A content analysis of policies and procedures for serving children with special school health needs in early education environments

Children with special school healthcare needs (CSSHN) are entering early education environments with increasing frequency. Advances in medical technology and interest in providing early education in least restrictive environments are cited as the reasons for the phenomenon. Most often, full-time nurses are not available in such settings to care for the needs of children with medical complexities. And yet, case law dictates that the delivery of nursing services is indeed the responsibility of the local education agency and, furthermore, that such nursing services do not need to be related to a special education program in order to be provided (Diaz, 2000). This case law, coupled with a current overall shortage of school nurses, results in a certain conundrum for early educators (Barrett, 2000).Via this research, policies and procedures were gathered from early intervention service providers across the Commonwealth of Pennsylvania revealing the extent to which agencies have formalized planning for supports and services to CSSHN. The text from the policies and procedures was coded and analyzed to reveal the elements of service delivery to Children with Special School Health Needs (CSSHN) receiving early childhood special education (ECSE). The study concludes with a suggested framework for practice in serving CSSHN.Literature is reviewed about the attitudes of teachers and other personnel, the delegation of nursing duties to unlicensed assistive personnel (UAP), and the needs of school entities and staff members in serving this population of children. Taken together, the studies indicate that the body of knowledge is growing about how to best serve children with such needs and that further study is needed to keep pace with medical advances that enable increasing numbers of children to access least restrictive environments.