ERIC/OSEP Topical Brief 2002
ERIC/OSEP TOPICAL BRIEF-SEPTEMBER 2002
Full-Service Schools' Potential for Special Education
Children's learning directly benefits from adequate social services and suffers when such services are not forthcoming. If the schools are to be held accountable for students' academic achievement and preparation for the workplace, they have a vested interest in other factors that impact learning. School Board Association, 1991
In order to benefit from school, a large number of children with risk characteristics their families health, social services, and other supports. In some cases, children may have multiple and/or complex needs that require comprehensive approaches that effectively link the school, home, and community. This is particularly true for children with disabilities, whose families often have disproportionately greater needs than families in the general population (Newman, 1997).
One relatively new approach that shows promise for addressing the complex needs of children and their families is full-service schools. During the early 1990s, the concept of full-service schools gained momentum in education and social reform movements as a promising approach for providing integrated, comprehensive, and intensive services to children and their families. Full-service schools have been described as a one-stop center at which educational, physical, psychological, and social requirements of students and their families are addressed in a coordinated, collaborative manner using school and community services and supports (Dryfoos, 1994).
For the most part, full-service school programs heretofore have been designed for at-risk children programs spanning different levels of intervention including prevention, early after-onset intervention, and treatment for severe and chronic problems. While students with disabilities may access these services, the potential of this approach for them is only beginning to become apparent.
This ERIC/OSEP Topical Brief examines the concept of full-service schools and considers how students with disabilities may interface with them, and ultimately benefit. To this end, the topical brief addresses the following questions:
Why Full-Service Schools: Addressing the Need
Increasingly, children are coming to school with a myriad of risk characteristics that interfere with or impede their learning. For the 70.2 million children under the age of 18 living in the United States, consider the following statistics (Federal Interagency Forum on Child and Family Statistics, 2000):
Persistent, often severe and enduring stressors are the backdrop from which serious emotional disturbances can arise, distracting children from their schoolwork and impeding their abilities to learn (Fox, Rubin, & Leone, 1994). Children with disabilities may be even more at risk, given that they are disproportionately poor, more likely to live in single-parent families, more likely to live in families whose head of household is not a high school graduate, and more likely to be victims of abuse or neglect in comparison to children in the general population (Crosse, Kaye, & Ratnofsky, 1993; Wagner et al., 1993).
Educators have long known that children who are hungry and undernourished, who fear for their safety in neighborhoods and homes, or who have unmet health or mental health needs will find it difficult to devote 100 percent of their attention to classroom learning. Without intervention, many of these children will develop educational and other difficulties that can negatively affect their long-term outcomes for later school and post-school success.
The provision of integrated services within school settings represents a promising trend that has the potential for helping students stay in school, where they are afforded the opportunity to learn to high standards (Wagner et al., 1994). Consider just a few of the positive results found in research studies:
The available data suggest that full-service schools have the potential to promote a better interface of school and human service systems, increase service use, and positively affect developmental outcomes for children living in high-risk situations (Adelman & Taylor, 1997; McMahon et al., 1999; Zigler et al., 1997). From a prevention perspective, full-service schools hold promise for reducing the escalation of problems in severity and intensity, as school personnel-who see students on a daily basis-have direct access to help when they need it. In addition, full-service schools may offer the potential for delivery of more intensive, integrated services to special education students in a natural and accessible setting-the neighborhood school.
What is a Full-Service School?
Full-service schools represent an effort to make human service systems partners in the educational process, while simultaneously making school systems partners in the delivery of human services. (Adelman & Taylor, 1999). Full-service schools are one model of school-linked services. In this model, schools house a variety of health, mental health, and other services for children and their families.
Housing services on school grounds alleviates many of the problems that interfere with families obtaining services for their children (e.g., no transportation, lack of understanding in how to navigate the public health and social service systems, inability to take time away from work, and no health insurance). While the type of services offered by full-service schools vary programs spanning different levels of intervention including prevention, early after-onset intervention, and treatment for severe and chronic problems hold in common the delivery of services on or near the school grounds. [Figure 1 presents examples of services.] Services are provided to children and their families through a collaboration between the school, agencies, and the families. Schools are among the central participants in planning and governing service design and delivery.
Prevention of the development of disabling conditions
A full-service school is a school that has broadened its mission and vision to meet the needs of all of its students by providing integrated services, mental health, social and/or human services, and other services are beneficial to meeting the needs of children and their families on school grounds or in locations that are easily accessible. Full-service schools also provide the types of prevention, treatment, and support services children and families need to succeed, including education, health care, transportation, job training, child care, housing, employment, and social services (Dryfoos, 1994). By meeting the noncurricular needs of children and families, the full-service school helps to ensure that learning will happen for all students in the school (Kronick, 2000).
In short, full-service schools encompass both quality education and comprehensive, integrated support services. Integration does not typically mean the merger of these service systems but rather increased collaboration among them. School, agency, community personnel, and families have common and shared goals and participate in joint decision making. Partners design comprehensive strategies to bring together a range of resources to strengthen families and promote the healthy physical, social, emotional, and cognitive development of children. Figure 2 presents a summary of key features found in full-service schools.
There are a variety of ways to describe full-service schools (Dryfoos, 1994), but all have similar features. These include
The Relationship of Full-Service Schools to Special Education
While there has been some research on the effectiveness of school-linked services in general and full-service schools in particular for the general population, little is known about these models and special education (Blackorby et al., 1997; Blackorby et al., 1998; Wagner et al., 1994). The literature base that is emerging ties the concept of full-service school to the following areas of need:
An Established Context in Special Education for Providing Comprehensive Services
The concept of full-service school underscores the importance of understanding and addressing community resources and supports in the design of systems of support for children, families, and schools. (Salisbury & Dunst, 1997). Providing comprehensive services is not a new concept in special education, as evidenced by the following:
Further, the concept of bringing comprehensive services to the child is a familiar one in special education. For example, it has long been established that children with emotional disturbance typically require multiple, comprehensive services. The National Agenda for Children and Youth with Serious Emotional Disturbance (U.S. Department of Education, 1994) called for the coordination among the numerous agencies, mental health, health, substance abuse, welfare, youth services, correctional, and vocational agencies services being brought to the child's environment. Schools were considered good places to base an integrated service system for children with emotional disturbance and behavioral problems because
IDEA supports the need to bring comprehensive services to children with its assertion that special education is not a place, but rather a service. The concept and structure of full-service schools fits within the special education agenda of integrating comprehensive services in educational contexts, and of bringing the services to the child.
A Look at Full-Service Schools Serving Students with Disabilities
During the last decade, the U.S. Department of Education's Office of Special Education Programs (OSEP) has funded several projects to investigate the status of school-linked service models, including full-service schools, in serving students with disabilities. The following project descriptions represent an emerging knowledge base on the state of practice.
SRI Looks at Participation of Students with Disabilities in California Statewide Initiative California's Healthy Start program, a state program designed to integrate services near or at school settings, provided the context for researchers at SRI International to evaluate system issues, service issues, and family outcomes related to providing school-linked services. Authorized by the Healthy Start Support Services for Children Act (SB 620), the initiative provides grants to local education agencies, working in collaboration with other public and private community organizations, to develop or expand existing efforts to provide comprehensive, integrated school-linked services. No single model of Healthy Start is defined in the state law or regulations. Some local initiatives center around school-based or school-linked health clinics as a way to bring health and mental health services to students. Others emphasize other parental support activities. As such, goals vary widely and include meeting a variety of needs, including health, mental health, family functioning, employment, and basic family household needs. Figure 3 is an example of a program.
The Healthy Start site is a resource center that is operated on the grounds of an elementary school. The school serves an ethnically diverse, highly mobile, and economically impoverished population of 700 children (45 percent Hispanic, 34 percent Asian-American, 14 percent Caucasian, 6 percent African American, and 1 percent Native American). The center houses a mental health clinician's office, 2 dental facilities, 3 medical examination rooms, a medical records room, a dental laboratory, a billing work station, a work station for the neighborhood services worker, a conference room, a waiting room, storage area, two restrooms, and a project coordinator's office. Originally, services were available only to students and families associated with the school, but later they were made available to the entire community.
The resource center accepts Medi-Cal and private insurance. Uninsured individuals pay on a sliding scale. Many medical, dental, and mental health services are available at the center. Following are examples:
Acknowledging the fact that almost nothing is known about the involvement and impacts for students with disabilities, their families, and their teachers, SRI researchers conducted a multi-site analysis of systems, services, and outcomes in school-based programs in California (Blackorby, Newman, & Finnegan, 1997; Blackorby, Newman, & Finnegan, 1998; Lopez, Blackorby, & Newman, 1996; Newman, 1997). Following are selected findings:
Overall, researchers concluded that the findings presented a picture of special education teachers as being linked to their schools' school-linked services programs. They stressed the importance of locating the integrated services program on school grounds--those teachers who were affiliated with school-based programs reported being more closely linked to the program and program staff, being better informed about the offerings, being involved in the planning, collaborating to a greater extent with service staff (e.g., attendance at IEP meetings, more feedback from referrals), having more favorable views of the impact of the program on students, and being willing to give up resources to keep the program funded.
Researchers also interviewed families of children with disabilities regarding their involvement and satisfaction levels with the school-linked program at their school. Families of special education students were less likely to go to the school center than families of general education students. Of those families who had received services, the majority found the services to be easily accessible and of high quality.
Based on their work, researchers offered the following recommendations for research:
Researchers also offered the following recommendations for practice:
University of Maryland
In 1995, researchers Nathan Fox, Peter Leone, Ken Rubin, and Jennifer Oppenheim at the University of Maryland received funding to replicate and evaluate Linkages to Learning, a model for the delivery of school-based mental health, health, and social services (Fox, Leone, Rubin, Oppenheim, Miller, & Friedman, 1999). The model was designed to provide prevention and early intervention services to children at risk for developing emotional and behavior disorders.
The Linkages to Learning model was developed as the result of a 1991 resolution calling for increased attention to the mental health and social service needs of at-risk children and their families (Leone, Lane, Arllen, & Peter, 1996). The resolution called for services to be both school-based and collaborative. A partnership developed between the school district, county department of health and human services, and a number of private agencies serving children and families. The partners in this initiative set as their goal the reduction of social, emotional, and somatic health problems that interfere with children's abilities to succeed in school, at home, and in the community.
The school and the community are involved in initial and ongoing needs assessments to determine the needs that must be addressed if children are to succeed. The core services offered are found in Figure 4.
Researchers selected an elementary school site for replication. The school served children in kindergarten through fifth grade, with both Head Start and day care programs on-site. Two self-contained special education classrooms were located in the building. The student body is culturally diverse, representing over 40 nations and 10 languages. Roughly 75 percent of parents are recent immigrants from Central America, Southeast Asia, Africa, and the Caribbean. The ethnic composition of the student population was 55 percent Hispanic, 27 percent African American, 18 percent Asian American, and 1 percent Caucasian. More than 90 percent of the students were eligible for free and reduced price meals.
A series of repeated measures analyses of variance was completed on data collected from three different sources: primary caregivers, teachers, and children. Analyses compared differences in the average scores between children in the target school and control school, and differences among children in the target school who did or did not receive services through the program. Key findings for children and their families in the target school follow:
University of Miami: A Look at the Relationship of Full-Service Schools To Prevention of Serious Emotional Disturbance
The term full-service school was first used in 1991 when the Florida legislature provided funding to support a system of interagency collaboration with mandates to make a comprehensive package of human services available in school buildings. This move represented a policy trend by the state to integrate services near or at school sites. Full-service schools receive funds from the statewide Full Service School (FSS) program.
Researchers Marjorie Montague and Anne Hocutt at the University of Miami looked at full-service schools from the perspective of prevention of the development of emotional disturbance. They studied two full-service schools in urban districts in the state of Florida.
One school served predominantly Hispanic children (70 percent) while the other served predominantly African American children (72 percent). Approximately 12 percent of the students in each school were served in special education classes. The schools were selected because they had a large proportion of children with the additional risk factor of poverty and likely eligibility for Medicaid.
Both schools had state funded clinic buildings on school grounds that housed the service providers. Both schools offered health services; one offered additional services (mental health, legal, dental, child care, and daily living assistance such as clothing and rent support). Some mental health (counseling, individual and group therapy, case management) services were not co-located on school grounds.
An important focus of the study was a qualitative investigation of the facilitators and barriers to service access and utilization with the full-service school approach for children at risk for emotional disturbance. Overall, locating the services on school grounds resulted in greater access and utilization. School level facilitators included
However, the lack of funding for services required by students became a barrier to carrying out the prevention goal. For many students with serious risk factors, it was determined that case management and therapeutic services were required, but funding was inadequate to provide them. A summary of key findings related to this issue follow (Hocutt, Montague, & McKinney, 2000):
In summary, researchers concluded that, given present regulatory requirements, Medicaid and managed care were not viable funding sources in the prevention of the development of serious mental health problems. By eligibility requirements focusing on those with serious impairments, limiting delivery of other services, and decreasing contacts between providers and families, managed care was not a viable financial structure for supporting prevention of the development of emotional disturbance.
Implications for Policy and Practice
Full-service schools hold promise for addressing the needs of children in special education in the following ways:
The concept of full-service schools fits with the trend in special education to form interagency and family collaborations and to integrate comprehensive services into the student's educational program.
While it is too early to tell if full-service schools will prove beneficial in addressing the needs faced by children with disabilities and their families, the theory suggests the potential for improving their educational results. More research is needed to explore specific features of how students with disabilities may be served in full-service school models. In addition, research is needed that addresses the variety of implementation issues (e.g., funding, forming collaborative partnerships, eligibility for services, and interfacing classroom staff with service providers) that affect delivery of services.
For Further Information
Marjorie Montague, Anne Hocutt
Lynn Newman, Jose Blackorby
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