Bowdy, A. Utilization of School Intervention Services for Children and Adolescents with Cystic Fibrosis

Utilization of School Intervention Services for Children and Adolescents with Cystic Fibrosis

1Ashley Bowdy UC COM MS2 (medical student), 2Thomas Boat, MD (PI), 2Elizabeth Hente, MPH, 3Sarah Strong, M.Ed.

1University of Cincinnati College of Medicine; 2Division of Pulmonary Medicine, Cincinnati Children’s Hospital (CCHMC); 3Center for School Services and Educational Research, CCHMC

Category: Clinical Medicine

Subcategory: Pulmonary Medicine

Introduction: Children with chronic illness are at a higher risk for problems with school performance and have a variety of educational needs that are not sufficiently addressed by current school supports in place (Lum et al., 2019). Services provided by school liaison specialists have been implemented for several illness populations at Cincinnati Children’s Hospital (CCHMC); services were initiated for the cystic fibrosis (CF) population in 2017.  Little is known about the utilization and benefits of school intervention services in this population. This study investigated the utilization of school intervention services by patients with CF and their families.

Methods: A school liaison specialist in the CF center at CCHMC provided school intervention services to patients and their families over three consecutive years. Educational risk assessments were administered using the Brief School Needs Inventory (BSNI; Elam et al., 2019). Retrospective chart reviews were performed for patients in grades K-12 who utilized school intervention services during the 2017-2018, 2018-2019, and 2019-2020 school years. The number and type (family or school), method of communication, and topic of conversation were collected for each encounter with the school specialist. Results of the BSNI and disease severity variables were also collected. A mixed framework method of inductive and deductive qualitative coding was used to describe encounter themes, including education, coaching, collaboration, general support, communication, and more, observed in clinical encounters. Statistical analyses assessed correlations between utilization of school intervention services and BSNI risk score (low, moderate, high) or disease severity.

Results: A total of 125 patients were included in analyses. Most patients/families had at least one encounter with the school specialist in a given school year (58%, 74%, and 68%). In all three years, encounters between the school liaison specialist and families were more common (372, 359, and 350, respectively) than encounters with school personnel (202, 124, and 168). In all three years, school progress and education plans (504, IEP) were the most prevalent topics in both family and school encounters. Communication, general support, and education were among the most prevalent encounter themes across all three years. Education risk score and number of days in the hospital in the 12 months prior to BSNI screening were significantly correlated in all three years (p=0.0380, p<0.0001, and p<0.0001). The total number of encounters in a given school year and the education risk score were significantly correlated in all three years (p=0.0024, p<0.0001, and p=0.0002).

Conclusions: The majority of patients with CF and their families utilized a range of intervention services, when made available, to improve school advocacy skills and address educational needs. Utilization was highest for families whose children had the greatest health and educational risks. Documenting extensive utilization of these services by many CF patients and families provides initial evidence of need for expanded attention to school engagement and academic performance in the pediatric chronic care model. School success is recognized as important for current emotional health and for lifespan wellbeing, and is particularly important for children with chronic, complex disorders.

Contact Information: Ashley Bowdy, bowdyan@mail.uc.edu; (859) 468-7020

Key Words: cystic fibrosis, school, education, pediatrics