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Focus on Student Health
At the intersection of special education and preventive mental
health programs
As
a child mental health advocate in New York State, Evelyn Frankford
stood at the sometimes turbulent intersection between family crises
and special education programs. Children whose behavior was affected
by family breakdowns were often placed in special education classes,
when support services and treatment could have been more effective. "The
practice was to place any students who 'acted out,' whatever the
reason, into special education," she says, "but many
of these children didn't need or benefit from special education.
Their behavior was treated as an education problem, but often the
acting out was a mental health problem made worse by family and
community conditions that affected the school."
The problem, from Frankford's perspective, was that schools were
treating special education as a cure-all for behavioral problems,
rather than part of a continuum of strategies to ensure that students
were psychologically prepared to learn. In New York, she was instrumental
in getting funding for preventive mental health programs at elementary
and middle schools. Now at EDC, Frankford works with colleagues
in EDC's Health and Human Development
Programs to promote prevention
and health promotion models on a national scale. The project she
directs, Making
Health Academic, develops and disseminates coordinated
school health and strong prevention strategies to administrators,
educators, and policymakers around the country.
"The research shows that prevention is a series of strategiesworking
with the school, working with families, working with the community," explains
Frankford. "You involve people in making decisions, you promote
healthy behaviors, and you ultimately create an environment that
is positive and supportive rather than one that leaves people alienated
and angry."
A Preventative Approach
Students with emotional disabilities present
a serious challenge to themselves, their families, and their schools.
As many as
a quarter of all American childrensome
10 millionare at risk of failure in school because of social, emotional,
and health handicaps. For many of these students, no help is available. For
those whose problems stem from mental or emotional disturbances, and are able
to access help, that help usually comes only from special education, which
may or may not be the appropriate intervention, either clinically or educationally.
"For poor, often minority children, special education has
meant a segregated environment. Even for middle-class families,
who can negotiate the system better, many kids with behavior problems
get labeled so they or their families can get services, when in
fact at least part of the response might be a more preventive,
social, environmental one," says Frankford. "That's the
strength of the preventive approach of coordinated school health
and the Making Health Academic project: It recognizes that school
is a whole, complex world that can change a student's educational
or mental health outcome."
Making Health
Academic builds on the link between a child's health
and his or her ability to learn. Project staff work with states
to overcome the failure of piecemeal efforts to improve children's
health, well-being, and academic success. The 1998 publication
Health is Academic: A Guide to Coordinated
School Health Programs (Teachers College Press), edited by EDC in conjunction with the
Centers for Disease Control (CDC), the Health Promotion Division
of Adolescent and School Health, and more than 300 professionals
from nearly 70 national organizations, contains the basic conceptual
framework for the current strategy.
Coordinated School Health
The Coordinated School Health
Programs movement, dating from the late 1980s, sees the schools
as "ground zero" in
children's health and developmentthe
most effective place to integrate children's learning, health, and well-being. "School
is the place where children are," says Frankford. "It's where we
can reach everybody."
Even as the school health movement has entered the mainstream,
so too has special education. Particularly following the 1997 amendments
to the Individuals with Disabilities Education Act, special education
has been recast as a vital and integral part of whole-school thinking,
learning, and reform. Frankford's emphasis is on prevention as
part of the continuum of care that should be available, but she
is clear that "once a child is diagnosed with a mental or
emotional illness, the schools have an important role in trying
to enable that child to function at his or her highest level."
An example, she says, of one of the innovations in the last 10
years has been to have a personal aide accompany a child with an
emotional disturbance: "You think of it when a child has a
physical disability, that that child might need a personal aide,
but a child with an emotional disturbance can function in a public
school with an aide, tooa person who constantly gives feedback
on behavior and what's required, and calms down an out-of-control
student or takes him or her out of the room."
Perhaps the most powerful case for effective prevention is the
argument, emphatically shared by Frankford, that well-constructed
prevention and early intervention strategies can deter a wide range
of behavioral and health problems. "Directives come down through
the chain of command: 'Do something about teen pregnancy, do something
about violence, do something about dropouts.' The fact is that
they all require the same intervention, which involves teaching
decision-making skills, providing services, changing the school
environment, and creating an opportunity for a kid to succeed.
There's no pregnancy prevention intervention that's different from
a dropout or substance abuse prevention intervention. It all comes
down to a comprehensive approach that supports children's functioning
at their highest possible levels," Frankford says.
For more information, contact Evelyn
Frankford.
For questions or comments, contact mosaic@edc.org.
Copyright 2000-2003
Education Development Center, Inc. All Rights Reserved.
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