Author Archives: Regina Leidy

IEP Should Prepare Teens for Adulthood

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Education is important for all children, but even more so for children with disabilities, whose social and economic opportunities may be limited.

The special education system has given children with disabilities much greater access to public education, established an infrastructure for educating them, helped with the earlier identification of disabilities, and promoted greater inclusion of these children alongside their nondisabled peers.

Once a child is identified as eligible for special education services, a team that includes the child’s parents and representatives of the public education system is charged with developing an individualized education program (IEP). The IEP outlines academic goals and incorporates all the services and supports necessary to meet the child’s unique needs.

The services and supports can include transportation, speech-language pathology and audiology, psychological services, physical and occupational therapy and many other individual services according to the child’s unique needs (The Future of Children: Children with Disabilities, Spring 2012).

Most parents of children with disabilities, educators and physicians are familiar with the IEP, but not all are aware that the Individuals with Disabilities Education Act mandates that an individualized transition plan (ITP) must also become part of the IEP once the child reaches his or her sixteenth birthday. (In some states, the age is even lower.)

The ITP prepares disabled youth for the transition to adulthood. One of the major differences between an IEP and an ITP is that the student becomes part of the ITP planning team. Parents and multidisciplinary representatives of the public school system continue to be a part of the team.

The types of goals differ once the ITP is included in the IEP. Federal law requires that the IEP be revised yearly to include goals for academic and school-related progress for the coming year. The ITP expands the time frame and range of goals. The team must consider skills and behaviors that will be required by the student for adulthood, as well as the student’s interests. As the goals being set will assist the student’s transition into adulthood, they often need to be long-range goals that won’t be completed in a given year.

One critical goal is determining whether the student will graduate with his or her classmates. Other transitional goals could include training opportunities that would strengthen skills needed for living in the community (general housekeeping, hygiene, public transportation skills and skills that would promote inclusion in recreational activities). Students with chronic illness need to learn medical self-management.

“Transition to adult life presents challenges and opportunities for practitioners guiding families of children with disabilities.” Thoughtful planning, beginning at a young age and supported in the home, can increase the chances that these young folks will be prepared to take on adult roles and responsibilities (AAP News, Nathan J. Blum, MD, FAAP & Stephen H. Contompasis, MD, FAAP).

Underprivleged Youth and the College Dream

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Written by Jonathan Wallace, Managing Editor.

According to a recent article in the New York Times, underprivileged youth who achieve their dream of enrolling in college too often end up with crushing debt and no degree to show for it. In fact, Future of Children author Susan M. Dynarski tells the Times, the gap between the share of poor Americans who earn a bachelor’s degree and the share of affluent Americans who do so has grown dramatically in the past 30 years. So despite an increase in access to college for the poor and minorities, the Times concludes, college is actually serving to perpetuate social stratification rather than enhance social mobility. Dynarski weighs in on “Financial Aid Policy: Lessons from Research” in the Future of Children‘s forthcoming issue on postsecondary education, scheduled for release on May 7, 2013.

Children with Disabilities: Medical Care, Education, and Cost

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A recent Child Trends Research Brief, “Children with Disabilities: State-Level Data from the American Community Survey,” uses data to look at the diverse needs of children with disabilities. Several critical findings and topics were also noted in the Future of Children’s recent issue on Children with Disabilities.

Both the Child Trends research brief and the Future of Children note that there is little consensus in defining children with disabilities. “Researchers tend to focus on the individual causes of disability such as autism, asthma, cystic fibrosis, or attention-deficit/hyperactivity disorder” (Future of Children). Regardless of the definition, children with disabilities need more specialized care medically, environmentally, and educationally. Parents of these children “often need to advocate for their child across multiple domains, from managing the child’s medical care, to ensuring an appropriate and individualized educational plan is in place, to meeting significant expenses that may arise due to the disability” (Child Trends).

“During 2008-2010, there were 2.9 million U.S. children with one or more disabilities. These comprised four percent (one in every 25) of all non-institutionalized children, ages birth to 17. Nearly one in three disabled children (31 percent) were living in poverty (compared with 20 percent of all children). Most children with disabilities (94 percent) were covered by health insurance; more than half (58 percent) were covered by public insurance programs.” (Child Trends)

As Child Trends notes, health insurance is vital for children with disabilities. The Child Trends brief cites Peter Szilagyi’s Future of Children chapter, “Health Insurance and Children with Disabilities,” which observes that the number of children with disabilities covered under private insurance declined by about 10 percent during from 2000 to 2008, while public insurance coverage increased. The two main public health insurance programs are Medicaid and SCHIP (known since 2009 as the Children’s Health Insurance Program or CHIP). Nearly half of children with special health care needs who have insurance are covered by one of these two programs; 90 percent are enrolled in Medicaid, the other 10 percent in CHIP. These are among several programs that provide health services for children disabilities. As Child Trends points out, “children with disabilities who are insured get more timely and comprehensive care, and that their parents are more satisfied with their child’s health care than are parents of children with disabilities who lack insurance.”

Mark Stabile and Sara Allin, in their Future of Children chapter, “The Economic Costs of Childhood Disability,” calculate that the direct costs to families, the indirect costs through reduced labor supply, the direct costs to disabled children as they age into the labor force, and the costs of safety net programs for children with disabilities all together average $30,500 a year per family with a disabled child. They note that the cost estimates on which they base their calculation vary widely depending on the methodology, jurisdiction, and data used.

Regarding education advances, Future of Children’s Laudan Aron and Pamela Loprest point out in their article, “Disability and the Education System,” that the special education system has given children with disabilities much greater access to public education, established an infrastructure for educating them, helped with the earlier identification of disabilities, and promoted greater inclusion of these children alongside their nondisabled peers. Despite these advances, many problems remain, including the over- and under-identification of certain subgroups of students, delays in identifying and serving students, and bureaucratic, regulatory, and financial barriers that complicate the program for everyone involved.

Despite improvements in recognition, early intervention, diagnosis, and a range of treatment and intervention programs, significant social disparities persist. The negative implications for health care, dependency, and educational costs of a growing number of disabled children lend urgency to our efforts to better understand and address, this growing health, economic and social liability (Future of Children).

The Importance of Dads

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In a recent New York Times letter to the editor, professor Sara McLanahan disputes how her research has recently been portrayed in the New York Times opinion pages.

Two recent opinion articles cite my research to support their claims that fathers aren’t necessary for a thriving household (“In Defense of Single Motherhood,” by Katie Roiphe, Aug. 12, and “Men, Who Needs Them?,” by Greg Hampikian, Aug. 25). That does not fairly describe my work.

Income security is very important. But fathers in most cases are critical contributors to family income. And income security is only half the story.

Emotional security — which children develop from living in stable families where they can form lasting relationships with adults who stick around for the long run — is also important. Stable homes with one parent are rare. More often in single-mother households, children meet, attach and then say goodbye to men who are only temporarily connected to the family.

Two parents committed to each other and to raising a child together are more likely to provide the economic and emotional security children need. That large numbers of fathers cannot provide economic and emotional security constitutes a serious social problem.

SARA McLANAHAN
Princeton, N.J., Aug. 28, 2012

Categories: Uncategorized

Growing Inequality for Single Parents

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“As rates of nonmarital childbirth have increased in the United States in the past half-century, a new family type, the fragile family, has emerged. Fragile families, which are formed as the result of a nonmarital birth, include cohabiting couples as well as noncohabiting, single mothers. Such families evoke public concern in part because they are more impoverished and endure more material hardship than married-parent families and have fewer sources of economic support.” Future of Children: Fragile Families- “Mothers’ Economic Conditions and Sources of Support in Fragile Families”

Jason DeParle asserts in his article in the NY Times that changes in family structure have helped to broaden income gaps. Americans who are college educated are more likely to marry one another, which brings the advantage of higher dual-income earnings. Women who have not finished college or who are less educated are becoming less likely to marry at all. Not only do they have lower paychecks themselves when compared to the college-educated, but they also lack the advantages of dual-income.

As DeParle writes, “estimates vary widely, but scholars have said that changes in marriage patterns–as opposed to changes in individual earnings–may account for as much as 40 percent of the growth in certain measures of inequality. Long a nation of economic extremes, the United States is also becoming a society of family haves and have-nots, with marriage and its rewards evermore confined to the fortunate classes.”

In his Economic Inequality and the Changing Family blog, DeParle states, “Inequality has grown much faster for households with children than it has for households over all.” Future of Children editor-in-chief Sara McLanahan points out that, “the people with more education tend to have stable family structures with committed, involved fathers. The people with less education are more likely to have complex unstable situations involving men who come and go. I think this process is creating greater gaps in these children’s life chances.”

As DeParle points out, “No one has suggested that single parenthood is the sole or even main force driving the increases in inequality, just an important one that is sometimes overlooked. Had single parenthood not continued to increase, there would be less inequality now.”

Over all, it is important for policy makers to recognize that with rates of nonmarital childbirth at their current level, and potentially rising still, fragile families are likely an enduring fixture among U.S. families. It is thus essential to strengthen policies that both support their economic self-sufficiency and alleviate their hardship during inevitable times of economic distress. Future of Children: Fragile Families- “Mothers’ Economic Conditions and Sources of Support in Fragile Families”

Juvenile Justice Moving into the Twenty First Century

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This week, the Supreme Court decided to effectively bar mandatory life terms for juveniles. (The New York Times) The ruling marks a significant point in a long period of transition for juvenile justice policy.

Beginning in the 1980s through the early 1990s, youth crime rates rose in the United States. Some politicians felt that the juvenile system was ineffective and that there was no evidence of rehabilitation in youth offenders. They saw the system as something that worked for the crimes of a milder time, but that with the violent crimes being committed by current youth, they needed more punitive policies. “As the juvenile crime rates – particularly homicide – rose, politicians across the country rushed to enact tough policies through several legislative strategies.” More than 250,000 young offenders were transferred each year into the adult system–getting adult time for adult crime. (Adolescent Development and the Regulation of Youth Crime- Future of Children-“Juvenile Justice”)

Discussions around the juvenile justice system, particularly the trying of children as adults and mandatory life sentences continued, with people from both sides of the issue passionate in their stance. Gradually, policies began to change. “In 2005, in Roper v. Simmons, the court eliminated the juvenile death penalty. In 2010, in Graham v. Florida, the court ruled that sentencing juvenile offenders to life without the possibility of parole was also unconstitutional, but only for crimes that did not involve killings.” And this week the Supreme Court ruled that laws requiring adolescents convicted of homicide to receive a life sentence are unconstitutional.

“Mandatory life without parole for a juvenile precludes consideration of his chronological age and its hallmark features–among them, immaturity, impetuosity, and failure to appreciate risks and consequences,” stated Justice Kagan. “It prevents taking into account the family and home environment that surrounds him–and from which he cannot usually extricate himself–no matter how brutal or dysfunctional” (The New York Times)

In their chapter, “Adolescent Development and the Regulation of Youth Crime,” Elizabeth Scott and Laurence Steinberg state that “Research in developmental psychology supports the view that several characteristics of adolescence distinguish young offenders from adults in ways that mitigate culpability. These adolescent traits include deficiencies in decision-making ability, greater vulnerability to external coercion, and the relatively unformed nature of adolescent character.”

Laurence Steinberg, professor of psychology at Temple University and issue editor of the Future of Children’s Juvenile Justice volume states in the New York Times, “About 10 percent of young violent criminals become adult offenders. But no one knows which ones. We tracked about 1,300 young convicted felons, the majority of them violent, over seven years. We interviewed each kid for hours so we knew more about them than any court will ever hope to know, and we saw them every six months. We were unable to predict which ones would be in the 10 percent.”

As the Future of Children’s policy brief on juvenile justice notes, “Both widely accepted legal principles and research on adolescent immaturity argue that juveniles are less responsible for their criminal behavior than adults and should therefore receive less severe punishment. Research shows that harsh punishment in adult facilities increases the probability of future violent crimes and that most youngsters who commit criminal offenses will abandon illegal behavior as they enter adulthood.”

“Monday’s ruling,” Steinberg said, “along with the earlier ones on juveniles, is clearly a win from the point of view of developmental science.”

“Lawmakers may be ready to approach juvenile justice policy more thoughtfully today than they have in a generation. If so, a large body of recent research that was not available twenty years ago offers insights about adolescence and about young offenders. Using this scientific knowledge to shape the direction of juvenile justice policy will promote both social welfare and fairness.” (Adolescent Development and the Regulation of Youth Crime- Future of Children-“Juvenile Justice”)

For more, go to: www.futureofchildren.org.

Speaking with Children about Obesity

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The childhood obesity crisis has been in the news for many months now. We know that obese children face certain difficulties with health in adulthood. Heart disease, high blood pressure, hardening of the arteries, type 2 diabetes, metabolic syndrome, high cholesterol, asthma, sleep disorders, liver disease, orthopedic complications, and mental health problems are just some of the health complications of carrying excess weight. (Future of Children, Childhood Obesity).

Despite all the public attention and concern, policymakers are uncertain how best to combat childhood obesity. Researchers have identified many possible causes of the obesity epidemic, but the research base on how to prevent obesity is still limited, making it difficult to decide how best to proceed. With state and federal budgets already strained, it is important to develop programs and policies that are effective and can be implemented at reasonable cost. Parents play an important role in these efforts.

In a recent article “Talking to your Kids About Weight Loss,” Chris Iliades, writes that “in a country where 17 percent of all children are obese and another 17 percent are overweight, childhood obesity should be a topic of conversation for families. But according to a recent study published in the journal Pediatrics, how we talk about childhood obesity could be just as important as whether we’re talking about it. According to the study, 36 percent of parents would react to words like “fat” and “obesity” by putting their child on a strict diet and another 35 percent would go off in search of a different doctor — and neither of these reactions are best for a child’s health..”

As the authors of the Future of Children’s Childhood Obesity chapter, “The Role of Parents in Preventing Childhood Obesity,” caution, “even though childhood obesity experts discourage dieting, parents who feel the need to control a child’s weight commonly encourage dieting. Studies on dieting behaviors consistently report that their parents’ inducement to diet is the most significant factor in causing children to begin dieting. Their parents’ direct verbal encouragement is more influential than the parents’ own dieting behaviors. Many adolescents whose parents urged them to diet report engaging in unhealthful dieting behaviors. Focusing on dieting for weight control may overemphasize the thinness ideal and over time may even lead to an increased risk for obesity. It is important for parents of overweight children to learn about the dangers of dieting and to talk with their child’s doctor or health care provider about ways to promote healthful habits.” (to view the source for this quote, please see page1 75 of this article.)

The authors conclude that “parents play a critical role at home in preventing childhood obesity, with their role changing at different stages of their child’s development. By better understanding their own role in influencing their child’s dietary practices…parents can learn how to create a healthful nutrition environment in their home, provide opportunities for physical activity, discourage sedentary behaviors such as TV viewing, and serve as role models themselves.”

To read more about parents’ role in preventing childhood obesity, please visit the Future of Children website and the journal on Childhood Obesity

Prevention of Disability in Children: The Role of the Environment

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Over the past fifty years, the number of reported childhood disabilities has steadily increased and the nature and consequences of disability have changed drastically. Prior to 1960, the poster child for childhood disabilities would have been a child with polio, wearing leg braces and using crutches for support. Today’s poster child could be a child with autism. Where the pre-60s child wore his disability for the world to see, in many cases today’s child experiences his disability internally. Over the past several decades, predominant childhood disabilities have shifted away from physical disorders toward mental health disorders. (Future of Children: Childhood Disabilities)

Much public attention and many resources are focused on medical research to identify risk factors and mitigate symptoms of disability for individual children. However, Stephen Rauch and Bruce Lanphear, in their chapter “Prevention of Disability in Children: Elevating the Role of the Environment,” argue for a broader focus on environmental influences that put entire populations at risk. “Identifying and eliminating or controlling environmental risk factors that incrementally increase the prevalence of disability is the key to preventing many disorders,” they write.

When seeking to prevent disability, there are three levels that need to be considered. Primary prevention seeks to keep disabilities from developing. Secondary prevention utilizes methods of screening and early detection to identify problems before they can do “too much damage.” Tertiary prevention focuses on restoring health and function to people who have already developed a disability. Tertiary and secondary prevention are the primary efforts of the clinical community. But in order to reduce the prevalence of disability in the population, primary prevention is essential.

The causes of many disabilities in childhood are complex and result from the interplay of environmental risk factors and genetic susceptibility. Purely genetic and purely environmental disabilities exist, but they are rare. Children are particularly vulnerable to environmental stressors; they pass through several delicate developmental stages and, pound for pound, they eat and breathe more environmental contaminants than adults. An exposure that is harmless in adults can have a dramatic effect when it occurs during fetal development or early childhood.

One example of an environmental risk for disabilities in children is lead in house paint. Lower IQ and ADHD in children have both been linked back to lead as has criminal behavior in adulthood. A cost-benefit analysis of requiring lead based paint to be removed concludes that every $1 spent to reduce lead hazards in housing would produce between seventeen and two hundred twenty one dollars in benefits by reducing screening and treatment for lead toxicity, ADHD treatment, and special education.

(Rauch and Lanphear Future of Children: Childhood Disabilities)

In a long awaited move, the CDC recently cut the threshold for lead poisoning. This new lower threshold “means public health agencies have a bigger job to screen children for lead and to prevent exposure in the first place,” said Lanphear in an interview with John Ryan of Seattle station KUOW “The new standard from the Centers for Disease Control and Prevention nearly doubles the number of children considered to have lead poisoning. Now, one out of 40 American kids has what’s deemed a dangerous level of lead in their blood, reported Northwest public radio.” (http://www.nwpr.org/post/cdc-cuts-lead-poisoning-threshold)

This change in lead level standards is just one example of how our regulations and knowledge about environmental risk factors changes over time. In the face of such changes, it makes sense to consider a preventive approach that shifts the entire population’s health curve in a positive direction. As Issue Editors Janet Currie and Robert Kahn summarize in the introduction to Children with Disabilities, “the heart of [Rauch/Lanphear’s] argument is that societal choices can shift the curve of child health outcomes to increase the probability that some children will be moved from a nondisabled to a disabled state. Exposure to chemicals in the environment, for example, may decrease the attentiveness of all children, but in a subset of more vulnerable children, the exposure may lead to symptoms and impairment that warrant an ADHD diagnosis. The implication is that society should pay attention to shifting the entire distribution of health outcomes in a positive direction and that doing so will reduce the toll of childhood disability. Such a public health focus on prevention is a useful comple­ment to the usual medical focus on improving technology or the quality of medical care for children who already have disabilities.”

For more information, read our Children with Disabilities volume: www.futureofchildren.org.

Minority Birth Rate Surpasses Whites in US

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New 2011 census estimates show that for the first time, racial and ethnic minorities make up more than half of the children born in the U.S. For these newborns of America’s first “majority minority” generation, and for all Americans under 50, Hispanics are the second-largest population group after whites of European descent (Wall Street Journal).

These findings come amidst data from the Pew Hispanic Center, which show that net immigration from Mexico has stopped, or possibly reversed. “The current congressional and Supreme Court interest in reducing immigration – and the concerns especially about low-skilled and undocumented Hispanic immigration – represents issues that could well be behind us,” notes William H. Frey, a demographer at the Brookings Institution who analyzed the census data, in the Huffington Post.

In fact, census data reveal that immigration is not the main driving force behind America’s growing diversity. Data for 2010 show Hispanic women give birth to 2.4 babies on average compared to 1.8 babies for non-Hispanic whites, and minority women are younger on average, so more of them are of childbearing age (Wall Street Journal). In addition, as Princeton professor and director of the Mexican Migration Project Doug Massey notes in Reuters, “net zero migration doesn’t just mean undocumented migrants are staying in Mexico; it also means those already here aren’t going home…” The census has forecast that non-Hispanic whites will be outnumbered in the United States by 2042.

This demographic shift has implications for United States’ policy, particularly in the area of education.

A substantial percentage of minority children, especially those with Latin American origins, are falling behind in school. Evidence from the Future of Children’s volume on Immigrant Children shows that three policy reforms – increased attendance in quality preschool, improved instruction in English, and increased attendance in postsecondary education – would lift their wellbeing as adults and increase their economic and social contributions in American society.

“Today’s minority youth are coming of age in an aging society… which will depend increasingly on the productivity of younger workers,” write Immigrant Children issue editors Marta Tienda of Princeton and Ron Haskins of Brookings. “At a critical juncture in its history, the United States has an opportunity to invest in [minority] youth and enable them to contribute to national prosperity.”

For more information on the country’s changing demographics, immigrant children, and education reform, see the Future of Children volumes on Fragile Families, Immigrant Children, Transition to Adulthood, and America’s High Schools.

How Do We Define and Measure Disabilities in Children?

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On Tuesday, May 8th 2012, the Brookings Institution hosted an event featuring the Future of Children’s most recent volume, Children with Disabilities and its corresponding policy brief, “The SSI Program for Children: Time for Change?“

Issue Editor Janet Currie, the Henry Putnam Professor of Economics and Public Affairs and director of the Center for Health and Wellbeing at Princeton University, highlighted the major themes from the volume including the documented increase in disabilities; the recent shift in disabilities from physical to mental health disorders; the significant costs associated with disabilities for individuals and families; the fragmentation of services; and the possibilities for improving the wellbeing of children with disabilities with the medical home model, new technologies, and prevention efforts.

Researchers’ efforts to track trends in disability and understand the causes and implications of the recent increase in diagnoses have been seriously complicated by changes over time in how disability is defined, which criteria should be used for screening, which services should be made available, and to what extent particular conditions are actually considered disabling.

These fundamental challenges of definition and measurement over time became more important as the discussion continued to the Supplemental Security Income (SSI) cash assistance program for children with disabilities. Ron Haskins, Co-Director of the Center on Children and Families at the Brookings Institution, asked a panel including keynote speaker Kenneth Apfel of the University of Maryland and former commissioner of the Social Security Administration, who presented on the history of the program, if it was time to change SSI.

The panel, which also included Marty Ford, Chief Public Policy Officer for the Arc of the United States, Matt Weidinger, Majority Staff Director of the Committee on Ways and Means, U.S. House of Representatives, Jonathan Stein, General Counsel at Community Legal Services of Philadelphia, and Michael Wiseman of the Office of Retirement and Disability Policy, emphasized the need to create a new vision for SSI. They contend that SSI should maintain the income stability it provides for severely disabled children (and there was debate as to how this should be done). It should also look more carefully at reviewing SSI recipients over time to better understand their differing disability levels, and to support them, particularly as they transition to adulthood.

Eventually, the conversation turned to the inevitable: budget constraints. As Ron Haskins and Matt Weidinger noted, Congress is going to cut funding, possibly looking even to means-tested programs such as SSI.

Given that, what is realistic? “And, what are the outcomes that show that SSI is working?” Weidinger asked.

Janet Currie’s response brought the conversation back to one of the volume’s key findings: without a consistent definition of disability and data that tracks children over time, it is difficult to discuss research-based outcomes of SSI. This is not because the program does not work, but because the data simply does not exist. But the credibility of the program should not be discounted simply because of a lack of evidence.

In the meantime, as the volume notes, “researchers must pay attention to how disability is defined and develop workable definitions that can be implemented in national surveys and maintained over time. Only in this way can they learn whether the increasing numbers of children with disabilities represent an exploding epidemic or an emerging, more nuanced understanding of what it means to be disabled… policy makers should be mindful that whether or not the number of special needs children is growing, large numbers of children must live with a diagnosed disability and these children merit attention.”

To listen to the panel’s recommendations for improving the SSI program, click here.

To read the Children with Disabilities volume, click here.