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OBJECTIVE: To assess the diagnostic status, the sociodemographic and health profiles for students with special educational needs (SEN) in a public educational system, and to map their use of educational/social services. METHODS: The sample comprised 1,202 SEN students from a total of 59,344 students. RESULTS: Only 792 students of the 1,202 had an established diagnosis. The most prevalent SEN condition was intellectual disability. There was a low percentage (29.4%) of use of specialized educational services or support. It was found that, for some neurodevelopmental disorders, prevalence data suggest an under-reporting in the school system. CONCLUSION: Results suggest that there is a mismatch between the diagnostic reports and the SEN condition legally recognized according to Brazilian law, in addition to the under-reporting and under specialized service use of students with disabilities.

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ABSTRACT Objective To assess the diagnostic status, the sociodemographic and health profiles for students with special educational needs (SEN) in a public educational system, and to map their use of educational/social services. Methods The sample comprised 1,202 SEN students from a total of 59,344 students. Results Only 792 students of the 1,202 had an established diagnosis. The most prevalent SEN condition was intellectual disability. There was a low percentage (29.4%) of use of specialized educational services or support. It was found that, for some neurodevelopmental disorders, prevalence data suggest an under-reporting in the school system. Conclusion Results suggest that there is a mismatch between the diagnostic reports and the SEN condition legally recognized according to Brazilian law, in addition to the under-reporting and under specialized service use of students with disabilities.

RESUMO Objetivo Avaliar a situação diagnóstica, o perfil sociodemográfico e de saúde dos alunos com necessidades educacionais especiais (NEE) de uma rede municipal de educação, assim como mapear o uso de serviços educacionais e sociais. Métodos A amostra foi composta por 1202 alunos com NEE de um total de 59344 alunos. Resultados Dos 1202 alunos somente 792 tinha diagnóstico estabelecido. A condição de NEE mais prevalente foi a deficiência intelectual. Verificou-se um baixo percentual (29,4%) de uso de serviços educacionais especializados ou de apoio. Foi constatado que, para alguns transtornos do neurodesenvolvimento, os dados de prevalência parecem indicar uma subnotificação. Conclusão Os resultados sugerem um descompasso entre os registros diagnósticos e a condição de necessidade educacional especial segundo a legislação brasileira, além disso verificou-se uma subnotificação diagnóstica e baixo uso de serviços especializados entre estudantes com deficiências.

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OBJECTIVE: To test whether a language screener administered during early childhood predicts special education referrals and placement in middle childhood. STUDY DESIGN: A series of logistic regressions was conducted in a longitudinal study of 731 children. Predictor variables included scores on the early language screener (Fluharty Preschool Speech and Language Screening Test-Second Edition [Fluharty-2]) at ages 3 and 4 years, a standardized measure of academic achievement at age 5 years, and parent report of special education services at ages 7.5, 8.5, and 9.5 years. RESULTS: Results showed that higher scores on the Fluharty-2 predicted a reduced likelihood of having an individualized education program (OR 0.48), being referred for special education (OR 0.55), and being held back a grade (OR 0.37). These findings did not vary by sex, race, or ethnicity, and remained significant after controlling for male sex, behavior problems, parental education, and family income. The Fluharty-2 remained predictive of special education outcomes even after controlling for children's academic skills at age 5 years. CONCLUSIONS: Results suggest that structured, brief assessments of language in early childhood are robust predictors of children's future engagement in special education services and low academic achievement. Primary care physicians may use a multipronged developmental surveillance and monitoring protocol designed to identify children who may need comprehensive evaluation and intervention. Early intervention may reduce the need for costly special education services in the future and reduce comorbid conditions.

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OBJECTIVE: To evaluate test proficiency and the receipt of special education services in school-age children who had undergone surgery for congenital heart disease (CHD) at age <1 year. STUDY DESIGN: Data from Arkansas-born children who underwent surgery for CHD at Arkansas Children's Hospital at age <1 year between 1996 and 2004 were linked to state birth certificates and the Arkansas Department of Education longitudinal database containing achievement test scores in literacy and mathematics for grades 3-4 and special education codes. The primary negative outcome was not achieving grade-level proficiency on achievement tests. Logistic regression accounting for repeated measures was used to evaluate for associations between achieving proficiency and demographic data, maternal education, and clinical factors. RESULTS: A total of 362 of 458 (79%) children who underwent surgery for CHD were matched to the Arkansas Department of Education database, 285 of whom had grade 3 and/or 4 achievement tests scores. Fewer students with CHD achieved proficiency in literacy and mathematics (P < .05) compared with grade-matched state students. Higher 5-minute Apgar score, shorter duration of hospitalization, and higher maternal education predicted proficiency in literacy (P < .05). White race, no cardiopulmonary bypass, and shorter hospitalization predicted proficiency in mathematics (P < .05). Sex, gestational age, age at surgery, CHD diagnosis, and type and number of surgeries did not predict test proficiency. Compared with all public school students, more children with CHD received special education services (26.9% vs 11.6%; P < .001). CONCLUSION: Children with CHD had poorer academic achievement and were more likely to receive special education services than all state students. Results from this study support the need for neurodevelopmental evaluations as standard practice in children with CHD.

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OBJECTIVES: To evaluate the effect of an intensive early intervention on special service use at school-age. STUDY DESIGN: The Infant Health and Development Program was a randomized controlled trial of an intervention for low birth weight (<2500 g) infants ages 0-3 years. We used multivariate logistic regression to test the association between intervention and risk of special education, remedial reading and math, and speech therapy at age 8 years. We also compared rates of service use between study arms among those with learning disabilities (LDs). RESULTS: There were 875 complete cases at 8-year follow-up. There were no statistically significant differences between groups in risk of special education (risk ratio [RR] 0.86, 95% CI 0.64-1.15), remedial reading (RR 0.88, 95% CI 0.68-1.14), remedial math (RR 0.92, 95% CI 0.63-1.34), or speech therapy (RR 0.87, 95% CI 0.62-1.23). The treatment arms did not differ in rates of LDs, and service use for those with LDs was low and unaffected by study group. CONCLUSIONS: Early gains in IQ from infant interventions may not protect children as they face the educational demands of grade school. Only a fraction of those having a LD were receiving school-based support services, indicating a high level of unmet need among low birth weight children with disabilities.

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BACKGROUND: Previous studies in special schools have shown a high prevalence of epilepsy, which is strongly associated with cerebral palsy and severe mental retardation. The conditions regulating school placement have also been described in those studies. In the City of Buenos Aires, information is known only for mainstream schools. OBJECTIVE: To determine the prevalence and characteristics of epilepsy in special schools and to compare results with common primary education settings. DESIGN AND METHODS: A cross-sectional study was carried out in special schools in the City of Buenos Aires, by adopting the same definitions, diagnostic criteria and questionnaire as those used in a previous study in the common primary school population. Responses from 1,682 children, aged 6-16 years, residing in the City of Buenos Aires, with mental retardation, visual or hearing impairment, psychiatric disorders and motor disabilities were analyzed. RESULTS: A total of 121 children with epilepsy were detected. Lifetime prevalence was 71.9 per thousand and active prevalence was 64.8 per thousand (22-25 times greater than rates in mainstream schools). Prevalence was highest in girls and generalized seizures prevailed over other seizure types. Ninety-two percent of cases received antiepileptic drugs, 57.9% as a single drug treatment and 85.1% in adequate doses. Only 56% of the children with a diagnosis of epilepsy proved to be true-positive cases, and almost 40% received antiepileptic drugs for nonepileptic disorders. Malformations/degenerative disease were the most common etiology. CONCLUSIONS: Special schools contain clusters of children with epilepsy as a comorbid condition. False high frequency is due to misdiagnoses and unnecessary treatments. These schools are an important target for educational interventions.

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Suicide is the second leading cause of death among school-aged students between the ages of 15 and 19. There is an increasing frequency of suicide and other self-destructive behaviors among Mexican American youth and students in special education classrooms for emotional and behavioral disabilities. Recognizing Mexican American youth in special education classes as a separate risk group, this study (a) identifies factors that contribute to suicide, (b) reviews the signs and characteristics associated with these factors, (c) interviews Mexican American students in special education who have either exhibited various characteristics of suicidal thoughts and/or have attempted suicide, (d) explores effective prevention programs, and (e) provides suggestions for school personnel. Interviews with five adolescent Mexican American special education students support previous research findings that depression, substance abuse, social and interpersonal conflict, family distress, and school stress are primary characteristics related to suicidal minority youth.

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El presente estudio fue realizado para determinar la experiencia de caries dental en niños con deficiencias auditivas en Caracas, Venezuela, y asÝ obtener los datos que permitan conocer sus necesidades para la salud bucal. La muestra comprende 50 niños con deficiencias auditivas: 28 varones y 22 hembras, en edades entre tres y diecisiete años, la media fue de 10 años. Los niños fueron seleccionados de dos institutos de educación especial del ßrea metropolitana de Caracas. La situación dental fue evaluada utilizando el Ýndice CPOD (cariado, perdido y obturado en la unidad diente). El examen clÝnico fue realizado por un odontólogo entrenado y calibrado en la utilización de los Ýndices CPOD. La proporción general de caries en los niños fue de 70 por ciento, perdido 23 por ciento y obturado 7 por ciento. La experiencia de caries en los niños con deficiencias auditivas es mßs alta que la mostrada por estudios nacionales realizados en niños normales. Los resultados proveen una evidencia de la necesidad de proporcinar una adecuada promoción de la salud y el acceso a los servicios de salud bucal a los niños con deficiencias auditivas

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OBJECTIVE: To address rising concerns about the possible overdiagnosis of attention-deficit hyperactivity disorder (ADHD) and overtreatment with stimulants. To date, almost no studies have examined ADHD in unbiased community-based studies, ascertaining both the prevalence of the diagnosis within nonreferred populations and the extent to which various treatments (i.e., stimulant medication, mental health treatments, and educational interventions) are used. METHOD: As a part of the Methods for the Epidemiology of Child and Adolescent Mental Disorders (MECA) Study, the authors examined epidemiological survey data obtained from 1,285 children and their parents across 4 U.S. communities. Analyses examined the frequency of children's ADHD diagnosis, the extent to which medications were prescribed, as well as the provision of other services (e.g., psychosocial treatments, school-based educational interventions). RESULTS: Findings indicated that 5.1% of children met full DSM-III-RADHD criteria across the pooled sample. Only 12.5% of children meeting ADHD criteria had been treated with stimulants during the previous 12 months. Some children who had been prescribed stimulants did not meet full ADHD diagnostic criteria, but these children manifested high levels of ADHD symptoms, suggesting that the medication had been appropriately prescribed. Children with ADHD were generally more likely to receive mental health counseling and/or school-based interventions than medication. CONCLUSIONS: Medication treatments are often not used in treating ADHD children identified in the community, suggesting the need for better education of parents, physicians, and mental health professionals about the effectiveness of these treatments. On the basis of these data it cannot be concluded that substantial "overtreatment" with stimulants is occurring across communities in general.

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Preliminary findings are provided from the data collected in Puerto Rico through the Annual Survey of Deaf and Hard of Hearing Children and Youth during the 1997-1998 school year. The study was conducted as a part of an initiative to increase participation in the Annual Survey among the deaf and hard of hearing school-age population in Puerto Rico. Demographic, instructional, etiological, audiological, and communication data on 336 deaf and hard of hearing school age children were collected and summarized. The findings suggest the existence of a heterogeneous deaf community rather than the traditionally conceived homogeneous community. The discussion emphasizes the description of those attributes that suggest heterogeneity and the urgent need to continue to collect the kind of data gathered in the survey. The authors urge that Puerto Rican educators and researchers be stimulated to address the educational and health-related needs of Puerto Rico's deaf and hard of hearing school-age population.

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O projeto de pesquisa tem como objetivo acompanhar uma intervençäo em sala de aula com crianças surdas pré-escolares. A intervençäo deve ser feita junto ao professor, mediador de um processo que deve levar essas crianças a desenvolver linguagem e ter um domínio da língua que as prepare para apropriar-se da leitura e da escrita, objetivo primordial da educaçäo escolar. Os recursos pedagógicos propostos säo jogos e brinquedos, considerados em sua dimensäo lúdica e cognitiva. Procura-se atingir a criança através da ajuda dada ao professor. Dando ao mediador-professor a oportunidade de melhorar a qualidade de sua açäo maior possibilidade de avançarem em suas aprendizagens. Pesquisas mostram que a criança pré-escolar beneficia-se enormemente de uma mediaçäo dirigida a sua deficiência

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O autor apresenta dados estatísticos sobre a falta do tratamento adequado para os portadores de Transtornos Invasivos do Desenvolvimento, em Belo Horizonte, Minas Gerais. Dos pacientes agendados num hospital público, havia 44 pacientes deste grupo nosológico e somente 14 tinham tratamento multi-profissional, mesmo que por período menor que quatro horas semanais. Discute-se a atual situaçäo: ausência de tratamento adequado para estas pessoas e a impossibilidade de aquisiçäo de habilidades após a adolescência.

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O objetivo deste estudo é o conhecimento das escolas e classes especiais para surdos de Säo Paulo. Através de um dos estabelecimentos, as abordagens utilizadas e a opiniäo sobre a utilizaçäo de sinais na educaçäo dos surdos. Com os dados analisados pôde-se visualizar o quadro da situaçäo atual da educaçäo especial

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