Supporting school re-entry of children with special health care needs post extended hospitalizations

Children with special health care needs (CSHCN) often face significant disruptions in their education due to extended hospitalizations. A recent study published online in Disability and Rehabilitation on July 1, 2024, by a multidisciplinary team of Kessler Foundation and Children Specialized Hospital researchers, highlights critical areas needing attention to ensure smoother school re-entries for CSHCN, ensuring they receive the necessary educational support post-hospitalization.

Involving parents, former patients, and rehabilitation professionals, the study underscores the need for better coordination and communication to facilitate seamless transitions back to school for CSHCN. Titled "Experiences of patients, parents, and health care professionals in the process of transitioning from hospital to community after inpatient pediatric rehabilitation among children with special health care needs", the article offers insights into the challenges and solutions for improving school re-entry for CSHCN.

Foundation authors are Yu-Lun Chen, Ph.D., OTR/L; Stephanie Jimenez; Alexa Bartalotta; John O'Neill, Ph.D.; and Amanda L. Botticello, Ph.D., MPH. Claire M. Marchetta, MPH, is from Children's Specialized Hospital.

Semi-structured focus groups were conducted with parents (n = 12), former patients (n = 20), and rehabilitation professionals (n = 8). "Through a detailed analysis of recurring themes, we identified three essential points to help achieve the best outcomes. However, these steps were not always effectively implemented to achieve the desired results," said lead author Dr. Chen, research scientist, Center for Outcomes and Assessment Research at the Foundation.

"Inpatient educational support such as instruction and schoolwork helped reduce the learning loss during hospitalization. However, these supports were sometimes complicated by lags in school approvals and challenges in coordination between systems," said Dr. Chen.

"Transition planning involved establishing necessary services to support CSHCN's educational and health care needs at school re-entry, though families reported limited information and guidance as key barriers," she explained. Providing clear and accessible information to families about transition processes is particularly crucial for those dealing with newly acquired health conditions, though families highlighted the lack of information and guidance as significant barriers to effective transition planning.

"And finally, continued support after discharge was essential, with many participants recommending reassessment and adjustment of transition plans to account for evolving developmental and educational needs. However, these supports were sometimes hindered by delays in school approvals and coordination challenges between health care and educational systems," concluded Dr. Chen.

The study stressed the urgent need to improve communication between clinicians and educators, provide comprehensive information for families, and ensure long-term follow-up on the changing educational needs of CSHCN post-rehabilitation.