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1.  Quantitative Deficits of Preschool Children at Risk for Mathematical Learning Disability 
The study tested the hypothesis that acuity of the potentially inherent approximate number system (ANS) contributes to risk of mathematical learning disability (MLD). Sixty-eight (35 boys) preschoolers at risk for school failure were assessed on a battery of quantitative tasks, and on intelligence, executive control, preliteracy skills, and parental education. Mathematics achievement scores at the end of 1 year of preschool indicated that 34 of these children were at high risk for MLD. Relative to the 34 typically achieving children, the at risk children were less accurate on the ANS task, and a one standard deviation deficit on this task resulted in a 2.4-fold increase in the odds of MLD status. The at risk children also had a poor understanding of ordinal relations, and had slower learning of Arabic numerals, number words, and their cardinal values. Poor performance on these tasks resulted in 3.6- to 4.5-fold increases in the odds of MLD status. The results provide some support for the ANS hypothesis but also suggest these deficits are not the primary source of poor mathematics learning.
PMCID: PMC3655274  PMID: 23720643
approximate number system; quantitative knowledge; mathematics achievement; learning disability; dyscalculia; Title I preschool; executive control
2.  Chaotic homes and school achievement: a twin study 
Chaotic homes predict poor school performance. Given that it is known that genes affect both children's experience of household chaos and their school achievement, to what extent is the relationship between high levels of noise and environmental confusion in the home, and children's school performance, mediated by heritable child effects? This is the first study to explore the genetic and environmental pathways between household chaos and academic performance.
Children's perceptions of family chaos at ages 9 and 12 and their school performance at age 12 were assessed in more than 2,300 twin pairs. The use of child-specific measures in a multivariate genetic analysis made it possible to investigate the genetic and environmental origins of the covariation between children's experience of chaos in the home and their school achievement.
Children's experience of family chaos and their school achievement were significantly correlated in the expected negative direction (r = −.26). As expected, shared environmental factors explained a large proportion (63%) of the association. However, genetic factors accounted for a significant proportion (37%) of the association between children's experience of household chaos and their school performance.
The association between chaotic homes and poor performance in school, previously assumed to be entirely environmental in origin, is in fact partly genetic. How children's home environment affects their academic achievement is not simply in the direction environment → child → outcome. Instead, genetic factors that influence children's experience of the disordered home environment also affect how well they do at school. The relationship between the child, their environment and their performance at school is complex: both genetic and environmental factors play a role.
PMCID: PMC3175268  PMID: 21675992
Gene–environment correlation; household chaos; environmental confusion; home environment; school achievement; twin studies; behavioural genetics
3.  Chaotic homes and school achievement: A twin study 
Chaotic homes predict poor school performance. Given that it is known that genes affect both children's experience of household chaos and their school achievement, to what extent is the relationship between high levels of noise and environmental confusion in the home, and children's school performance, mediated by heritable child effects? This is the first study to explore the genetic and environmental pathways between household chaos and academic performance.
Children's perceptions of family chaos at ages 9 and 12 and their school performance at age 12 were assessed in more than 2300 twin pairs. The use of child-specific measures in a multivariate genetic analysis made it possible to investigate the genetic and environmental origins of the covariation between children's experience of chaos in the home and their school achievement.
Children's experience of family chaos and their school achievement were significantly correlated in the expected negative direction (r = −0.26). As expected, shared environmental factors explained a large proportion (63%) of the association. However, genetic factors accounted for a significant proportion (37%) of the association between children's experience of household chaos and their school performance.
The association between chaotic homes and poor performance in school, previously assumed to be entirely environmental in origin, is in fact partly genetic. How children's home environment affects their academic achievement is not simply in the direction: environment → child → outcome. Instead, genetic factors that influence children's experience of the disordered home environment also affect how well they do at school. The relationship between the child, their environment, and their performance at school is complex: both genetic and environmental factors play a role.
PMCID: PMC3175268  PMID: 21675992
gene–environment correlation; household chaos; environmental confusion; home environment; school achievement; twin studies; behavioral genetics
4.  Visual acuity and visual skills in Malaysian children with learning disabilities 
There is limited data in the literature concerning the visual status and skills in children with learning disabilities, particularly within the Asian population. This study is aimed to determine visual acuity and visual skills in children with learning disabilities in primary schools within the suburban Kota Bharu district in Malaysia.
We examined 1010 children with learning disabilities aged between 8–12 years from 40 primary schools in the Kota Bharu district, Malaysia from January 2009 to March 2010. These children were identified based on their performance in a screening test known as the Early Intervention Class for Reading and Writing Screening Test conducted by the Ministry of Education, Malaysia. Complete ocular examinations and visual skills assessment included near point of convergence, amplitude of accommodation, accommodative facility, convergence break and recovery, divergence break and recovery, and developmental eye movement tests for all subjects.
A total of 4.8% of students had visual acuity worse than 6/12 (20/40), 14.0% had convergence insufficiency, 28.3% displayed poor accommodative amplitude, and 26.0% showed signs of accommodative infacility. A total of 12.1% of the students had poor convergence break, 45.7% displayed poor convergence recovery, 37.4% showed poor divergence break, and 66.3% were noted to have poor divergence recovery. The mean horizontal developmental eye movement was significantly prolonged.
Although their visual acuity was satisfactory, nearly 30% of the children displayed accommodation problems including convergence insufficiency, poor accommodation, and accommodative infacility. Convergence and divergence recovery are the most affected visual skills in children with learning disabilities in Malaysia.
PMCID: PMC3460699  PMID: 23055674
Learning disabilities; Malaysian children; visual acuity; visual skills
5.  Language, Reading, and Math Learning Profiles in an Epidemiological Sample of School Age Children 
PLoS ONE  2013;8(10):e77463.
Dyscalculia, dyslexia, and specific language impairment (SLI) are relatively specific developmental learning disabilities in math, reading, and oral language, respectively, that occur in the context of average intellectual capacity and adequate environmental opportunities. Past research has been dominated by studies focused on single impairments despite the widespread recognition that overlapping and comorbid deficits are common. The present study took an epidemiological approach to study the learning profiles of a large school age sample in language, reading, and math. Both general learning profiles reflecting good or poor performance across measures and specific learning profiles involving either weak language, weak reading, weak math, or weak math and reading were observed. These latter four profiles characterized 70% of children with some evidence of a learning disability. Low scores in phonological short-term memory characterized clusters with a language-based weakness whereas low or variable phonological awareness was associated with the reading (but not language-based) weaknesses. The low math only group did not show these phonological deficits. These findings may suggest different etiologies for language-based deficits in language, reading, and math, reading-related impairments in reading and math, and isolated math disabilities.
PMCID: PMC3796500  PMID: 24155959
6.  Predicting First Grade Reading Performance from Kindergarten Response to Tier 1 Instruction 
Exceptional children  2011;77(4):453-470.
Many schools are beginning to implement multi-tier response to intervention (RTI) models for the prevention of reading difficulties and to assist in the identification of students with learning disabilities (LD). The present study was part of our larger ongoing longitudinal RTI investigation within the Florida Learning Disabilities Center grant. This study used a longitudinal correlational design, conducted in 7 ethnically and socio-economically diverse schools. We observed reading instruction in 20 classrooms, examined response rates to kindergarten Tier 1 instruction, and predicted students’ first grade reading performance based upon kindergarten growth and end of year reading performance (n = 203). Teachers followed an explicit core reading program and overall, classroom instruction was rated as effective. Results indicate that controlling for students’ end of kindergarten reading, their growth across kindergarten on a variety of language and literacy measures suppressed predictions of first grade performance. Specifically, the steeper the students’ trajectory to a satisfactory outcome, the less likely they were to demonstrate good performance in first grade. Implications for future research and RTI implementation are discussed.
PMCID: PMC3156651  PMID: 21857718
response to intervention; beginning reading; classroom observations; reading growth
7.  Anxiety, Depression, and Coping Skills Among Mexican School Children: A Comparison of Students With and Without Learning Disabilities 
The purpose of this study was to compare severity and risk status for anxiety and depression with coping skills among 130 Mexican school children with learning disabilities (LD) and 130 school children without LD. This research is the first to explore the emotional difficulties of Mexican children with LD. Children completed the Spanish version of the Spence Children’s Anxiety Scale and Children’s Depression Inventory, and the Cuestionario de Afrontamiento (Coping Skills Questionnaire). Results indicated that a higher percentage of children with LD were at risk for anxiety (22.3% vs. 11.5%) and depression (32% vs. 18%). No statistically significant differences were found for coping skills. Results support the idea that there is an increased awareness of comorbid depression and anxiety among students with LD and a need to promote early identification and intervention in schools. Efforts should focus on better understanding the relationship between social-emotional difficulties and academic achievement and on developing effective interventions to support children with LD.
PMCID: PMC3820485  PMID: 24223470
anxiety; depression; learning disabilities; elementary school
8.  Consequences, Characteristics, and Causes of Mathematical Learning Disabilities and Persistent Low Achievement in Mathematics 
The goals of the review are threefold; a) to highlight the educational and employment consequences of poorly developed mathematical competencies; b) overview the characteristics of the children with persistently low achievement in mathematics; and c) provide a primer on cognitive science research that is aimed at identifying the cognitive mechanisms underlying these learning disabilities and associated cognitive interventions.
Literatures on the educational and economic consequences of poor mathematics achievement were reviewed and integrated with reviews of epidemiological, behavioral genetic, and cognitive science studies of poor mathematics achievement.
Poor mathematical competencies are common among adults and result in employment difficulties and difficulties in many common day-to-day activities. Among students, about 7% of children and adolescents have a mathematical learning disability (MLD) and another 10% show persistent low achievement (LA) in mathematics despite average abilities in most other areas. Children with MLD and their LA peers have deficits in understanding and representing numerical magnitude, difficulties retrieving basic arithmetic facts from long-term memory, and delays in learning mathematical procedures. These deficits and delays cannot be attributed to intelligence, but are related to working memory deficits for children with MLD, but not LA children. Interventions that target these cognitive deficits are in development and preliminary results are promising.
Mathematical learning disabilities and learning difficulties associated with persistent low achievement in mathematics are common and not attributable to intelligence. These individuals have identifiable number and memory delays and deficits that appear to be specific to mathematics learning. The most promising interventions are those that target these specific deficits and, in addition, for children with MLD interventions that target their low working memory capacity.
PMCID: PMC3131082  PMID: 21285895
learning disability; mathematical learning disability; poor achievement; mathematical cognition; working memory
9.  School meals and the rate of growth of primary school children. 
The effect of school meals on the rate of growth was assessed in two sets of children over one, two, and three-year periods in England and Scotland between 1973 and 1979. In all analyses children were subdivided into three groups: poor, not poor, and undefined, according to a set of questions on social circumstances. The rate of growth was assessed for children receiving school meals, lunches prepared at home, and those who changed scheme during the study period. No relation between rate of growth and uptake of school meals was found at any of the levels of poverty in England. In Scotland there was some indication in the poor group that children who received school meals had a smaller rate of growth than children having lunches prepared at home. There was inconclusive evidence that children from the poorer sectors of the community whose mother's worked outside the home may benefit from the school meals system. Although children selected for welfare support were smaller than other children, in so far as the design of the study allowed school meals during the 1970s did not increase the rate of growth of primary school children in any social stratum.
PMCID: PMC1052247  PMID: 6875451
10.  Academic career after treatment for acute lymphoblastic leukaemia 
Archives of Disease in Childhood  2000;82(5):353-357.
AIM—To evaluate academic career in long term survivors of childhood acute lymphoblastic leukaemia (ALL), in comparison to their healthy siblings.
PATIENTS—Ninety four children treated for ALL with cranial irradiation 18 or 25 Gy and intrathecal methotrexate as CNS prophylaxis. Median age at evaluation was 20 years; median follow up since diagnosis was 15 years at the time of the study.
METHODS—Patients and their 134 siblings completed a questionnaire on school career. The percentage of referrals to special primary schools for learning disabled, and the final level of secondary education in patients and siblings were compared, using a six point classification. Within the patient group, the effect of possible risk factors (age at diagnosis, irradiation dose, and gender) was investigated.
RESULTS—Significantly more patients than siblings were placed in special educational programmes. A significant difference was found for level of secondary education. No effect of gender or irradiation dose was found, but younger age at diagnosis was significantly related to both referrals and school levels.
CONCLUSION—Treatment for childhood ALL with cranial irradiation and chemotherapy at a young age is clearly associated with poorer academic career.

PMCID: PMC1718299  PMID: 10799421
11.  Social capital and mental health among mothers in Vietnam who have children with disabilities 
Global Health Action  2013;6:10.3402/gha.v6i0.18886.
Having a child with a disability is a heavy burden for mothers, especially in developing countries, where there is little available financial or other government support. Having a child with a disability is also linked to mental health problems and poor quality of life. Communities rich in social capital and individuals who have high levels of personal social capital generally enjoy day-to-day and long-term health and social benefits but this has not been investigated in Vietnam among mothers of children with disabilities. This study aims to investigate these mothers’ distress in terms of their social capital.
A cross-sectional study based on an interviewer-assisted survey included 172 mothers of children with moderate/severe disabilities in two provinces of Vietnam (one in the North and one in central Vietnam), using a newly translated and modified version of the Australian community participation questionnaire, several measures of personal social cohesion, and Kessler's 10-item measure of general psychological distress. Hierarchical linear regression modelling was used to explore the relationships among socio-demographic factors, multiple components of structural and cognitive social capita, and mothers’ distress controlling for a wide range of socio-demographic characteristics, the nature of the child's disability, and mothers’ personality (extroversion).
Mothers in this study were highly and multiply disadvantaged, and they had very high levels of distress and low levels of community participation. Furthermore, most forms of participation were associated with greater, not less, distress. Socio-demographic characteristics, child's disability, and mothers’ personality did little to explain variance in mothers’ distress, but types and amounts of participation were important predictors. The final regression model explained 29% of variance in distress, with major contributions made by living in a mountainous area, having a ‘reserved’ personality, and frequency and types of participation.
Vietnamese mothers whose children have disabilities are extremely marginalised and distressed. They have only modest social capital, but the little they have tends to be related to better mental health. Being from the mountains; being ‘reserved’; spending time with friends, neighbours, and in educational activities; and trusting others are related to better mental health among these women. However, several types of participation are associated with worse mental health. Such activities should be avoided in any interventions designed to increase social capital as a mental health promotion strategy.
PMCID: PMC3570571  PMID: 23402280
distress; social capital; mothers; children with disabilities; community participation; personal social cohesion; women's health; mental health
12.  Caring for children with disabilities in Kilifi, Kenya: what is the carer's experience? 
Child  2011;37(2):175-183.
Carers of children with disabilities have repeatedly highlighted their feelings of discrimination, stigma and exclusion in many domains of their lives. There is little research from Africa addressing these issues. This study investigated the challenges encountered by these carers and the mechanisms of coping with these challenges while caring for children with disabilities in a poor rural setting in Kenya.
Thirty-five in-depth interviews were conducted with 20 carers, 10 community members and 5 primary school teachers. Ten unstructured observations were also conducted in home environments to observe mechanisms used in meeting the needs of the children with disabilities. All interviews were tape-recorded, transcribed and translated from the local dialect. Note-taking was performed during all the observations. Data were stored in NVivo software for easy retrieval and management.
The arrival of a disabled child severely impairs the expectations of carers. Hospital staff underestimate carers' emotional distress and need for information. Fear for the future, stress, rumour-mongering and poverty are encountered by carers. As they grapple with lost expectations, carers develop positive adaptations in the form of learning new skills, looking for external support and in some cases searching for cure for the problem. For their emotional stability, carers apply spiritual interventions and sharing of experiences.
Despite the challenges faced by the carers, values and priorities in adaptation to the challenges caused by the child's disability were applied. It is recommended that these experiences are considered as they may influence programmes that address the needs of children with disabilities.
PMCID: PMC3072473  PMID: 20645990
carers; challenges; coping strategies; disability
13.  Neighborhood & Family Effects on Learning Motivation among Urban African American Middle School Youth 
Motivational theorists in psychology have moved away from individual-based approaches to socio-cognitive and socio-ecological models to explain student engagement and motivation for learning. Such approaches consider, for example, the influence of family and neighborhood environments as important constructs in youth behavior. In this study, links between neighborhood condition (e.g. external appearance of the blocks nearest to the respondents’ home), family dysfunction, and motivation for learning are investigated. Data were obtained from two hundred and sixteen (216) urban African American middle school children enrolled in a substance use prevention intervention. Analytic models show associations between poor neighborhood condition and both family dysfunction and lower learning motivation. Family dysfunction was also found to mediate the effect of neighborhood condition on motivated learning. Neighborhood and family characteristics are important determinants of urban schoolchildren’s motivation for learning.
PMCID: PMC3290410  PMID: 22389576
Environmental exposure; Youth; Learning; Structural equation
14.  Assessing knowledge of primary school teachers on specific learning disabilities in two schools in India 
Evaluation of fund of knowledge about SLD among kindergarten and primary school teachers is essential to avoid misdiagnosis of SLD and to plan for specific teacher education to enable early identification of SLD among children.
To assess the knowledge of learning disability among primary school teachers in India and to investigate its psychometric properties.
Materials and Methods:
An observational study was carried out 34 primary school teachers from 2 different schools in Puducherry town agreed to participate in this study with informed consent. We used a multiple choice questionnaire format with a total of 50 questions, 5 choices for each question and a total score of 50. The study was held at the schools where these teachers were employed using pen and paper testing method and data were entered into the computer for statistical analysis.
Statistical Analysis:
Total scores on the questionnaire of all teachers were calculated. Content validity, reliability coefficient, discrimination factor, and facility factor were analyzed using SPSS software.
29% of the questions were correctly answered by all 34 teachers. The mean total score for this sample was 14.50 ± 9 and total item score for the 50 items was 9.90 ± 4. Cronbach's (α) reliability was 0.89. Overall discrimination index was + 0.2 and facility factor analysis score was 0.26.
Validation of this new screening questionnaire was successful in Indian setting. It has to be used in other settings to extrapolate our findings.
PMCID: PMC3778643  PMID: 24083280
Kindergarten; primary school; specific learning disability
15.  Memory Processes in Learning Disability Subtypes of Children Born Preterm 
The purpose of this study was to evaluate immediate auditory and visual memory processes in learning disability subtypes of 40 children born preterm. Three subgroups of children were examined: (a) primary language disability group (n = 13), (b) perceptual-motor disability group (n = 14), and (c) no learning disability diagnosis group without identified language or perceptual-motor learning disability (n = 13). Between-group comparisons indicate no significant differences in immediate auditory or visual memory performances between language and perceptual-motor learning disability groups. Within-group comparisons revealed that both learning disability groups performed significantly lower on a task of immediate memory when the mode of stimulus presentation and mode of response were visual.
PMCID: PMC3968320  PMID: 22375897
16.  The Grammar of Information: Challenges for Older Students With Language Impairments 
Topics in language disorders  2010;30(4):288-307.
The purpose of this article is to describe the nature of informational (expository) language in terms of unique grammatical characteristics and discuss applications for assessment and intervention for older school-age children and adolescents with language impairments.
Information presented is based on a selected literature review of topics including the nature of academic texts, expository text processing of older children and adolescents with language impairments and/or learning disabilities, and language intervention studies that target higher level language in the same populations.
We summarize key grammatical strategies found in informational text: (1) complex nominal (noun phrase) groups, (2) clausal subordination, and (3) theme and information mechanisms. Although facility with these structures is not routinely or systematically tested by language clinicians, we highlight assessment procedures useful this purpose. Promising intervention evidence suggests that grammatical features characteristic of informational text can be targeted with positive results for students who struggle with this aspect of higher level language.
Success comprehending and producing informational text requires unique grammatical knowledge. A qualitative literature review is used to derive best practices in assessment and intervention with school-age children who are particularly challenged by these types of texts.
PMCID: PMC3626072  PMID: 23596344
academic literacy; language assessment; complex syntax; expository; grammar; intervention; language impairment
17.  Participation in everyday activities and quality of life in pre-teenage children living with cerebral palsy in South West Ireland 
BMC Pediatrics  2008;8:50.
Cerebral palsy (CP) is the most common cause of physical disability in children but its impact on quality of life is not well understood. This study examined participation in everyday activities among children without CP and children with mild, moderate and severe impairment due to CP. We then examined ten domains of quality of life in children with CP and investigated whether participation in everyday activities was associated with improved quality of life independent of gender, age and level of impairment.
This was a cross-sectional study of children aged 8–12 years based on two questionnaires, frequency of participation (FPQ) and KIDSCREEN, completed by parents of 98 children on the South of Ireland Cerebral Palsy Register (response rate = 82%) and parents of 448 children attending two Cork city schools (response rate = 69%) who completed one questionnaire (FPQ). Multiple linear regression was used: firstly to estimate the effect of severity of CP on participation in everyday activities independent of age and gender and secondly we estimated the effect of participation on quality of life independent of age gender and level of impairment.
Participation in 11 of the 14 everyday activities examined varied across the children without CP and the children with varying severity of CP. In general, increased impairment decreased participation. Independent of age and gender, there was a highly significant decrease in overall participation with a fall of -6.0 (95% CI = -6.9 to -5.2) with each increasing level of impairment. The children with CP generally had high quality of life. Increased impairment was associated with diminished quality of life in just two domains – Physical well-being and Social support and peers. Overall participation in everyday activities was significantly associated with quality of life in 3 of the 10 domains (Physical well-being, Social support and peers & Moods and emotions) in analysis adjusted for gender age and level of impairment.
While increased impairment due to CP restricts participation in the majority of everyday activities, the level of participation has a limited effect on the quality of life of the children with CP in age 8–12 years.
PMCID: PMC2585080  PMID: 18976459
18.  LEARN 2 MOVE 7-12 years: a randomized controlled trial on the effects of a physical activity stimulation program in children with cerebral palsy 
BMC Pediatrics  2010;10:77.
Regular participation in physical activities is important for all children to stay fit and healthy. Children with cerebral palsy have reduced levels of physical activity, compared to typically developing children. The aim of the LEARN 2 MOVE 7-12 study is to improve physical activity by means of a physical activity stimulation program, consisting of a lifestyle intervention and a fitness training program.
This study will be a 6-month single-blinded randomized controlled trial with a 6-month follow up. Fifty children with spastic cerebral palsy, aged 7 to 12 years, with Gross Motor Function Classification System levels I-III, will be recruited in pediatric physiotherapy practices and special schools for children with disabilities. The children will be randomly assigned to either the intervention group or control group. The children in the control group will continue with their regular pediatric physiotherapy, and the children in the intervention group will participate in a 6-month physical activity stimulation program. The physical activity stimulation program consists of a 6-month lifestyle intervention, in combination with a 4-month fitness training program. The lifestyle intervention includes counseling the child and the parents to adopt an active lifestyle through Motivational Interviewing, and home-based physiotherapy to practise mobility-related activities in the daily situation. Data will be collected just before the start of the intervention (T0), after the 4-month fitness training program (T4), after the 6-month lifestyle intervention (T6), and after six months of follow-up (T12). Primary outcomes are physical activity, measured with the StepWatch Activity Monitor and with self-reports. Secondary outcomes are fitness, capacity of mobility, social participation and health-related quality of life. A random coefficient analysis will be performed to determine differences in treatment effect between the control group and the intervention group, with primary outcomes and secondary outcomes as the dependent variables.
This is the first study that investigates the effect of a combined lifestyle intervention and fitness training on physical activity. Temporary effects of the fitness training are expected to be maintained by changes to an active lifestyle in daily life and in the home situation.
Trial registration
This study is registered in the Dutch Trial Register as NTR2099.
PMCID: PMC2989952  PMID: 21044314
19.  Math Anxiety and Math Ability in Early Primary School Years 
Mathematical learning disabilities (MLDs) are often associated with math anxiety, yet until now, very little is known about the causal relations between calculation ability and math anxiety during early primary school years. The main aim of this study was to longitudinally investigate the relationship between calculation ability, self-reported evaluation of mathematics, and math anxiety in 140 primary school children between the end of first grade and the middle of third grade. Structural equation modeling revealed a strong influence of calculation ability and math anxiety on the evaluation of mathematics but no effect of math anxiety on calculation ability or vice versa—contrasting with the frequent clinical reports of math anxiety even in very young MLD children. To summarize, our study is a first step toward a better understanding of the link between math anxiety and math performance in early primary school years performance during typical and atypical courses of development.
PMCID: PMC2853710  PMID: 20401159
math anxiety; development of calculation ability; mathematical learning disability
20.  Exploring the experience of children with disabilities at school settings in Vietnam context 
SpringerPlus  2014;3:103.
The initial findings from 230 questionnaires’ survey and 36 interviews, in which informants are CWD, children with non-disabilities (CWND), parents of CWD, and teachers in school settings, are stated as: (a) the general understanding of disability is based on medical model and individual model rather than social model, such understandings contribute great impacts to the CWD’s experiences in their daily life in general and in school contexts in particular; (b) the most important difficulties which CWD experience at school are those of learning facilities, the empathy from their student peers and barriers in the physical environment; (c) the ways which CWD try to deal with such difficulties are mostly ‘do-by-themselves’ or try to adapt themselves rather than asking for supports actively. Based on these findings, recommendations for having further activities to change social awareness of disabilities, specific support structures for CWD and school staff are stated in order to promote the social inclusion of CWD in schools.
PMCID: PMC3940718  PMID: 24600550
Children with disabilities; Vietnam; Social inclusion; Inclusive education
21.  Added Value Measures in Education Show Genetic as Well as Environmental Influence 
PLoS ONE  2011;6(2):e16006.
Does achievement independent of ability or previous attainment provide a purer measure of the added value of school? In a study of 4000 pairs of 12-year-old twins in the UK, we measured achievement with year-long teacher assessments as well as tests. Raw achievement shows moderate heritability (about 50%) and modest shared environmental influences (25%). Unexpectedly, we show that for indices of the added value of school, genetic influences remain moderate (around 50%), and the shared (school) environment is less important (about 12%). The pervasiveness of genetic influence in how and how much children learn is compatible with an active view of learning in which children create their own educational experiences in part on the basis of their genetic propensities.
PMCID: PMC3032733  PMID: 21311598
22.  Parent Perspectives of Diabetes Management in Schools 
The Diabetes educator  2008;34(6):996-1003.
The purpose of this study is to investigate parent reports of the diabetes care support their children receive in school, their concerns about diabetes management in school, and their knowledge of federal laws that protect children with diabetes. In addition, the study explores ethnic and socioeconomic status differences in diabetes management in school.
An ethnically heterogeneous sample of 309 parents of children with diabetes was recruited from a community-based and a university-based diabetes outpatient clinic. Parents completed a survey assessing supports their child's school provides for diabetes care, worries about diabetes care in school, and awareness of federal laws that pertain to children with diabetes.
Many children did not have a written care plan or a nurse at school, but significantly more white children had these supports than Hispanic or black children. Most children were not allowed to check blood glucose levels or administer insulin in class. Most parents were worried about hyperglycemia and hypoglycemia in school, and most were not at all or only a little confident in the school's ability to care for diabetes. Most parents were not aware of federal laws, but high-income and white parents were more likely to be aware.
According to parents in the current study, children receive inadequate diabetes management support in schools. Minority children are less likely to receive supports than white children. Parents are worried about diabetes management in school, but most do not have the knowledge of federal laws necessary to protect their children.
PMCID: PMC2929970  PMID: 19075081
23.  Recent findings from the 1970 child health and education study: preliminary communication. 
The progress is described of the longtudinal cohort study based on all children born in England, Scotland and Wales in one week of April 1970. The children and their mothers have been surveyed at birth, at five, and recently, at ten. Analyses of the data presented include the finding of improved intellectual outcome in children who had been immunized against pertussis, compared with poor intellectual outcome in children who had had hospital admissions for the disease itself. Preliminary data collected at 10 show that routine hearing and vision testing during the child's school life fell short of recommended standards. The major aim of the 10-year-old contact, however, is to establish details of the national prevalence and pathogenesis of disability. The identification of disability uses a life skills questionnaire, medical history and examination.
PMCID: PMC1438120  PMID: 6215488
24.  Family Involvement in School-Based Health Promotion: Bringing Nutrition Information Home 
School psychology review  2008;37(4):567-577.
Family-school collaboration related to children’s physical development has become increasingly important as childhood obesity rates continue to rise. The present study described the development and implementation of a literacy-based, family component of a school-based health education program and investigated its viability, acceptability, and effectiveness. Interactive children’s books were the mechanism by which students, parents, and teachers received consistent messages at home and school regarding nutrition information. The home-school intervention served to bridge home and school cultures in an urban population. Preliminary process evaluation results indicated that the interactive children’s books were feasible to implement in the school context. Parents, children, and teachers had positive perceptions of the books. Parents who received the books demonstrated increased knowledge of 5 a Day, the primary nutrition message communicated in the program. Although not statistically significant, after the first and second years of intervention, parents in the experimental group reported that their children were eating 0.54 and 0.36 additional servings of fruit and vegetables per day compared with children in the control group. The program did not seem to impact the availability and accessibility of fruits and vegetables at home.
PMCID: PMC2714582  PMID: 19633724
25.  Inequalities in Oral Health for Children with Disabilities: A French National Survey in Special Schools 
PLoS ONE  2008;3(6):e2564.
Despite wide recognition that children with disability often have poor oral health, few high quality, controlled results are available.
Twenty-four objective and subjective criteria covering feeding, autonomy, access to dental care, oral hygiene, oral disease, general health and behavior were evaluated in a observational cross-sectional study of 2,487 children with disability (DC group), 4,772 adolescents with disability (DA group) and 1,641 children without disability (NDC group). Five algorithms ranked the subjects according to clinical criteria in three original oral health indices: the Clinical Oral Health Index (COHI), indicating the level of oral health problems, the Clinical Oral Care Needs Index (COCNI) giving dental care need levels, and the Clinical Oral Prevention Index (COPI) determining possible needs in terms of dental education initiatives.
DC-group children presented poorer oral health and had greater needs in both treatment and preventive oral health actions than NDC-group children (OR = 3.97, 95% CI = 3.25–4.86 for COHI; OR = 2.01, 95% CI = 1.77–2.28 for COCNI; OR = 5.25, 95% CI = 4.55–6.02 for COPI). These conditions were worse again in the DA group comparing to the DC group (OR = 3.52, 95% CI = 2.7–4.6 for COHI; OR = 1.52, 95% CI = 1.38–1.69 for COCNI; OR = 1.53, 95% CI = 1.39–1.69 for COPI).
Clinical indices generated by algorithmic association of various clinical indicators allow sensitive clinical measurement, and in this study demonstrated inequalities in oral health for children with disabilities schooling in institutions. Questions need now to be addressed as to the measures that could be taken to compensate for this situation.
PMCID: PMC2432497  PMID: 18575600

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