments, classified in school as “other health impaired,” increased nearly 51%, between 2005-06 and 2014-15 school years. In the same age group, students classified with autism spectrum disorder had risen 165% nationwide. Children classified with “autism” or “other health impaired” account for more than 1 in 5 school-aged children covered under IDEA nationwide.
The least restrictive environment (LRE) mandate within IDEA requires that all students in special education be educated with typical peers to the greatest extent possible to prevent segregation, while still providing a free and appropriate education. This means children with IEP’s or 504 plans and their typical peers are integrated in one classroom with a general education teacher when possible. While some students receive in-class support with the help of an aid and sometimes a special education teacher, many general education teachers report they lack the support, training, and resources necessary to teach classified students appropriately. In addition, some children presenting with emotional and behavioral issues, who have not been identified or classified at all, do not receive any accommodations for educational or behavioral support. As a result of limited funding and teacher shortages, general education teachers are often challenged to divide their time and attention teaching the curriculum to general education students while managing classified as well as unclassified students with attentional, emotional and behavioral issues at once. These issues affect the quality of education for all students.
Mental Health Issues in the Schools
Mental health problems often develop during childhood and adolescence and are treatable if recognized and diagnosed. Students with mental health issues present challenges to teachers and commonly have social-emotional issues affecting peer relationships. Studies show that mental health disorders are at the root of some bullying behavior occurring in schools. School nurses report frequent complaints of “stomach aches” and “headaches” because an individual’s mental health is intertwined with their physical being. Yet research shows most children who need a mental health evaluation do not receive services. Because schools are often understaffed with social workers, counselors, and school nurses, the burden is placed on the classroom teachers who are with the students throughout the school day.
Educating children with mental health issues is not the only challenge for general education teachers. More and more teachers are reporting explosive outbursts by students including hitting, scratching, and flipping desks, putting teachers at risk, while at the same time they are trying to protect other students in the classroom. Disciplinary actions including suspensions are on the rise across the nation. Classified students with behavior issues are frequently sent home from school when teaching assistants are not available to shadow them. For students with autism who have complex behavior issues, physical restraints have become commonplace and can occur daily. Add to it the significant rise in self-harm and teen suicides; schools are being forced to look at this epidemic and to provide solutions at all costs. Some schools are attempting to mitigate the issues by creating sensory rooms and calming stations, while others have even created new mental health clinics on site to help manage the behavioral issues.
Compared to the national average, only 40% of students with emotional, behavioral, and mental health disorders graduate.
Studies looking at teacher job stress in early childhood education show that teacher-child conflicts are more common where workplace stress is higher. Essentially, this reduces the ability of the teachers to work effectively with students with emotional and behavioral problems. These teachers also report they felt mentally, emotionally, or physically exhausted or overwhelmed by working with these children, ultimately leading to burnout and staff turnover.
What about the severely disabled?
Children with severe disabilities have even more difficulty getting their needs met in district as the school may not have the resources on site to accommodate their various educational and healthcare needs. In such cases, these high-needs students may be offered placements in private schools for the disabled outside of the local school district. Children diagnosed with autism spectrum disorder, cerebral palsy, and other medically complex disabilities require services beyond what most districts can afford to provide because they require specialized training and care. This can include nursing, advanced technologies for communication and learning, special transportation, and more. While providing out of district placement can cost an average of $10,000 more per student than placements within district for similar students, keeping them in-district may not be cost effective if they need to hire staff and purchase equipment for just a few high-needs individuals.
Accommodating chronically ill kids
With chronic health conditions on the rise, schools are faced with additional challenges of providing for the medical needs of children with severe health issues. Food allergies now affect 1 in 13 children, and asthma affects 1 in 10 children, requiring nursing staff on site to help care for these students. In addition, juvenile diabetes increased 23% between 2001 and 2009, while epilepsy/seizures affect 1 in 20 children. Some schools are opening health clinics on site to manage the medical needs of the student population. Unfortunately, the cost of building and staffing such clinics is prohibitive for most districts which already lack funding to meet the basic needs of special education students.
Who pays for all of this?
You do. We all do. Federal, state and local governments all contribute to fund K-12 public special education. IDEA was established to provide the bulk of federal funding contribution for special education and governs how states and public agencies provide early intervention, special education, and related services. The states distribute funds to local agencies to be used in accordance with state and federal law, and allocation is based upon the local district’s tax structure. The local district budgets vary greatly and are dependent on local revenues resulting, however, in significant disparities.
Unfortunately, Congress historically fails to fully fund IDEA. While they have authorized special education funding equal to 40% of the national average per pupil expenditure (APPE), spending typically ranges between 10-20% per child.
This leaves the burden on the states to make up the difference. IDEA funding is based on FY 1999. This formula was derived from the number of children identified with disabilities in each state in relation to total state population. However, populations within states have increased or decreased, as have the number of children with disabilities within each state yet the base award has not changed. This creates a wide disparity in funding across the US. Additionally, when a state decides to accept federal funds, mandates apply in association with those programs. Despite this funding, many states find it insufficient to cover the local costs of meeting those program’s requirements. Consequently, districts are often compelled to tap into their general education funds to meet those requirements.
The number of students with disabilities and chronic health issues are rising across the nation while programs and services are being cut to save money. Currently, all taxpayers are bearing the financial burdens of the local school districts as property taxes help fund special education programs. Although Medicaid helps to offset the gap by covering health-related expenses for students with disabilities, cuts in Medicaid funding are frequently threatened. Without appropriate education, therapies, and medical services, these children will grow up to be adults who may not reach their full potential. In turn, employability will decrease, and without sustainable jobs, they may not become productive, self-sustaining adults. 1 in 36 children between 3-17 yrs. of age have ASD now; this means in the next 1-15 years, these individuals will become adults. Individuals with ASD have a normal life expectancy, and many will outlive their parents, requiring other family members to take care of them, if willing and able. And if not, tax-payers will be responsible for funding supportive housing and living costs, including health care, for those unable to live and care for themselves.
This system is unsustainable, and it is spiraling out of control, yet few people are talking about it. More importantly, nobody is asking “What is happening to our children?” In fact, the latest report just released by The National Center for Health Statistics within the US Department of Health and Human Services, does the opposite. Authors of the 2017 report “Estimated Prevalence of Children with Diagnosed Developmental Disabilities in the United States, 2014-2016” point out the prevalence of children aged 3-17 years who had ever been diagnosed with a developmental disability has increased from 5.76% to 6.99%. This increase of 1.23% is STATISTICALLY SIGNIFICANT. The prevalence of autism spectrum disorder in the US reportedly increased from 2.24% to 2.76%, a difference of .52%. According to NCHS, this increase is not statistically significant. While the article failed to disclose the sample size, the fact is, both increases are alarming.
According to the Centers for Disease Control (CDC) “The mission of the National Center for Health Statistics (NCHS) is to provide statistical information that will guide actions and policies to improve the health of the American people. As the Nation’s principal health statistics agency, NCHS leads the way with accurate, relevant, and timely data.” The first step to making change is acknowledging we have a problem. A .52% rise in ASD indicates I in 36 children have autism, up from 1 in 45 in 2014; however, the CDC has not released a statement acknowledging this increase. The CDC must stop burying its head and work to address this problem first, by admitting we have one, and second, by identifying the causes with trustworthy science so that we may stop this epidemic. Until then, this and many other systems are destined to fail, affecting not only those individuals with special needs and their families, but every citizen in our nation.
Meet Sheri A. Marino, MA, CCC-SLP
Director, Pediatric Health Initiatives
Sheri is a pediatric speech and language pathologist with over 25 years of clinical experience specializing in autism. She has published numerous articles on autism and shares her clinical expertise through writing and lecturing internationally. Sheri is passionate about treating the “whole child” through integrative medicine and is interested in research that examines the environmental causes of autism. As a consultant to FFH, Sheri contributes her clinical knowledge and management experience to help develop and carry out the mission of the Focus for Health Foundation. She has been featured on CBS News, NBC News, NJN and multiple Cable networks.