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Medically Fragile Students and the Attendance Trap


Special education officials often complain about how the testing provisions of No Child Left Behind penalize schools with high numbers of students with disabilities, but the Washington Post had an interesting story on the front page today about a lesser-known problem: schools with high numbers of medically fragile students may get penalized under the law because their students don't meet the law's daily attendance standards.

Stephen Knolls School suffered the ignominy of failure under federal law in 2006 and 2007 for low test scores. This year, the Kensington school finally made the grade in reading and math -- only to be sanctioned for poor attendance.

The challenge in this case is not truancy. Stephen Knolls serves medically fragile children with severe physical and cognitive disabilities, such as cerebral palsy, spina bifida, and Rett syndrome.

One student missed 119 days of school last year because of illness. An 8th grade boy logged more than 80 absences before dying in January. When school health aides call home for routine matters, they take pains to begin each conversation by saying, "This is not an emergency," because parents generally prepare for the worst.

"We know that there are legitimate reasons for [students] to be home," said Tina Shrewsbury, school coordinator. "They're going to [medical] specialists. . . . They're having lab tests done. They're being hospitalized."

However, Stephen Knolls could be exempted from this rule, as a special education center. Its students could be counted, for NCLB purposes, at their "base" school. Montgomery County, Md., where this school is located, has chosen not to exercise this provision.
...Montgomery school officials say it would be disingenuous to pretend that Stephen Knolls students attended any other school. Many of them have never studied anywhere else. Montgomery officials say the school deserves credit for working hard against long odds to make academic progress.

"We're not looking to beat the system. We're just looking for some common sense to be applied to it," said Brian Edwards, chief of staff to Montgomery Schools Superintendent Jerry D. Weast.

This doesn't just happen to schools with a high population of medically fragile students. My colleague, David Hoff, recently wrote a short article about a Utah school that was facing similar sanctions because its student population, primarily Ute Indians, were missing class because of tribal obligations.


Really glad to see that they are recognizing the specialized medical and educational needs of this group. I knew a kid with Crohns whose family was getting hassled about attendance issues--and it hadn't occured to the district that the kid probably qualified for special educational services under "other medical condition." It does seem to me that there would be a way to write the IEP that would specify delivery of services (the LRE) to be inclusive of both home and school in recognition of the specific needs of specific kids. We put kids "on home instruction" for various other things (usually behavioral), why not do so for this group?

This is a complex situation. There is not really anyone at fault. The students cannot help that they have disabilities or are mentally fragile. And, the school system understands the children cannot do anything about it. But, the attendance record is still being affected. It would a whole lot easier if the county would recognize Stephen Knolls as a special education center. That could make it where the school system is not so affected by the attendance of the children with disabilities.

I agree that this issue is both complex and delicate. The people designated by law to create the IEP for students with special needs are uniquely empowered to create an individualized plan. This means services for the whole child, and includes attendance. The team needs to expressly designate specialized attendance situations in the IEP. Easier said than done, I realize, with the conflicts created by the power struggle between NCLB and IDEA. As you can tell by my post, I support and participate in using the power of the IDEA to work on behalf of the whole child and family system.

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