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PubMed2006

A comparison of mainstream and special education for teenagers with Down syndrome: implications for parents and teachers.

This article presents data from a research study designed to compare the achievements of teenagers with Down syndrome educated in mainstream classrooms or in special education classrooms throughout their full-time education. Progress is reported for speech and language, literacy, socialisation, daily living skills and behaviour. For all the teenagers, there is evidence of progress with age on all the measures except for communication. Communication continued to improve through teenage years for the included children but not for those in special education classrooms. There were no significant differences in overall outcomes for daily living skills or socialisation. However, there were large significant gains in expressive language and literacy skills for those educated in mainstream classrooms. Teenagers educated in mainstream classrooms showed fewer behavioural difficulties. Further, comparison with data published by these authors in an earlier study, showed no improvements in school achievements in special education over a 13 year period in the UK (1986-1999).

Activities of Daily Living↗
PubMed2004

Bringing holism into mainstream biomedical education.

Introducing holism and complementary medicine into mainstream medical education provides many scientific, philosophical, and personal challenges. The growth of new knowledge always necessitates venturing into areas, which are, by definition, unknown, hence arise potential clashes of ideology, knowledge, evidence, interpretation, language, and personality. This paper outlines some of the experience and progress made at Monash University Victoria, Australia, in teaching this material in undergraduate medical education. The Monash medical course has always been known for its commitment to an integrated curriculum, a holistic perspective, and the personal development of its students. Some of the points of integration in the core curriculum already achieved include health enhancement and mindfulness-based stress management programs right from first year, lectures and forums on complementary medicine, integration of this material into weekly case-based teaching, and health promotion and mind-body medicine. For very interested students, electives provide an opportunity to explore subjects in more depth. Experience has taught us that it is as important to learn how to deliver the message as it is to refine its content. This presents challenges that are as much personal as they are intellectual. Areas of particular importance are the academic environment, language, diplomacy, style, relevance, and evidence. In this process, building relationships, collegiality, patience, objectivity, impartiality, and humor are helpful.

Academic Medical Centers↗
PubMed2006

Mainstreaming interprofessional education in the United Kingdom: a position paper.

Interprofessional education (IPE) is being built into the mainstream of professional education for all health and social care professions throughout the United Kingdom (UK) driven by the Labour Government elected in 1997, coincidentally the year that this Journal hosted the first All Together Better Health conference in London. The incoming government prioritized pre-qualifying IPE to be provided in partnership by universities and service agencies supported regionally by workforce development confederations, later absorbed into strategic health authorities (SHAs), and centrally by educational, professional and regulatory bodies. Ambitious agenda for pre-qualifying IPE set by government are being tempered by realistic assessment of current outcomes borne of experience and corroborated by evidence. This paper suggests some ways to ease constraints and improve outcomes, but emphasizes the need to generate continuing interprofessional learning opportunities that build on the basics. It argues that accumulating experience and evidence must be brought to bear in formulating criteria for the approval and review of IPE within regulatory systems for professional education. Can IPE be sustained within mainstream professional education once initial enthusiasm ebbs and earmarked funds run dry? That is the issue.

Health Personnel↗
PubMed1990

Modifications of speech language levels by preservice educators based on language features.

Increased efforts to mainstream handicapped learners have been accompanied by a growing concern for the ability of mainstream educators to accommodate the special needs of these students. A particular concern involves the ability of mainstream educators to adjust their levels of spoken language when conversing with hearing-impaired learners. The present study compared the language levels produced by preservice educators with either high or low levels of previous experience with hearing-impaired individuals. Results indicated that (1) neither group adjusted their spoken language to levels understood by two hearing-impaired women and (2) members of the high experience group produced higher language levels than members of the low experience group. Discussion of these results focuses on implications for interactions with hearing-impaired learners.

Adult↗
PubMed1982

Differential influence of various instructional factors on self-concepts of handicapped and non-handicapped children in mainstreamed physical education classes.

The purpose of this study was to determine the differential influence of students' expression of effort, school, teachers' expectations, sex, being handicapped/non-handicapped, grade, teachers, and race on self-concept of 28 handicapped and 108 non-handicapped children in mainstreamed physical education classes (K-3). The Martinek-Zaichkowsky Self-concept Scale measured self-concept and two unpublished tests were used to test students' expression of effort and teachers' expectations. A stepwise multiple regression technique was applied to self-concept to determine the comparative influence of the eight independent variables. Data analysis showed that three of the independent variables contributed significantly to the variability of self-concept. Students' expression of effort had the strongest influence followed by school and teachers' expectation of students' ability to reason.

Child↗
PubMed1992

Curriculum at the Scholl College. Toward mainstream medical education.

The Dr. William M. Scholl College of Podiatric Medicine in Chicago recently affiliated with a teaching hospital, the Illinois Masonic Medical Center, and used this alliance as a catalyst to effect a change in the clinical curriculum. The affiliation set up a joint venture to operate two clinics, one on Scholl College's traditional campus and one at the teaching hospital. At the hospital site, Scholl College students rotate through clinical externships in areas such as internal medicine, emergency medicine, and podiatric elective; podiatric and general medical residents assist in the tutelage of the students. At the Scholl College campus, beginning clinical students learn basic skills in a teaching clinic, then refine and further their skills in a comprehensive clinic under the guidance of faculty members. The faculty and administration at Scholl College have embraced the concept of mainstream medical education, and are striving to prepare podiatric physicians to practice 21st century medicine.

Chicago↗
PubMed1996

The relation between neonatal thyroxine levels and neurodevelopmental outcome at age 5 and 9 years in a national cohort of very preterm and/or very low birth weight infants.

Transient neonatal hypothyroxinemia is very common in preterm infants. The literature on the effect of this hypothyroxinemia is, however, controversial, and large or long-term follow-up studies are not available. In a nationwide prospective follow-up study on very preterm and (or) very low birth weight infants (n = 717), we studied the relationship between thyroxine levels in the 1st wk of life and neurodevelopmental outcome at 5 y of age and school performance at 9 y of age. Thyroxine concentrations from filter paper eluates were determined in 717 infants: 32% had levels of more than 3 SD below the mean (< 60 nmol/L). The percentage of infants with such low levels increased with decreasing gestational age. At the age of 5 y, 96% of survivors (n = 640) were available for extensive neurodevelopmental examination: 85 (13.3%) had a disability and 92 (14.3%) a handicap. At the age of 9 y, 83% of survivors (n = 552) answered a questionnaire on school performance: 300 (54.3%) were in mainstream education in a grade appropriate for age, 151 (27%) were in mainstream education with grade retention, and 101 (18.3%) were in special education. Both neurologic dysfunction at age 5 y and school failure at age 9 y were significantly related to lower neonatal thyroxine levels even after adjustment for other perinatal factors (odds ratio, 1.3). Whether this relationship is causal should be investigated. If a causal relationship exists, substitution therapy may at least partially prevent neurologic dysfunction and learning disabilities, both common sequelae of very preterm birth.

Birth Weight↗
PubMed1994

School performance at nine years of age in very premature and very low birth weight infants: perinatal risk factors and predictors at five years of age. Collaborative Project on Preterm and Small for Gestational Age (POPS) Infants in The Netherlands.

To assess the impact of both perinatal disorders and developmental problems identified at preschool age on school performance, we followed a virtually complete birth cohort of very premature (< 32 completed weeks of gestation) and very low birth weight infants until they were 9 years of age. In 84% of the survivors (n = 813), data on school performance were available for analysis. At the age of 9 years, 19% of the children were in special education. Of the children in mainstream education, 32% were in a grade below the appropriate level for age and 38% had special assistance. After correction for other perinatal items, children of low socioeconomic status and boys had significantly higher adjusted odds ratios for special education. Logistic regression with a perinatal and a 5-year time category showed that the most predictive factors for special education were developmental delay, neuromotor and speech/language function, inattention and hyperactivity score, total problem score, and reported school results at the age of 5 years. When children with disabilities were left out of the analysis, the importance of neuromotor function and total problem score disappeared. Increased risks of any school failure in nondisabled children included mild or severe developmental delay and marginal or poor school performance at the age of 5 years. Long-term follow-up with specific attention to these predictors at 5 years of age, although time-consuming, is necessary.

Birth Weight↗
PubMed1981

Correlates of class rank of high school handicapped students in mainstream vocational education programs.

This study examined the relationship between performance in a training program (class rank) and intelligence-skills (Purdue Pegboard, Weschler, a work-behavior rating scale) for a group of handicapped students "mainstreamed" into two regular vocational-technical high school programs IQ type of disability, work-personal behaviors ratings and prior academic achievement were found to be predictors of class rank.

Achievement↗
PubMed1998

Educational placement of deaf children following cochlear implantation.

This study examined the educational placements, before cochlear implantation, of 121 deaf children, and the educational placements, two years after implantation, of the 48 children who had reached that stage, looking at the influence of age at implantation and duration of deafness on the placement of these children. In addition, it compared the educational placements of those given implants prior to schooling, and those given implants when already in an educational setting. Categories used were pre-school, school for the deaf, unit or resource base within a mainstream school and full-time mainstream provision. Age at implantation and duration of deafness were found to be significant predictors of placement two years after implantation. The duration of deafness of children in schools for the deaf or units was twice that of children in mainstream education. Fifty-three per cent of children who were in pre-school at the time of implantation were in mainstream schools two years after implantation, whereas only 6% of those who were already in educational placements at the time of implantation were in mainstream education. This difference was statistically significant. The results indicate that children who are given implants early, before an educational decision has been made, are more likely to go to mainstream schools than those given implants when already in an educational setting.

Adolescent↗
PubMed1985

Self-labeling by educably mentally retarded high school students in their mainstream and special education classes.

Educably mentally retarded (EMR) students and nonhandicapped students from their mainstream classes completed semantic differential ratings of a stereotypic popular teen-ager, juvenile delinquent, and special education student. Subjects also rated their global self-concepts and situation-specific self-concepts within the mainstream and the special class settings. Ratings were done at the beginning (Time 1) and the end (Time 2) of a semester. Results showed that mainstream classes did not "de-label" EMR students. Within the mainstream class, the number of EMR students who saw themselves as similar to a special education student significantly increased over time. Moreover, at Time 2, EMR students were more likely to think of themselves as similar to a special education student in their mainstream class than in their special education class. However, EMR subjects' global self-concepts did not change. Implications for mainstreaming are discussed.

Adolescent↗
PubMed2003

Epilepsy in mainstream and special educational primary school settings.

This population based study compared the prevalence, nature and management of epilepsy between primary school children in mainstream education and those attending a special educational placement (children with special needs). The overall prevalence of epilepsy was 4.3/1000, but was 30 times higher in children with special needs, many of whom also had severe physical disabilities. Seizure types and the proportion of subjects with multiple seizures were similar in mainstream children and those with special needs. Epilepsy syndromes were identified in 74% of children. Although seizures were better controlled in children at mainstream school, 44% of these children did not have well controlled seizures. Children with epilepsy are an educationally vulnerable group and both education and health staff need to be aware of the additional support that many of these children require in all types of primary educational settings.

Child↗
PubMed2000

The story of naturopathic education in Australia.

Early naturopaths in Australia learned their skills via a loose combination of self-education and an apprenticeship-style system. Naturopathic education developed gradually and outside mainstream education until the last decade. Now it has formalized to include university training. These changes in education are paralleled by dramatic increases in popularity in the practice of natural medicine. Legislative changes regarding the provision of higher education by private institutions, plus the popular acceptance of natural medicine in the last decade, have led to the current situation where degrees are available to naturopath via a number of different pathways.

Australia↗
PubMedDate not supplied

School reentry and the child with a chronic illness: the role of the pediatric nurse practitioner.

Being attentive to the educational needs of chronically ill children is a relatively recent development in American education. Advances in medical sciences that have improved survival rates for some conditions and increased public acceptance of people who are different or disabled and legislation that has established education as an entitlement for all children have allowed for the entrance of many chronically ill children into mainstream education. Successful school reentry is essential if the child is to develop normally, in terms of intellect, social skills, and peer relationships. Caregivers must not lose sight of the fact that school provides opportunities for social, emotional, and cognitive development. Thus the pediatric nurse practitioner can promote the benefits gained from schooling in numerous ways and provide the child, family, and school personnel with the support and information needed for a smooth transition back into the school system.

Child↗