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Thursday, June 30, 2016

Sharing Treatment Decisions Challenges Doctors, Parents of Young Children with Autism

From Children's Hospital of Philadelphia
via ScienceDaily

June 20, 2016

Parents of young children diagnosed with autism spectrum disorder (ASD) may experience significant difficulties in discussing treatment options with the child's pediatrician, according to new research.



Among the barriers are problems with communication, physicians' lack of knowledge about specific ASD treatments and community resources, and uncertainty about the pediatrician's role in making treatment recommendations for a child with ASD.

Many parents in the study reported that they did not discuss the choice of any treatment options with their pediatricians, and others said their physicians provided only general recommendations or referrals.

The study team suggests that tools such as decision aids and practice guidelines may help foster more effective communication between families and pediatricians.

"We investigated shared decision making--an interactive process in which patient families and physicians work together to arrive at a treatment plan," said study leader Susan E. Levy, M.D., M.P.H., a developmental and behavioral pediatrician in the Center for Autism Research and the Division of Developmental and Behavioral Pediatrics at The Children's Hospital of Philadelphia (CHOP).

The study appears online in Academic Pediatrics.

Shared decision making (SDM) has been studied over recent decades as a method for improving provider-patient communication and partnership, with improvements seen in satisfaction, adherence and health outcomes.

"Although there are more studies in adult health settings, SDM concerns continue to expand into pediatric practice," said study co-author Alexander G. Fiks, M.D., M.S.C.E., a pediatrician at CHOP's Policy Lab and the Center for Pediatric Clinical Effectiveness who has investigated how to implement SDM approaches for children with special needs.

The current single-center study used a qualitative approach, with in-person or telephone interviews of 20 pediatricians and 20 parents of young children with a diagnosis of ASD, ages two to five years. All participating clinicians were from the CHOP pediatric network, drawn in equal numbers from urban and suburban offices. Families came from Philadelphia and surrounding suburbs.

The study team identified three principal themes:

  • 1.) both parents and physicians reported knowledge gaps about ASD treatments and community resources, and described ambiguity about the pediatrician's role in ASD care;
  • 2.) a lack of communication existed between parents and pediatricians about treatment choices; and,
  • 3.) the use of complementary and alternative medicine (CAM) treatments created conflict between pediatricians and parents.

The researchers suggest that as primary care pediatricians encounter more children with ASD in their practice, they may benefit from the use of tools available through the American Academy of Pediatrics, such as the Autism Toolkit and clinical practice guidelines. Such tools have helped support pediatricians in managing children with attention deficit hyperactivity disorder (ADHD) in the primary care setting.

However, noted Fiks, there are significant differences between the disorders, including more medication options for managing core symptoms of ADHD than for ASD. Referring to ASD management, one pediatrician told the interviewer, "we in general are not so much an expert on it so it is harder to just prescribe things, and it turns out we really can't do it anyway."

Many parents sought treatment options outside the medical community, from school staff or various therapists. As has been found in the literature, many parents pursued CAM treatments. Parents reported they did not discuss these treatments with their pediatrician due to the pediatrician's lack of knowledge or discomfort with the topic.

One parent said, "Look, I left the last guy because he wouldn't listen to me. At this point this is what my son is on [a special diet]."

If pediatricians are uncomfortable in discussing unproven CAM therapies, such as specialized diets, supplements or vitamin shots, they miss an opportunity to discuss benefits and risks.

Given the study's findings of knowledge barriers and a lack of engagement in treatment decisions, the authors suggest some specific measures for primary care practices: using care coordinators, ASD care plans, creating summaries of outside resources and providing families with logs to monitor progress.

More fundamentally, the authors conclude, shared decision making will involve greater recognition by both providers and parents that partnering in care for children with ASD falls within the scope of pediatricians' jobs and is in the families' best interest. "Much work remains to be done to improve this process in caring for children with ASD," said Levy.


Journal Reference
  • Susan E. Levy, Rosemary Frasso, Stephanie Colantonio, Hayley Reed, Gail Stein, Frances K. Barg, David S. Mandell, Alexander G. Fiks. Shared Decision Making and Treatment Decisions for Young Children With Autism Spectrum Disorder. Academic Pediatrics, 2016; DOI:10.1016/j.acap.2016.04.007

Rhode Island Governor Signs School Recess Mandate into Law

From Boston.com

June 28, 2016

PROVIDENCE, R.I. (AP)A new Rhode Island law is requiring elementary schools to give children at least 20 minutes of recess each day.

Rhode Island Governor Gina Raimondo

Democratic Governor Gina Raimondo signed the school recess legislation into law on Monday. The mandate takes effect immediately, and requires schools to provide at least 20 consecutive minutes of free play.

The law also allows schools to treat recess as instructional time so that they don’t have to extend the school day to meet the requirement.

Parent groups had pushed for the recess mandate and had wanted to ban teachers from taking a child’s recess away as punishment. That ban was dropped in the compromise legislation that passed the state’s General Assembly this month, but the new law says teachers should make a good-faith effort not to withhold recess.

.............................................................

From WPRI.com

What You Need to Know About a Bill That Would Regulate Recess in R.I.

By Shannon Hegy, Nick Domings and Diana Pinzon
May 19, 2016

PROVIDENCE, R.I. (WPRI) – Unlike math, science, or English, recess isn’t a subject your children are graded on, but it’s become the subject of a debate that’s made it all the way to the state house.

The Rhode Island House of Representatives has approved a bill requiring that public schools provide children with 20 minutes of recess each day. It’s a victory for supporters, who argue recess is crucial to a child’s cognitive function. But opponents say requiring it by law comes with too many challenges.

So, is your child’s health recess at risk? The Academy of Pediatrics warned it was back in 2013 – as more and more American schools were joining a growing trend of spending more time on academics.

“We really think recess should be part of the school day guidelines,” said Tracy Ramos, a mom of two. She’s part of the group Parents Across Rhode Island, which is leading the charge to regulate recess in the state.

“People say all the time, ‘When I was a kid I had plenty of recess.’ But things are really different now,” said Ramos. “Younger kids now are under so much more pressure than we were.”

The coalition Recess for Rhode Island found that 10% of the state’s elementary school principals reported providing less than 10 minutes of recess per day, and 34% reported taking away recess as a punishment. Now in motion at the state house: a law requiring Kindergarten through 5th grade public school students get at least 20 minutes of free-play recess during the school day.

It’s already passed the House. And Ramos says it’s about much more than exercise.

“It’s really about brain development,” she told us. “All of the studies show that recess is critical for allowing kids to maintain the kinds of attention and focus we expect of them in their academic career.”

In 2010, a Centers for Disease Control study found “Recess or physical breaks were associated with improvements in attention, concentration, on task classroom behavior and test scores.”

Tim Duffy is the Executive Director of the Rhode Island Association of School Committees. While he acknowledges the benefits of recess, he doesn’t believe it should be required by law.

“The bill doesn’t provide for a penalty currently,” said Duffy. “So if schools are not adhering to it, if a teacher doesn’t adhere to it, either they don’t provide the 20 minutes or they use it as discipline, there’s no mechanism to say you can’t do that. So there’s no enforcement mechanism.”

Duffy also argued that not every school in the state has the facilities to provide recess during inclement weather. Rather than a law, Duffy says recess should be a regulation imposed not by lawmakers, but the Rhode Island Department of Education. That way, he says exceptions could be made. And penalties imposed.

“If a school district somehow discriminated against a particular class of students,” said Duffy, “They can withhold state aid. They have that right to do that.”

Ramos and a group of parents approached the Department of Education last fall with a petition of nearly 800 signatures. But RIDE voted not to impose the recess regulations, citing the state’s Basic Education Program. It requires that schools provide “daily recess opportunities,” but doesn’t specify how long that should be.

Representative Kathleen Fogarty of South Kingstown proposed the legislation. The Senate held a hearing on similar legislation in March, which was proposed by Senator Cynthia Coyne. In a statement, Coyne said in part, “A uniform statewide policy will ensure that the taking away of recess is not used as a punitive or academic measure, and that all children enjoy the benefits of free play recess.”

But after the hearing, the senate voted to hold the measure for further study. Governor Gina Raimondo isn’t sold on the legislation. A spokesperson for the Governor said,

“As a mother of three young children, she knows how important recess can be to helping kids stay focused during the day, but she does not believe that this situation is best handled by passing a law requiring a one-size-fits-all approach."

The Governor instead believes the decision should be handled by teachers, principals and parents on a school-by-school basis.”

We looked into neighboring states and found Massachusetts does not require recess by law. Connecticut, however, passed a recess bill in 2012. Just like the one being proposed here, it requires 20 minutes of recess per day and does not allow schools to take away recess as a punishment.

We’ll be tracking any new developments on Rhode Island’s recess bill, and of course will update you when they happen.

Wednesday, June 29, 2016

Researchers Link Childhood Hunger, Violence Later in Life

From the University of Texas at Dallas
via ScienceDaily

June 20, 2016

Children who often go hungry have a greater risk of developing impulse control problems and engaging in violence, according to new U.T. Dallas research.

The study, published in the International Journal of Environmental Research and Public Health, found that people who experienced frequent hunger as kids were more than twice as likely to exhibit impulsivity and injure others intentionally as adolescents and adults.

Thirty-seven percent of the study's participants who had frequent hunger as children reported that they had been involved in interpersonal violence. Of those who experienced little to no childhood hunger, 15 percent said they were involved in interpersonal violence.


The findings were strongest among whites, Hispanics and males.

Previous research has shown that childhood hunger contributes to a variety of other negative outcomes, including poor academic performance. The study is among the first to find a correlation between hunger, low self-control and interpersonal violence.

"Good nutrition is not only critical for academic success, but now we're showing that it links to behavioral patterns. When kids start to fail in school, they start to fail in other domains of life," said Dr. Alex Piquero, Ashbel Smith Professor of Criminology and associate dean for graduate programs in the School of Economic, Political and Policy Sciences.

Researchers used data from the National Epidemiologic Survey on Alcohol and Related Conditions to examine the relationship between childhood hunger, impulsivity and interpersonal violence.

Participants in that study responded to a variety of questions including how often they went hungry as a child, whether they have problems controlling their temper, and if they had physically injured another person on purpose.

More than 15 million U.S. children face food insecurity -- not having regular access to adequate nutrition, according to the study. Piquero said the results highlight the importance of addressing communities known as food deserts that have little access to grocery stores with healthy food choices.

The findings suggest that strategies aimed at alleviating hunger may also help reduce violence, Piquero said.

"At the very least, we need to get children the nutritional food they need," Piquero said. "It's not a very difficult problem to address, and we can envision lots of gains."

Piquero also has co-authored other recent studies related to the role that self-control plays in delinquency and violence.

Journal Reference
  • Michael Vaughn, Christopher Salas-Wright, Sandra Naeger, Jin Huang, Alex Piquero. Childhood Reports of Food Neglect and Impulse Control Problems and Violence in Adulthood. International Journal of Environmental Research and Public Health, 2016; 13 (4): 389 DOI:10.3390/ijerph13040389

‘Finding Dory’ and ‘Finding Nemo’ Change the Way We See Disability

From The Washington Post

June 17, 2016

Dory (Ellen DeGeneres), the regal tang at the
center of  ”Finding Dory.” (Disney/Pixar)

Forget “Me Before You,” the weepy romantic drama about a quadriplegic man, the young woman who falls in love with him while working as his caregiver and his plans to commit suicide, which has come under fire from disability activists.

The biggest movie about characters with disabilities hits theaters Friday, and if history is any record, it’s likely to be a massive global hit.

Of course, it says a lot about the state of storytelling about disability in Hollywood that the characters in question are cartoon fish.

But the entertainment industry’s larger failings in no way diminish “Finding Dory,” the sequel to the 2003 Pixar smash “Finding Nemo.” In the first film, a clownfish named Marlin (Albert Brooks) overcomes his fears and chases after his son Nemo (voiced by Alexander Gould in 2003, Hayden Rolence in 2016) when Nemo is scooped up by an aquatic collector, meeting a regal tang named Dory (Ellen DeGeneres), along the way.

“Finding Dory” is devoted to Dory’s search for her parents, from whom she was separated as a child.


It’s easy to read both films broadly as stories about parents learning to trust their children; for all their charming specificity, Pixar movies are designed to tug heartstrings as widely as possible. Marlin was deeply affected by an early loss: his wife, Coral (Elizabeth Perkins), and many of their eggs were eaten by a barracuda, leaving Marlin to raise Nemo alone.

Dory’s parents, we learn in “Finding Dory,” never gave up hope that their daughter would find her way home to them.

And in both cases, the children in question have disabilities. The barracuda attack on his family caused trauma to Nemo’s egg, and he hatched with a small right fin that somewhat impairs his swimming. And Dory has short-term memory loss that means she repeats herself, forgets what she’s doing or where she’s going, and even how to find her way home.

“What if I forget you?” the young Dory asks her parents, Charlie (Eugene Levy) and Jenny (Diane Keaton) terrified, in an early scene in “Finding Dory.” “Will you forget me?”

The way Marlin, Charlie and Jenny handle their children’s growing independence is inevitably influenced by Nemo’s fin and Dory’s mind. Marlin, rather than seeing Nemo’s determination and persistence in learning to swim as quickly and as far as his friends, only sees his son’s weakness and vulnerability.

Charlie and Jenny are more encouraging, finding ways to give Dory long-term memories, teaching to her brain, rather than trying to make it work differently.

One of the more poignant threads running through “Finding Dory” is the idea that while Marlin has learned that Nemo’s disability doesn’t make his son weak, he is still impatient with, and occasionally unkind to, Dory. Marlin discourages her from going to school because he believes she will be nuisance. And at one point, he snaps at her to “Go wait over there and forget. It’s what you do best.”

Nemo has to point out to his father than denigrating Dory for the way her mind works is just as cruel and unfair as denigrating Nemo for his fin. “You made her feel like she couldn’t do it,” Nemo tells his father, suggesting that Marlin’s skepticism is a bigger obstacle for Dory than Dory’s own unique brain.

Along her journey, Dory meets other fish and whales who deal with their own impairments. Destiny (Kaitlin Olson), a whale shark who Dory knew as a child, has limited vision, and often bumps into the sides of her tank. Bailey (Ty Burrell), a beluga whale, has a head injury that has interfered with his echolocation. And octopus Hank (Ed O’Neill) has lost a tentacle and fears losing another one.

Where they see their limitations, Dory sees their variety and their talents. “You swim beautifully,” she tells Destiny. “I’ve never seen a fish swim like that before.” Together, they free themselves and help reunite Dory with Jenny and Charlie again.

I suspect that many of the families who go see “Finding Dory” will walk out of the theater without thinking much about the film’s treatment of disability, though those for whom the themes are particularly resonant will notice them everywhere.

When thinking back on “Finding Nemo” before seeing “Finding Dory,” I have to admit Nemo’s fin wasn’t the first thing that came to mind. But if we treat Nemo’s fin or Dory’s brain as normal dramatic challenges, rather that causes for tragedy or pity, maybe that’s the point.

“Finding Dory” is a joyful movie, one that thrills in Dory’s capabilities and creativity, rather than lamenting what her brain has cost her. Her mind may operate in its own “Dory way” as Jenny puts it, but it still brought her home.

Just as the sheer variety of fish and landscapes in the ocean are what make “Finding Nemo” and “Finding Dory” beautiful, the different ways Nemo and Dory move through the world, and the kindnesses they find there, make us see just how challenging and marvelous it can be.

..........................................................

Alyssa Rosenberg blogs about pop culture for The Washington Post's Opinions section. Follow @AlyssaRosenberg

‘Finding Dory’ and ‘Finding Nemo’ Change the Way We See Disability

From The Washington Post

June 17, 2016

Dory (Ellen DeGeneres), the regal tang at the
center of  ”Finding Dory.” (Disney/Pixar)
Forget “Me Before You,” the weepy romantic drama about a quadriplegic man, the young woman who falls in love with him while working as his caregiver and his plans to commit suicide, which has come under fire from disability activists.

The biggest movie about characters with disabilities hits theaters Friday, and if history is any record, it’s likely to be a massive global hit.

Of course, it says a lot about the state of storytelling about disability in Hollywood that the characters in question are cartoon fish.

But the entertainment industry’s larger failings in no way diminish “Finding Dory,” the sequel to the 2003 Pixar smash “Finding Nemo.” In the first film, a clownfish named Marlin (Albert Brooks) overcomes his fears and chases after his son Nemo (voiced by Alexander Gould in 2003, Hayden Rolence in 2016) when Nemo is scooped up by an aquatic collector, meeting a regal tang named Dory (Ellen DeGeneres), along the way.

“Finding Dory” is devoted to Dory’s search for her parents, from whom she was separated as a child.


It’s easy to read both films broadly as stories about parents learning to trust their children; for all their charming specificity, Pixar movies are designed to tug heartstrings as widely as possible. Marlin was deeply affected by an early loss: his wife, Coral (Elizabeth Perkins), and many of their eggs were eaten by a barracuda, leaving Marlin to raise Nemo alone.

Dory’s parents, we learn in “Finding Dory,” never gave up hope that their daughter would find her way home to them.

And in both cases, the children in question have disabilities. The barracuda attack on his family caused trauma to Nemo’s egg, and he hatched with a small right fin that somewhat impairs his swimming. And Dory has short-term memory loss that means she repeats herself, forgets what she’s doing or where she’s going, and even how to find her way home.

“What if I forget you?” the young Dory asks her parents, Charlie (Eugene Levy) and Jenny (Diane Keaton) terrified, in an early scene in “Finding Dory.” “Will you forget me?”

The way Marlin, Charlie and Jenny handle their children’s growing independence is inevitably influenced by Nemo’s fin and Dory’s mind. Marlin, rather than seeing Nemo’s determination and persistence in learning to swim as quickly and as far as his friends, only sees his son’s weakness and vulnerability.

Charlie and Jenny are more encouraging, finding ways to give Dory long-term memories, teaching to her brain, rather than trying to make it work differently.

One of the more poignant threads running through “Finding Dory” is the idea that while Marlin has learned that Nemo’s disability doesn’t make his son weak, he is still impatient with, and occasionally unkind to, Dory. Marlin discourages her from going to school because he believes she will be nuisance. And at one point, he snaps at her to “Go wait over there and forget. It’s what you do best.”

Nemo has to point out to his father than denigrating Dory for the way her mind works is just as cruel and unfair as denigrating Nemo for his fin. “You made her feel like she couldn’t do it,” Nemo tells his father, suggesting that Marlin’s skepticism is a bigger obstacle for Dory than Dory’s own unique brain.

Along her journey, Dory meets other fish and whales who deal with their own impairments. Destiny (Kaitlin Olson), a whale shark who Dory knew as a child, has limited vision, and often bumps into the sides of her tank. Bailey (Ty Burrell), a beluga whale, has a head injury that has interfered with his echolocation. And octopus Hank (Ed O’Neill) has lost a tentacle and fears losing another one.

Where they see their limitations, Dory sees their variety and their talents. “You swim beautifully,” she tells Destiny. “I’ve never seen a fish swim like that before.” Together, they free themselves and help reunite Dory with Jenny and Charlie again.

I suspect that many of the families who go see “Finding Dory” will walk out of the theater without thinking much about the film’s treatment of disability, though those for whom the themes are particularly resonant will notice them everywhere.

When thinking back on “Finding Nemo” before seeing “Finding Dory,” I have to admit Nemo’s fin wasn’t the first thing that came to mind. But if we treat Nemo’s fin or Dory’s brain as normal dramatic challenges, rather that causes for tragedy or pity, maybe that’s the point.

“Finding Dory” is a joyful movie, one that thrills in Dory’s capabilities and creativity, rather than lamenting what her brain has cost her. Her mind may operate in its own “Dory way” as Jenny puts it, but it still brought her home.

Just as the sheer variety of fish and landscapes in the ocean are what make “Finding Nemo” and “Finding Dory” beautiful, the different ways Nemo and Dory move through the world, and the kindnesses they find there, make us see just how challenging and marvelous it can be.

..........................................................

Alyssa Rosenberg blogs about pop culture for The Washington Post's Opinions section. Follow @AlyssaRosenberg

Tuesday, June 28, 2016

More Testing, Less Play: Study Finds Higher Expectations For Kindergartners

From nprEd
How learning happens.

By Anya Kamenetz and Elissa Nadworny
June 21, 2016



This summer, millions of excited 4-, 5- and 6-year-olds will be getting ready for their first real year of school. But some of them may be in for a wake-up call when that first bell rings.

If you have young kids in school, or talk with teachers of young children, you've likely heard the refrain — that something's changed in the early grades. Schools seem to be expecting more of their youngest students academically, while giving them less time to spend in self-directed and creative play.

A big new study provides the first national, empirical data to back up the anecdotes. University of Virginia researchers Daphna Bassok, Scott Latham and Anna Rorem analyzed the U.S. Department of Education's Early Childhood Longitudinal Study, which includes a nationally representative annual sample of roughly 2,500 teachers of kindergarten and first grade who answer detailed questions. Their answers can tell us a lot about what they believe and expect of their students and what they actually do in their classrooms.


The authors chose to compare teachers' responses from two years, 1998 and 2010. Why 1998? Because the federal No Child Left Behind law hadn't yet changed the school landscape with its annual tests and emphasis on the achievement gap.

With the caveat that this is a sample, not a comprehensive survey, here's what they found. Among the differences:

  • In 2010, prekindergarten prep was expected. One-third more teachers believed that students should know the alphabet and how to hold a pencil before beginning kindergarten.
  • Everyone should read. In 1998, 31 percent of teachers believed their students should learn to read during the kindergarten year. That figure jumped to 80 percent by 2010.
  • More testing. In 2010, 73 percent of kindergartners took some kind of standardized test. One-third took tests at least once a month. In 1998, they didn't even ask kindergarten teachers that question. But even the first-grade teachers in 1998 reported giving far fewer tests than the kindergarten teachers did in 2010.
  • Less music and art. The percentage of teachers who reported offering music every day in kindergarten dropped by half, from 34 percent to 16 percent. Daily art dropped from 27 to 11 percent.
  • Bye, bye, brontosaurus. "We saw notable drops in teachers saying they covered science topics like dinosaurs and outer space, which kids this age find really engaging," says Bassok, the study's lead author.
  • Less "center time." There were large, double-digit decreases in the percentages of teachers who said their classrooms had areas for dress-up, a water or sand table, an art area or a science/nature area.
  • Less choice. And teachers who offered at least an hour a day of student-driven activities dropped from 54 to 40 percent. At the same time, whole-class, teacher-led instruction rose along with the use of textbooks and worksheets.
  • Not all playtime is trending down, though. Perhaps because of national anti-obesity campaigns, daily recess is actually up by 9 points, and PE has held steady.

Bassok was surprised by her results. "We went into the study seeing a lot of anecdotal evidence" about the ratcheting up of expectations in kindergarten, she says. "I thought part of this was a nostalgia for what we imagined kindergarten may have been. It's pretty amazing to me that, over a 12-year period, we see such drastic changes in teachers reporting what they expect and how they spend their time."


But what do these findings mean? And are they inherently bad?

Sonja Santelises, vice president for K-12 policy and practice at the Education Trust, which focuses on efforts to reduce the achievement gap, says rising expectations are a good thing, though "rigid instruction" is not.

"The report clearly raises important questions about how we are teaching our youngest learners," Santelises says. "But we need to be careful that we're not conflating the challenge of high-quality, engaging instruction and the actual target of learning to read."

Bassok agrees. "The changes that seem potentially troubling are more around how kids are learning, not what kids should be learning," she says. "There are classrooms that are very hands-on and allow kids to explore and also have terrific focus on math and are language-rich. Those things don't need to be at odds at all."

It's easy to make this a story about teachers' responses to high-stakes testing. Especially when you consider that, for every one of these indicators, the trend was even stronger in high-poverty classrooms and in schools with more nonwhite children — schools that no doubt felt extra accountability pressure under NCLB.

However, the authors caution that there are lots of factors at play here. Since 1998, the number of children attending public preschool has jumped dramatically. There's been an even bigger leap in students attending full-day versus half-day kindergarten, which gives teachers more time to cover every subject.

Parents also appear to be spending more time reading to kids and otherwise introducing language and math. In short, it's possible teachers' academic expectations have risen, at least in part, because more kids are coming to kindergarten better prepared.

Also, kindergartners are older than they used to be: 1 in 5 is 6 years old, in part due to the practice of "redshirting."

It should be said: The data in this study are six years old. It doesn't capture changes that may have taken place in schools since the adoption of the Common Core, for example.

Kindergarten changed dramatically in just over a decade; as policies continue to shift, so too could practice. For now, it's less pretend time and more reading for the kids at Walker Jones Elementary, compared to what teacher Marisa McGee, 29, says she was expecting when she started.

"When I came into kindergarten, down from first grade, I was like: Yes! What can I order for dramatic play?" McGee says. "And I was told: Kindergartners don't do dramatic play anymore."

NCES Publishes a Report on School Crime and Safety

From Jim Gerl's Special Education Law Blog

By Jim Gerl, Esq.
June 4, 2016

The national Center for Education Statistics of the Institute of Education Sciences has released a report entitled Indicators of School Crime and Safety 2015.

The report includes a wealth of school safety information for both K-12 and post-secondary education. Topics include victimization, school conditions, discipline, safety and security measures, and criminal incidents.

Read the entire 246-page report here.

It includes a chapter on bullying.

Concerning special education and discipline: I particularly call your attention to Tables 19.1 and 19.2 on pages 177-178 of the report. Here are a few statistics from the report; all numbers are for the 2011-2012 school year:
  • 0.42% of students with disabilities received corporal punishment as compared to 0.36% of students in general.
  • 11.84% of students with disabilities received out-of-school suspensions vs. 6.4% of all students.
  • 0.38% of students with disabilities were expelled vs. 0.22% of all students.
  • 0.27% of students with disabilities were arrested at school vs. 0.13% of all students. 

Check out this large compilation of data on school crime and safety.

Why It’s Imperative to Teach Empathy to Boys

From KQED's Blog "Mind/Shift"
How we will learn.

By Gayle Allen and Deborah Farmer Kris
June 25, 2014



When searching for toys for their kids at chain toy stores, parents typically encounter the following scenario: toy aisles are color-coded pink and blue. They shouldn’t bother looking for LEGOS, blocks, and trucks in the pink aisle, and they certainly won’t find baby dolls in the blue aisle.

While parents, researchers, and educators decry the lack of STEM toys for girls — and rightly so — what often goes unnoticed is that assigning genders to toys harms boys, as well.


Too often children’s playrooms reinforce gender stereotypes that put boys at risk of failing to gain skills critical for success in life and work. The most important of these? Empathy.

Meg Bear, Group Vice President of Oracle’s Social Cloud, calls empathy “the critical 21st century skill.” She believes it’s the “difference between good and great” when it comes to personal and professional success.

Researchers at Greater Good Science Center out of the University of California, Berkeley, echo Bear’s assertion. They define empathy as “the ability to sense other people’s emotions, coupled with the ability to imagine what someone else might be thinking or feeling.

Why is empathy important?

First, empathy breeds courage. In a recent study of nearly 900 youth, ages 11-13, Nicola Abbott and Lindsey Cameron’s, psychology researchers at University of Kent, found that participants with higher levels of empathy were more likely to engage in “assertive bystander behavior.” In other words, they were willing to stand up to a bully on behalf of someone outside their peer group.

This kind of courage can be life changing for a victim of bullying and prevent the damaging effects of social isolation and exclusion that often lead to anxiety and depression.It’s clear we need to cultivate empathy in all children, but gender stereotypes — often reinforced in playrooms — risk leaving boys, in particular, with a social deficit.

Empathy also yields happiness. People with empathy have stronger interpersonal connections and are more eager to collaborate, effectively negotiate, demonstrate compassion, and offer support. They’re team players, and employers recognize this.

So important has this skill become that a research team in England, after engaging in a six-month review of its schools, submitted a report that placed empathy in the top three of important outcomes for its students. Similarly, employers, when asked to compile a list of the 20 People Skills You Need to Succeed at Work,” placed it fifth.

Empathy drives thoughtful problem solving. Empathic problem solvers put themselves in others’ shoes in a way that allows them to design life-saving baby warmers, easily collapsible baby strollers, and energy-saving car sharing services.

In addition, they’re often willing to work with others to solve persistent and, at times, larger problems. Rather than hoarding their knowledge and expertise, they open themselves up to what Greg Satell calls cognitive collaboration, in order to serve patients, clients, students, and even their respective fields, more effectively.

It’s clear we need to cultivate empathy in all children, but gender stereotypes — often reinforced in playrooms — risk leaving boys, in particular, with a social deficit.

What Parents Can Do

Play with dolls. Parents will find that boys can be just as interested as girls in playing with dolls. Just watch little boys when they interact with an infant: they want to pat the baby’s head and see the little toes, and their faces show distress when that baby starts to cry. Recognizing the importance of young children’s interactions with babies for building social skills, organizations like Roots of Empathy do just that. They bring babies into elementary school classrooms as part of their empathy building, evidence-based programs.

Don’t have a baby at hand? Dolls allow young children to simulate dressing, feeding, calming and caring for babies – particularly if adults participate and model this care. For parents of boys, it’s worth a trip to the pink aisles to find one.

Pretend play helps children self-regulate, develop a strong “theory of mind,” and integrate positive and negative emotions. When kids adopt different personas, they face dilemmas and solve problems “in character” – in essence, they’re taking empathy for a test drive. Play researcher Dorothy Singer, Senior Researcher at Yale University’s School of Medicine, contends that make believe helps children “be anyone they wish.”

Through it, they “learn how to cope with feelings, how to bring the large, confusing world into a small, manageable size; and how to become socially adept as they share, take turns and cooperate with each other.”

Parents can expand boy’s empathic skills through pretend play by blurring the traditional pink-blue boundary lines. Toy kitchens should co-exist with trucks, doll houses with action figures.

Read together. Researchers have shown that reading fiction promotes empathy. Children’s book author and illustrator, Anne Dewdney, echoes that finding when she argues that, “When we open a book, and share our voice and imagination with a child, that child learns to see the world through someone else’s eyes.”

Sadly, studies reveal that parents in the U.S., Canada, and Great Britain spend less time reading and telling stories to their sons than to their daughters. In fact, in as early as nine months, researchers found a gender gap in literary activities.

To address this, turn to picture books as empathy primers. Together parents and boys can look at a character’s body language and facial expressions and then identify corresponding emotions. Parents can pause while reading to ask: How do you think that make her feel? How would that make you feel? What would help him feel better?

Empathy, “an understanding that other people have feelings, and that those feelings count,” is a learned behavior. For boys, as for girls, that learning begins in infancy. As University of Wisconsin’s Carolyn Zahn-Waxler aptly notes, “There is no gene for empathy.”

Parents play a key role in nurturing empathy, from explaining others’ feelings to encouraging prosocial behaviors with friends and siblings. Playroom toys and forms of play are equally important. Given all the benefits associated with empathy for success in life and work, it seems like now, more than ever, we need to mind the gap.

.........................................................

Gayle Allen spent nearly two decades as a teacher, school leader, and founder of two professional development institutes. She holds an Ed.D. from Teachers College, Columbia University, where she focused her research on teacher learning. Gayle currently serves on the advisory board for BioBuilder Educational Foundation. She blogs at Connecting the Thoughts and tweets @GAllenTC.

Deborah Farmer Kris has taught elementary, middle, and high school and served as a charter school administrator. She spent a decade as an associate at Boston University’s Center for the Advancement of Ethics and Character researching, writing, and consulting with schools. She is the mother of two young children.

Autism with Intellectual Disability Linked to Mother's Immune Dysfunction During Pregnancy

From the University of California - Davis
via ScienceDaily

June 7, 2016

Pregnant women with higher levels of inflammatory cytokines and chemokines, proteins that control communication between cells of the immune system, may be at significantly greater risk of having a child with autism combined with intellectual disability, researchers with the UC Davis MIND Institute have found.

The research also suggests a potential immune profile for the differentiation of autism combined with intellectual disability, as distinct from either autism or developmental disability alone.

"Inflammation during the second trimester in the mothers of children with autism who also have intellectual disability was significantly greater than in mothers of children autism without intellectual disability in our study," said Judy Van de Water, professor of Internal Medicine in the Division of Rheumatology, Allergy and Clinical Immunology and a researcher affiliated with the U.C. Davis MIND Institute.

"However, equally significant was that profiles of mothers whose children go on to be diagnosed with autism and intellectual disability differed markedly from those whose children have intellectual disability without autism, as well as from the typically developing general population," said Van de Water, director of the U.C. Davis Center for Children's Environmental Health and the study's senior author.

"Their profiles are distinct from all of the other groups that we studied, based on their cytokine and chemokine profiles," Van de Water continued. "This finding suggests an avenue that we will explore to potentially identify possible markers to separate sub-phenotypes in the autism population."

The study is published online in Molecular Psychiatry, a Nature publication.

Chemokines have been shown to regulate the migration, proliferation and differentiation of neuronal cells, and studies have identified the roles of specific cytokines during neurodevelopment, such as influencing neurogenesis, neuronal and glial cell migration, proliferation, differentiation and synaptic maturation and pruning.

The large, diverse, population-based study was conducted using blood serum samples obtained from the California Department of Public Health of mothers in the Kaiser Permanente Early Markers for Autism Study -- 184 whose children developed autism and intellectual disability (previously known as mental retardation), 201 who had children with autism without intellectual disability, 188 whose children had developmental disability alone and 428 general population control participants.

The largely Southern California-based study was designed to evaluate biomarkers for autism. Women were eligible for participation if they delivered their infants between July, 2000 and September, 2003. The participants were largely from Orange, San Diego or Imperial counties.

The researchers examined the mothers' mid-gestational blood serum levels of 22 different cytokines and chemokines, including GM-CSF, IL-1Alpha, IL-6, and IFN-Gamma.

"The fact that we see this increase in inflammatory markers with the autism/intellectual disability group compared with all of the other reference groups is striking, because the ones we're seeing that are affected are usually down-regulated during the second trimester of pregnancy," said Karen L. Jones, study first author and a post-doctoral fellow in the Division of Rheumatology, Allergy and Clinical Immunology.


"This really is suggesting that there is a lack of the immune regulation in these moms that is typically associated with a healthy pregnancy."

The authors postulate that alterations in the gestational immune environment among mothers of children autism with intellectual disability may lead to alterations in the neurodevelopmental trajectory of the developing fetus, which may subsequently result in the altered behavioral phenotype characteristic of children with autism and intellectual disability.

The researchers noted that maternal immune activation represents one of several pathways that can result in differences in maternal cytokines, including environmental toxicants such as pesticides, polychlorinated biphenyls and polybrominated diphenyl ethers.

Mid-gestational maternal cytokine and chemokine levels also may interact with other potential risk factors, such as parental genetics.

"It is particularly exciting that this work does start to tease apart a potential source of differences in autism with and without intellectual disability, as well as from intellectual disability without autism," Jones said.

"This study is incredibly valuable because it helps us understand more about the sources of variability within autism spectrum disorder, providing important insights into the different neurobiological mechanisms underlying important subtypes of the disorder," said Leonard Abbeduto, director of the MIND Institute.

"At the same time, the study reinforces the importance of the maternal immune system in to a host of child outcomes. Most importantly, this study brings us closer to knowing how to prevent adverse developmental outcomes," he said.


Journal Reference
  • K L Jones, L A Croen, C K Yoshida, L Heuer, R Hansen, O Zerbo, G N DeLorenze, M Kharrazi, R Yolken, P Ashwood, J Van de Water. Autism with intellectual disability is associated with increased levels of maternal cytokines and chemokines during gestation. Molecular Psychiatry, 2016; DOI: 10.1038/mp.2016.77

Monday, June 27, 2016

5 Ways Parents Can Help Prevent Teen Depression

From the Greater Good Science Center

By Jill Suttie
June 21, 2016


Parents are understandably worried about their teens. Last year’s spate of teen suicides in Palo Alto, coupled with high rates of teen depression, make parents wonder what they could be doing to better help their kids navigate the sometimes-treacherous waters of their adolescent years.

Fortunately, scientists who study teen depression have some preliminary advice. By looking at new findings in neuroscience, as well as other psychological research and longitudinal data, scientists are zeroing in on a better understanding of what impacts teen depression and how to prevent it.

Here are some of the suggestions coming out of the science:

1.) Provide continual warmth, caring, and support.

Parents may think that they have little to offer teens; but recent studies suggest otherwise.

In one 2016 study of a large group of teenagers from diverse ethnic backgrounds, results showed that teens with high levels of parental support had lower depression symptoms and lower cortisol and C-reactive protein levels—two physiological markers associated with depression—than teens with less supportive relationships. Interestingly, peer support levels did not change these markers, suggesting that parental support may be key.

In another study, Eva Telzer and colleagues found that having a positive relationship with parents decreased activation of the ventral striatum, the reward center of the brain, during a risk-taking exercise performed in the lab. This suggests that parents can help reduce higher levels of teen risk-taking, which has been associated with depression.

So what does positive parental support actually look like? According to developmental neuroscientist Ron Dahll, the best way to help guide your teens is to provide appropriate supports without discounting their emotional lives. He suggests showing empathy, asking open-ended rather than pointed questions, seeking to understand rather than correct, being gentle when your teen’s words and actions don’t match, and showing support for their growing autonomy.

A combination of warmth and appropriate limits, as well as looking for the positive in your child, is the best way to help them avoid depression.

2.) Teach and model strong social and emotional skills.

Just like adults, teens often have to cope with difficult social and emotional situations—changing friendships, romantic relationships going sour, disappointments in their work, the stress of academics or college admissions procedures. Yet because brains are designed to heighten emotions during adolescence, coping with these challenges can be particularly difficult, making teens more prone to depression.

In one study, how parents responded to their teen’s distress during a stressful task impacted how the teens were able to handle anxiety in the real world. Teens were asked to make a speech while being evaluated, and those teens whose parents demonstrated low levels of anxiety during the speech were less reactive later on in emotionally charged interactions with their peers. This suggests that parents can help their kids face emotional challenges by modeling positive emotional responding.

Parents can also help their kids through emotional coaching, according to Christine Carter, starting with accepting their and their teen’s feelings. Some recent studiessuggest that practicing mindfulness—a nonjudgmental awareness of one’s present emotions, thoughts, and experiences—can help parents keep their cool when interacting with teens, which helps teens avoid depression, anxiety, and drug use (which has been itself linked to depression).

Similarly, a recent randomized control trial found that a nine-session mindfulness group program offered in schools significantly decreased depression symptoms in students immediately afterward and up to six months later in comparison to students in a control group. Other social-emotional programs in schools have had similar results, and have also helped teens do better academically.

3.) Encourage positive peer relationships.

All teens look to their peers for approval and status. But if these relationships are fraught, they may lead to depression.

In a 2005 study of 421 adolescents by Annette La Greca and Hannah Harrison, having positive friendships, being in a romantic relationship, and feeling a part of a social crowd were protective against developing social anxiety and depression. However, negativity—or worse, victimization and abuse—in friendships and romantic relationships predicted social anxiety and depression.

One recent study found that teens with at least one close friend were more psychologically resilient, because friendship helped them to cope with emotional setbacks in healthier ways. Other studies have shown that high-quality friendships and being part of an accepting social crowd provide benefits down the road including not only less depression and anxiety, but also better-quality adult relationships and improved physical health.

Longitudinal research on adolescent mental health suggests that we don’t want to discount our teens’ friendships or discourage normal group bonding.

So how can parents help? By not freaking out because our kids have “too many” or “not enough” friends, and by understanding that taking risks in relationships is part of growing up. Parents can find time to talk to their teens about what it means to be a caring friend and a thoughtful romantic partner, and how to protect oneself if a relationship goes sour.

Being a role model yourself for how to negotiate differences in friendships can help your kids see that relationships don’t always have to be perfect to be nurturing, and that close friendships can last a lifetime.

4.) Encourage teens to seek purpose in life.

As teens put lots of effort into excelling at schoolwork and after-school activities, it’s important that those activities have some personal meaning for them, rather than serving as padding for college applications.

Research shows that having a sense of purpose in life—or even searching for one—is beneficial for teens, especially as they get older. In one study by Kendall Bronk and colleagues, purpose was associated with greater life satisfaction and hope in all age groups, including teens.

Bronk suggests that parents need to engage their teens by asking open-ended questions about what they care about and then listening carefully to their responses, in order to assess where their sense of purpose may lie. She also suggests practicing gratitude as a way of encouraging purpose, and other research has found that gratitude also provides direct psychological benefits for teens.

5. Work to change the school environment.

We want what’s best for our kids; but some of that may involve things beyond the scope of our own family—systemic changes in schools, for example, that could lead to better psychological health for teens.

In light of research showing that teens who are sleep-deprived do worse in school and have a higher likelihood of developing depression, some parents are pressuring high schools to have later starting times. In addition, parents are insisting that schools provide healthy food to students, so they will get the good nutrition needed to prevent mental health issues down the road.

As teen advocate Vicki Abeles argues in her book, Beyond Measure, petitioning schools to assign less homework to students over holidays and vacations, while providing more specialized tutoring for kids who may need the extra attention, may help kids find more balance in their lives.

Restorative justice programs at schools that help teens take responsibility for problematic behaviors (like bullying) and make amends to those affected have shown promise in reducing absenteeism andimproving social climates for all students.

Of course, the path to teen depression can be varied and complicated. We can’t simply apply a formula and expect everything to turn out fine. As my brother-in-law told me when my first son was born, “Children are not machines.” That means that we must treat them as individuals and recognize their unique skills and challenges, while providing the kinds of supports they need to thrive, whatever challenges they face.

In that way, we not only help teens to avoid problems like depression, we help shape a positive future for them and for society.

Escaping the Disability Trap

From The Atlantic

By Alia Wong
June 15, 2016

What’s the best way to prepare special-needs students for the workforce?

Today, more than 1 million students are trapped in an education system that wasn’t built for them. That system wasn’t designed to accommodate their disabilities—the kinds of intellectual, cognitive, communicative, and physical conditions that often conjure images of people reliant on wheelchairs and aides, of individuals consigned to dreary, isolated lives.

Many of the public schools they attend rest on the assumption that those stereotypes are inevitable truths.

But these students, even those with the most severe disabilities, have potential far beyond what they are often educated for. Although the law known as the Individuals With Disabilities Education Act, or IDEA, has long required schools to help students design “transition plans” and provide job training for their lives after graduation, a majority of adults with intellectual or developmental disabilities are unemployed or underemployed.

According to a 2012 Bureau of Labor Statistics survey of disabled adults, that’s largely because of a lack of training and education, which respondents listed as the most common barrier to employment aside from the disabilities themselves.

“The big concern that remains [is] what happens when you’re done ... and you’re finished with school? Are you sitting at home on the couch?” said Margaret (“Muncie”) Kardos, a Connecticut-based educational consultant who helps students with disabilities plan for the transition. The poor preparation, she said, leaves many special-needs people with few other options.

Their prospects at graduating are grim to begin with: Nationally, only about two-thirds of students ages 14 through 21 with disabilities graduate with a regular diploma, while most of the remaining students simplydrop out. And these figures encompass all students with disabilities, including those who are relatively high-functioning. The statistics for those who are severely disabled are much more bleak.

Compared to their peers from all disability groups, youth with intellectual disabilities, for example, have the lowest rates of education, work, or work preparation after high school. A 2011 Department of Education study that looked at the outcomes of young adults with disabilities up to six years after high school found fewer than half of the young adults with multiple disabilities had a paid job at the time of the survey, compared to 79 percent of young adults with specific learning disabilities such as dyslexia.

If and when special-needs adults are employed, it’s often in jobs when they’re working exclusively alongside other people with disabilities. In 2014, a Justice Department investigation found that thousands of disabled adults in Rhode Island were fed into “sheltered workshops”—doing jobs like placing tops on bottles and stickers on boxes—for just $2.21 an hour on average.

Some of the disabled employees, the report found, were even working for free: A commercial greenhouse, for example, didn’t pay people for picking dead leaves off of plants because the work was deemed “therapeutic.” According to the Washington Post, 30 percent of intellectually disabled adults who were employed in 2014 were working in sheltered workshops where they were segregated from non-disabled adults.

Specialized workforce academies for students with disabilities are growing in popularity as a solution to these realities, in part thanks to federal grants and legislation such as the Workforce Innovation and Opportunity Act. Special-education advocates often describe these job-training programs—which often place participants in internships with prospective employers—as the long-awaited solution to the perennial challenge of how to support students with disabilities through graduation and into adulthood.

But how different are the experiences at segregated workforce academies from those at sheltered workshops, and how effective are they at leading students to mainstream jobs?
Historically, specialized programs faced scrutiny for separating disabled students from their peers, a practice that fueled emotional, often bitter, debates over how to best educate kids with unique and complex learning needs. Through the early 1970s, many students with disabilities were denied access to regular public schools and forced into special schools—a practice known as “institutionalization.”

Broader stigmas also developed around vocational academies, which, American RadioWorks’s Emily Hanford has reported, were perceived as “a kind of dumping ground for kids who weren’t succeeding in the traditional academic environment.”

By the 1990s, the pendulum had swung in the other direction: Institutionalization had become a taboo word in special education, and “inclusion”—the integration of special-needs students into mainstream classrooms as much as possible—became the gold standard.

“Regular schools with this inclusive orientation are the most effective means of combating discriminatory attitudes, creating welcoming communities, building an inclusive society and achieving education for all,” a UNESCO report on special education proclaimed. Even children in special schools, the report contended, shouldn’t “be entirely segregated.”

Specialized and completely segregated programs never disappeared completely, however—and neither did those emotional, bitter debates over inclusion. Vociferous opposition to the idea has challenged the movement since it took hold.

“This is about the Special Education Department’s philosophy of inclusion,” Mary Andrews, whose mentally disabled son a Chicago high school for special-needs students, told the Reader in 1994 in response to district plans to close the school down. “They have something to prove, and they want my son to be the guinea pig in their experiment.”

Many school districts now seem to be pivoting away from full-blown inclusion toward more-specialized options like the workforce academies that are, oddly, in some ways reminiscent of the institutionalization era.

Not surprisingly, the same concerns are re-emerging, with some critics worrying that such programs are an extreme form of tracking, in which students perceived to have limited potential are pigeonholed into non-academic settings and low-paying jobs that nobody else wants.

Compounding the issue is the reality that students of color are disproportionately assigned to special education. Do the programs perpetuate inequality and stifle socioeconomic mobility? Do they prevent students from pursuing college? What if the ones who benefit most aren’t the students but the companies that often get to rely on their labor for free?

Then there’s the question of whether these programs are truly effective in improving students’ prospects at getting jobs they want. While the country’s schools are still struggling to shepherd students with disabilities into fulfilling lives, experts tend to agree that they’re getting there—and that, with a little trial and error, the newly emerging workforce-preparation programs may be a model that sticks.

* * * * *

Kelly Custer stands at the front of a classroom at the River Terrace Special Education Center, gesturing as he walks his students through the math of a problem-solving exercise about money. After pacing in front of a gleaming interactive whiteboard, he pivots toward a group of students sitting in front of a sequence of iMacs and school supplies and asks them to help him solve the question. A few raise their hands gingerly; some look around, smiling; some stare off in another direction completely.

He gets a similar response from another group of students, who are sitting against a wall covered in words such as “photosynthesis,” “stomata,” “chlorophyll,” and “carbon dioxide.” Custer guides them through the math and then moves on with the lesson.

This is about as academic as things get in this modern Washington, D.C., classroom—at least in the traditional sense of the word. It’s not even a classroom, really. Forget the neatly aligned rows of desks and multiple-choice worksheets and textbooks; forget posters motivating kids to apply to college.

The room feels more like a spacious laboratory that blends in with the patio and trees right outside. The north-facing wall is made almost entirely of glass, allowing sunlight to illuminate the room on this chilly day. Potted anthuriums are sitting on each of the several tables where the class’s dozen or so students are clustered. And it smells faintly of dirt—probably because the room is attached to a greenhouse filled with plants and soil and spray bottles and shovels.

Custer’s course aims to equip special-needs high-schoolers with the basic training they need to get jobs in horticulture. The year-long certificate program is comprehensive and part of River Terrace’s larger Workforce Development Center, which opened this past school year in an effort to feed participants into a handful of industries. Aside from Custer’s track, another suite exposes students to the health-care field—mainly jobs maintaining hospital facilities—and the third trains kids in hospitality.Kelly Custer leads a class. (Grey Korhonen / The Atlantic)

When they’re in the classroom, students learn soft skills—What does it mean to have a job? How do you keep a job? How do you deposit a paycheck?—and practice their work tasks in retrofitted classrooms. (Students in the hospitality track, for example, learn how to prepare a basic meal, make a bed, clean a bathroom, and load a laundry cart in a room that’s equipped with a bed, a hotel-like bathroom, a washing machine, a dining table, and more.) But students spend most of their days doing internships in their respective industries, all of which are paid.

Today, Custer’s students are about to receive their first paychecks for the jobs they started earlier that month. Hence, the math lesson. “Did you miss a day of work?” Custer asks somewhat rhetorically, looking around the room. Students shake their heads. “You’re going to get a paycheck every two weeks,” he continues, “but you’ll only get the whole paycheck if you come to work every single day.”

Kelly Custer leads a class. (Grey Korhonen / The Atlantic)

For the roughly 35 students who participated in one of the three tracks this past school year, these opportunities may be their only shot at employment later on: They all fall into the 1 percent of students in D.C. Public Schools with the greatest special-education needs. The experiences of other special-education students in D.C. and around the country suggest they would otherwise struggle to enter the workforce, let alone land even minimum-wage jobs.

And River Terrace’s students largely live east of the Anacostia River, which has the highest concentration of neighborhoods considered economically challenged in Washington. These are majority-African American neighborhoods with extremely high rates of unemployment, adults without high-school diplomas, and households headed by a single mother.

At River Terrace, which is also located in this community, 88 percent of the population is black, 10 percent is Latino, and every single student qualifies for free or reduced-price lunch.

The students in River Terrace’s workforce-development center are a relatively small subset of the adult special-needs population in D.C. Public Schools who need a more intensive environment, according to Pamela Downing-Hosten, who oversees transition programs for the district. The district’s previous workforce-development program, she explained, wasn’t adequately preparing students for jobs. So she and other educators consulted students, assessed what kinds of fields would lead to “viable-income, high-demand jobs,” and decided on the three suites.

A younger student at River Terrace (Grey Korhonen / The Atlantic)

River Terrace’s workforce center exemplifies one of the most promising models in the effort to better prepare the nation’s special-needs students for life after high school—and, in many ways, it actually promotes integration rather than segregation. “We want to expand the concept of inclusion from the classroom to the workplace ... On the worksite, [students] are just like any other employee,” Downing-Hosten said. “So they’re not separate and segregated, and that’s the experience we want our kids to have."

While the River Terrace Special Education Campus as a whole serves students in grades two through 12, the workforce component targets young adults ages 18 through 21 who have already progressed through regular high schools. In other words, they’ve already experienced mainstream education; for many, it’s the first time that they’re learning exclusively alongside peers who also have disabilities.

“We want them to know that, ‘Okay, here are my abilities, here are my limitations—and I’m going to work competitively despite those limitations,’” Downing-Hosten continued.

What’s more, unlike many other job-training programs, River Terrace enjoys the ingredients that Erik Carter, a special-education professor and researcher at Vanderbilt University, has found are key to their later success: things like early employment opportunities, involved families, and supportive community employers.

“I’m most excited about programs that provide real-life, hands-on work experiences for students at some point throughout their high school that’s not simulated, that’s not ‘pre-vocational,’ that’s not [simply] preparatory but that puts them in a real place where they’re doing real work that matches their interests,” he said.

Research conducted by Carter and two other special-education experts suggests that students are more than twice as likely to have paid employment in their first two years after high school if they have early work experience. Yet fewer than one in four students with intellectual disabilities and autism have early work experiences, according to Carter, and while an increasing number of parents hold high expectations, many are under the impression that sheltered jobs are the only option for those with disabilities.

Custer, who used to teach special education in an inclusive setting, sees the benefit of a specialized place like River Terrace for the students who attend it—in large part because it’s so different from what they were used to.

“Many of [my students] have experienced school as a place where, academically, they’re left out,” he said. “In previous experiences they were the ones that were doing very poorly in class; now, they’re getting 100s in their classwork, and you can see that they really take ownership of that, so it changes their confidence—and that spills over to the worksite.”

He also highlighted the benefits for students who are higher functioning and more socially inclined. In inclusive classrooms, he said, those students are often self-conscious and “don’t try because they don’t want to feel ashamed.” At River Terrace, on the other hand, “there’s a culture that making a mistake or risk-taking is just ingrained … Students participate. They’re not afraid to get the wrong answer. They’re not afraid to try different things that work.”

Back in Custer’s classroom, I step into the greenroom to take a look. Andreana Washington, a smiling African American 19-year-old with freckles, accompanies me to demonstrate some of what she’s learned in class. Shyly, she sprays a handful of African Violets and points to the other plants she’s helping to maintain; she chose the horticulture track because she likes working with her hands and being outside.

Washington, who has one of the best attendance rates at River Terrace, doesn’t say much when I ask her questions, nor does she look directly at me, but it’s clear—from her smile, her gestures, her occasional giggle—that she enjoys working with plants and her teacher. When we go back into the classroom, she takes her seat and listens attentively, keeping her eyes on her teacher the whole time.

Andreana Washington (Grey Korhonen / The Atlantic)

That sense of belonging is evident in many of the students I chat with over the course of my visit. Each classroom has a different tenor, but all are lively, with students engaging in different activities or raising their hands in response to a teacher’s prompt.

One of the most engaged students on campus is Janika Napper, a student in the health-care suite. Napper, who eagerly poses for the camera as she grins a toothy smile and displays her VA Medical Center volunteer vest, spends her shifts at the hospital washing tables, stacking trays, and restocking paper towels in the food court, among other tasks. Her back against a sign detailing how to use syringes, the 20-year-old explains that she enjoys the job—and plans on putting all her earnings into a saving account—but doesn’t want to do it forever: She wants to be a fashion designer.

As she goes off to talk to some friends, a teacher motions me over to explain that she’s also the class president and a member of the prom committee. In fact, according to the teacher, she even planned a donation drive for old dresses for last year’s prom.

Down the hall, Adrian Bland tells me about her experience in the hospitality suite, which partners with Embassy Suites to train kids in a range of positions, from housekeeping to food prep. Bland works as a porter, what she later described as her dream job. “I like that I get to talk to people,” responded Bland, 18, when I asked her the best thing about the job, which she elected after trying out a number of positions, including as the door person, laundry attendant, and dishwasher.

The fact that she, unlike at the other hotel jobs, gets tips also helps; her biggest single tip amounted to $20, she adds, beaming. As of early June, Bland is one of the few River Terrace students to have secured a job: She’s been hired by Embassy Suites’s Chevy Chase Hotel.

Janika Napper (Grey Korhonen / The Atlantic)

During my visit to River Terrace, Napper and Bland—both of whom are graduating this year—are visibly proud. And they clearly feel at home. When students start to trickle out into the hallways at the end of the school day, chatter reverberates throughout the glass hallways, and the campus looks just like any other high school.

“In all the classrooms, there’s a strong sense of community among the students; they applaud each other a lot. When kids come up [to the board] and touch the right answer, everybody applauds,” Custer said. “To see [students] rally around one another and look out for one another and recognize one another’s ability—I don’t think that’s going to happen in a general-education school,” Custer said, “because here, nobody’s worried about being cool.”

* * * * *

Although inclusion looks great on paper, such programs seldom succeed in lifting disabled students’ opportunities, and that’s probably why teachers such as Custer and Jamin Hollingsworth, the hospitality teacher, champion places like River Terrace. For many educators, the employment outcomes generated by these specialized programs are more important than the fact that students are segregated from the mainstream population.

But that doesn’t give school districts license to prioritize workforce programs that separate special-needs students from their peers over others that promote inclusion, argued Vanderbilt’s Carter, who worked as a transition specialist before getting his doctorate. The conversation, he said, should instead be on how to improve inclusive programs so that special-needs students get the support they need.

“My experience generally is that segregated experiences tend to lead to segregated experiences,” Carter said. Students may get job training—but for jobs that are filled almost exclusively by people with disabilities.

“If we can show that whatever experiences we’re doing actually lead students to attain the kinds of jobs they want and not the kind of jobs we think they ought to fit into then I get much less worried about what the path was,” Carter added. “The problem is that most of the things we do under the auspices of being vocational training [don’t] actually lead to integrated community jobs.”

The health-care classroom (Grey Korhonen / The Atlantic)

Integrated workforce programs can also help motivate special-needs youth, Carter said, giving them the opportunity to hear about their peers’ college and career goals. Then there’s the more abstract benefit of showing mainstream children and teachers that special-needs students—even those with more severe developmental disabilities such as Down syndrome—have workforce potential.

What’s at risk of being lost when special-needs students enroll in specialized programs such as River Terrace are “the opportunities for others in the community to come and see people with severe disabilities as having gifts and strengths and to see them in a different light,” said Carter, who isn’t familiar with the River Terrace program specifically but has researched its general model extensively.

Another risk is that the programs pigeonhole severely disabled students into a vocational path and as a result never encourage them to consider college. The DOE’s longitudinal study found that slightly fewer than one in three of the people with multiple disabilities had enrolled in some type of postsecondary schooling.

Yet for many of them, higher education is possible; in fact, roughly250 colleges across the country, including Carter’s Vanderbilt and places like Georgia Institute of Technology and Syracuse University, enroll and provide extra supports for students with intellectual disabilities, often with strong results.

The denial of academic opportunity to special-needs students has been a longstanding concern among advocates, and it reflects broader anxieties about the role of vocational learning.

“I think a lot of schools will take kids that [have] behavioral issues and will say, ‘You know what? I think technical education is where you need to be.’ I think they will take kids who have learning disabilities, and rather than work with them in academics, push them on that track,” Carol Burris, the executive director of the Network for Public Education, told PBS Newshour in a segment on workforce education. “We just know that historically.”

Nationally, the college-going rate for any students who take some kind of career-and-technical coursework is below average. And the fact that students with disabilities are typically overrepresented in career-and-technical education has raised concerns that schools are negatively tracking them into such programs and directing them away from higher education.

“I think it’s very dangerous,” Burris said in her PBS interview. “I have seen so many kids who have been academic late-bloomers, [and] all of a sudden they mature and they buckle down and they do their studies and they go to college.”

According to Carter, more than a third of all high-school students with intellectual disabilities have in their transition plans the goal of attending some sort of postsecondary educational institution. In a survey of more than 1,000 parents of students with such disabilities in Tennessee, three-fourths of respondents identified college as “an important goal.” Just 15 percent actually end up enrolling within two years after high school.

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Just because it emphasizes practical skills over academic ones, however, encouraging special-needs students to pursue career-and-technical education isn’t necessarily setting them up for failure; some research suggests quite the opposite.

To assess whether negative tracking was happening in its well-established network of vocational schools, the state of Massachusetts consulted Shaun Dougherty, an assistant professor of education policy and leadership at the University of Connecticut. Dougherty did find that students with disabilities were overrepresented in the state’s voc-tech schools, accounting for about 25 percent of their enrollment (versus 15 percent of the entire high-school population).

Yet attending a voc-tech school often enhanced a special-needs student’s educational prospects. Compared to their peers with disabilities who weren’t in the workforce programs, they were more likely to finish high school in four years—a particularly noteworthy statistic considering special-needs students can stay in school until age 21, according to Dougherty.

“On all available objective measures, students [with disabilities] were no worse off and actually better off in terms of high-school graduation,” he said.

Still, research on whether such programs actually improve special-needs kids’ long-term economic outcomes is mixed. Although participation in a workforce program tends to boost special-needs students odds at graduating, there isn’t much recent evidence to suggest that it makes a significant difference in terms of their post-graduation employment and wages.

In an April study for the right-leaning Fordham Institute, Dougherty looked at schools in Arkansas, where the vast majority of students take at least one career-and-technical course. While taking such courses raised a typically developing student’s employment odds and wages one year after high school, the impact wasn’t as apparent for special-needs students. “For students with disabilities, they’re not worse off—it’s just not clear that they’re experiencing the same benefit as their typically developing peers,” Dougherty said.

The hospitality classroom (Grey Korhonen / The Atlantic)

Regardless, it’s hard to deny that the workforce-education option is the best route for at least some students with disabilities. “If you’re looking at the 18-to-21 experience to continue to be academic in nature, for some students that may be appropriate but for a lot of students it isn’t,” said Kardos, the education consultant.

Indeed, for the students at River Terrace—at least according to the educators there, academics are all but irrelevant. “We have students who are not readers, and I think probably historically they’ve been told if you can’t read it’s hard to experience success,” said Hollingsworth, the hospitality teacher.

“My task is not to teach my students to read—I don’t have time—so that’s not what we’re doing. I don’t care that he can’t read. Today … I’m showing them how to set up their checking accounts.”

Whether workforce academies are a model worth supporting hinges on what happens after students graduate. Are they actually getting jobs upon completing the program? Are they able to lead lives that are more independent and more fulfilling than they would had they gone a more traditional route? Are they happy? The idea is great in theory, but “it all comes down to how many people are actually going to be employed when you’re done with this—that’s going to be the litmus test as to whether or not [workforce programs] are successful,” Kardos said.

“They’re certainly well-intentioned—and students are going to learn lots of things that are critical to their lives—but [that test] is really going to be about who ends up living a more independent lifestyle in a less restrictive environment and whether or not they’re gainfully employed.”

At River Terrace, the ingredients that Carter and Kardos highlighted as key to a transition program’s success seem to be coming together. The school has a deliberate curriculum. The students are doing real work; they’re paid. Parents seem engaged: The school has a thriving PTA that fundraises and helps organize movie screenings at the school’s outdoor amphitheatre.

And, the respective employers, along with D.C.’s Rehabilitation Services Agency, have bought into the program. Groundworks Anacostia—a nonprofit that focuses on environmental restoration and partners with students in the horticulture track, training them how to do things like grow seedlings and maintain fish traps—even showcases the partnership on its website and encourages other community organizations to participate in River Terrace’s career fair.

Even though the company doesn’t pay the students’ salaries, Embassy Suites treats the students like actual employees, Hollingsworth said. And ultimately, students like Washington and Napper and Bland are at River Terrace because they want to be there. “It comes down to having choice and not having that decision [to enroll in the school] being made based on your disability or your IQ score,” Kardos said.

Still, despite all that, the school’s end-of-the-year results demonstrate just how tricky transition planning remains. Less than half of the students who enrolled in the workforce center this past year are graduating, and only five have landed jobs so far. The school year ends in just a few days.

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This article is part of our Next America: Higher Education project, which is supported by grants from the Bill & Melinda Gates Foundation and Lumina Foundation.