Managing and Preventing Chronic Health Problems in Children and Youth: School Psychology's Expanded Mission

How physicians support children with disabilities and their families: Roles, responsibilities and collaborative partnerships

BACKGROUND

The American Association of Pediatricians (AAP), in collaboration with the Council for Children with Disabilities and the Council on School Health, recommends that physicians learn special education law and practices in order to increase their ability to work with schools to support children with disabilities and their families. However, there is limited research that examines how doctors perceive their role as collaborators with families and school personnel.

OBJECTIVE

The purpose of this study was to explore the perceptions and collaborative experiences of doctors treating children with disabilities in order to develop an initial understanding of how doctors collaborate within the doctor/family/school triad.

METHOD

Semi-structured interviews with doctors (n = 13) from two states in the North Eastern United States were collected and analyzed using grounded theory methodology. Doctor specialty areas included general pediatrics, developmental pediatrics, rehabilitation pediatrics, and neurology.

RESULTS

Analysis of the data revealed four key categories: (a) what doctors do with regard to children with disabilities and schools, (b) elements that interfere with doctor/family/school collaboration, (c) what doctors know and understand about topics related to special education, and (d) how doctors learned about topics related to special education. Doctors disclosed they learned about these topics through mentorship and on-the job training, not formally during medical school or residency.

CONCLUSIONS

This research presents powerful evidence in support of a paradigm shift with regard to infusing a focus on doctor/family/school collaboration for children with disabilities into the medical school curriculum.

Adolescent chronic pain problems in the school setting: exploring the experiences and beliefs of selected school personnel through focus group methodology

PURPOSE

To systematically analyze school personnel's understanding of adolescent chronic pain problems and to learn how healthcare and school systems can collaborate more effectively to address these problems.

METHODS

Focus group methodology was employed in middle- and high-school settings. Five groups, comprised of 38 schoolteachers, administrators, school nurses, and guidance/mental health staff participated.

RESULTS

Transcript analyses indicate that focus group members cited many challenges related to working with adolescents with pain in school (including high absence rates, wide individual variation in presentation of symptoms and impairment, the need to balance accommodations with school policies, attending to the needs of other students, and dealing with parents) and identified needs for more information about chronic pain problems and more guidance from healthcare professionals regarding how to manage pain symptoms and pain-related behaviors in the school setting.

CONCLUSIONS

Results indicate that school personnel struggle when they encounter chronic pain problems in the school setting and feel inadequately educated about how to work effectively with students with chronic pain. Improved collaboration between healthcare and school systems is needed and could increase school success (i.e., the ability to attend school and to perform to the best of one's abilities) for adolescents with chronic pain disorders.