AJPH -- eLetters for Stingone and Claudio, 96 (9) 1593-1598

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RESEARCH AND PRACTICE:
Jeanette A. Stingone and Luz Claudio
Asthma and Enrollment in Special Education Among Urban Schoolchildren
Am J Public Health 2006; 96: 1593-1598 [Abstract] [Full text] [PDF]

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Response to Stingone and Claudio: Madeline Lee (21 November 2006)

Response to Stingone and Claudio 21 November 2006

Madeline Lee,
PhD Student
Washington University in St. Louis George Warren Brown School of Social Work
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Re: Response to Stingone and Claudio

mylee{at}wustl.edu Madeline Lee

20 November 2006
Dear Editor:
In the September 2006 issue, Stingone and Claudio’s study assessed the relationship between asthma and urban elementary school children’s use of special education services in New York City. I commend the authors’ work on highlighting the public health significance of poor management of asthma among urban children and possible educational ramifications.
I am writing to address a couple of questions regarding the study. The authors state that the temporal relationship between an asthma diagnosis and placement in special education was established by analyzing the model that focused only on children who had been diagnosed with asthma before entering school (before their fifth birthday), but details about this analysis were not reported. Information regarding the number of children eliminated to create the new model (or sample size of the children who were diagnosed with asthma before the age of 5), along with the variance explained, could strengthen this analysis since the temporal relationship between asthma diagnosis and special education eligibility is important in supporting other major findings in the study.
The authors discuss that their findings point to the possibility that children who have poor asthma management are at risk of having learning difficulties that lead to enrollment in special education, but the nature of these learning difficulties is not specified. This is an important implication of their findings that may be supported with longitudinal data, including school academic records and Individualized Education Programs with the special education eligibility category of the student that could confirm if poor asthma management was indeed followed by what specific kinds of learning difficulties and then followed by special education services. Longitudinal data would reveal the timing of events which could inform better targeted interventions.
Stingone and Claudio’s study emphasizes the need to target school health programs for low-income urban children, which may decrease unnecessary enrollment in special education. This is important from both a public health and educational perspective. I look forward to future research in this area. Thank you very much for your consideration.
Sincerely,
Madeline Lee, MSW