Thoughts on The Line Between Health and Education

Experience soon teaches us that we learn better when we are physically and mentally well; we all have experienced the flu, or extreme stress or depression, something that made us perform well below our capacity. This truth is recognised within mainstream education, where marks in exams can be altered or ignored to take into account such mental or physical illnesses. But that simple life lesson seems to be forgotten by the public, when it comes to acknowledging and addressing the needs to special-needs children within the education system.

Children with special needs frequently have health issues that far exceed those of non-special-needs children. Sometimes those health issues are an integral part of the child’s special needs, sometimes they are more indirect results of the special needs. For example, my son is not physically or mentally sick, but his autism frequently causes high anxieties and interferes with his ability to learn and perform basic self-care skills, so he needs higher levels of assistance than the average student, in order to just be able to attend a class-room and follow a lesson. If he is receiving adequate assistance, he is better able to learn (or able to learn at all). For other children with special needs, the health needs can be more extreme and obvious, such as those who simply cannot feed themselves or who pose a frequent physical danger to themselves if not adequately monitored.

Just like mainstream children, a contagious or serious illness will mean they’re kept home from school. But the mere fact of having higher and on-going health needs can’t be a reason to keep them home from school, else they’d never attend school at all. Which is what some members of the public strongly feel should be the case.

Today I was reading a public forum discussion where a number of people were arguing that special-needs children who spend a lot of their time at school having basic health needs addressed, shouldn’t be at school at all. That services like physiotherapy and occupational therapy should not be part of any school’s function; that they have nothing to do with an education system and should be done at home or at a hospital. Some of these people were expressly calling special-needs schools “baby-sitting services;” places where children don’t learn anything because of their high health needs, so would be better off never coming to school in the first place. This discussion took place within the broader topic of the closing down of various residential special needs schools here in New Zealand.

The up-shot of saying education and health should never mix, is the denial of an education to children like my son, and to potentially all special-needs children. My son would be at home or at various government health institutions for these therapies, a fair chunk of the week, obviously and necessarily impacting on this education. I can imagine some responding that isn’t this what is essentially happening anyway; that his education at school is side-lined to attend his health needs. The answer is no: Within the special-needs school that he attends, his therapies are coordinated fully into his learning program. They tie the skills and assistance they give him, into speech goals, physical education goals, social goals, maths goals. The integration of all services being provided through the single institution, provides coherence and focus that couldn’t be achieved if all these therapies were separated out from his education. Because they are performed through the same institution, the school also has that immediate and meaningful understanding of how his health is directly impacting on his learning. He is treated as a whole individual, not as a grouping of separate issues dealt with in an isolated and unconnected manner.

This often artificial distinction between health and education – and the problems that arise from their separation – was obvious to me from the Early Intervention point with my son, prior to school. Back then he had a speech therapist, educational psychologist and support worker through the Ministry of Education, and an occupational therapist, physiotherapist and carer support hours, provided from the Ministry of Health . The various professionals and organisation attempted to organise themselves with each other, but there were frequent times that the lack of co-ordination meant conflicting goals and expectations that I had to work hard to smooth over and co-ordinate myself, which would at times make me appear to be a “difficult parent” as I argued with various therapists about what they were doing and how it was impacting on other services he was receiving. I recognise why my son’s services were provided in this manner – that he has complex needs that required various professionals – but the consequences of approaching his care in this diverse manner were not good, for him or for me as his primary care-giver.

I do understand the arguments against combining health needs part-in-parcel with education needs, and I understand why we have split Ministries at a government level to that end. But I think it is important to recognise that the distinction will often be unhelpful, and that if we insist that they not mix, then we are effectively arguing that children with special needs don’t have a right to the education that other children do, simply by virtue of their special needs. If we are going to tell parents to keep their children at home or in the hospital – and out of the school – we are socially isolating our children and negatively impacting on their general development. We all know that we need good mental and physical health to be able to learn, but this simple important truth is inconvenient and “too expensive” when it comes to our most vulnerable citizens.  If that is the case, then the government – and society – needs to change; it is not our special needs children who are falling short, it is the “mainstreamed” adults in positions of power and influence, who are failing them.

I expect much of what I discuss in this post is addressed in teacher-training institutions, especially training institutions for those who will interact with our special needs children. I haven’t been through any such course. If you have, or otherwise have insights of the relationship between health and education, I would love to hear from you. This post is just the musings of a frustrated parent trying to make sense of a world that doesn’t seem to want children like my own, to get an education.

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4 Responses to Thoughts on The Line Between Health and Education

  1. Joanne says:

    While it has been a long time since I went through under-grad teacher preparation courses here in the U.S., I remember discussing factors such as this. In my own classroom, I could point to data that I keep from benchmark tests that we do three times a year. One student in particular came in on a testing day with a horrible head cold. His scores on that test were almost half of how he normally performed. Just for a little background, I teach 11-14 year olds in a low-income, racially diverse school just outside Chicago. My students are all English Language Learners and half of them have been identified as “Special Education” with diagnoses as varied as Cerebral Palsy, Autism, Severe ADHD, and “invisible seizures.”

    In a quick search of online articles on the correlation between health and educational performance, I found the following:

    From the National Poverty Center:

    From the Centers for Disease Control:

    From the National Bureau of Economic Research :

    and from the Children’s Health Fund:

    An abstract on a study of Oral Health and School Performance by University of North Carolina, Chapel Hill

    And a longitudinal study of Child Health and School Enrollment

    All these articles, on a quick perusal back the fact that the health of a child affects their school peformance.

    The University where I attended for my Bachelor’s in Education has philosophy entitled “Realizing the Democratic Ideal.” This ideal is not only for how it prepares educators, but this ideal has influenced my own philosophy as an educator. While I agree with all of this ideal, two of the committments still ring especially true and strong for me: “Knowledge and appreciation of the diversity among learners” and “Understanding of the factors that affect learning and appropriate teaching strategies.”

    While I can’t answer to why some people feel the need to keep anyone but the “normal” student out of classrooms, I can say that your instincts as a parent align with all of the research that I have found, and with the experiences that I have had as an educator.

  2. Jim Reeve says:

    I too would like to see the health care side interact with the school side more. We as parents, have so much to do as we raise our special needs children. And acting as a liason between the two can be a bit exhausting. I don’t mind doing it, but I’d sure like it if they were always on the same page.

  3. momtuition says:

    Hi, I agree with you. It needs to be a holistic approach to education.

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