DOI: 10.3886/icpsr39560
title: Return to School: A Mixed Methods Investigation of Community Integration After Pediatric Rehabilitation, New Jersey, 2021
title: Archival Version

description: Education is an essential part of childhood, and
attending school is vital to community integration for children with special
health care needs. These children continue to face significant barriers to
obtaining a high-quality educational experience, despite decades of federal
legislation designed to promote full inclusion and access to schools for
everyone. Children with special health care needs often struggle with school
functioning because chronic health problems increase the risk for lengthy
illnesses and hospitalizations. Pediatric rehabilitation specialists assist
these children and their families with the transition back to school after a
health event. However, there is a lack of information available to help clinicians, families, and educators plan for the dynamic
experience of disability as a child develops and interacts with the school
environment. Healthcare providers need this information to evaluate their
transition services from hospital to community and develop new interventions
that can improve the educational success of these children over time. The purpose of this project was to engage former patients and their families to identify the school experiences and processes that affect their return to school, a key aspect of community integration, after medical rehabilitation. This study used focus groups with parents, former patients, and clinicians to understand the experience of return to school after pediatric rehabilitation, identify barriers and supports, and the impact on educational outcomes based on lived experience.
description: The intention of rehabilitation care is to improve the ability of persons with disabilities to live meaningful and productive lives in the community. For children with special health care needs (CSHCN), this means enhancing the ability to participate in school and attain educational goals. Despite this common objective, relatively little is known about the experiences of "return to school" following an acute hospitalization. The families of CSHCN face significant challenges in navigating their child's return to the school environment and attaining services needed to maximize social integration and academic participation. Research in this area is limited by small sample sizes, a lack of recent studies, focus on a single impairment, a lack of objective outcome measures, and the absence of meaningful comparison groups. What is needed in the field of pediatric rehabilitation is in-depth descriptive information of the long-term outcomes in this population so that researchers, clinicians, and parents alike can better assess academic integration post-discharge.
Botticello and O'Neill designed a mixed methods program of research to understand school outcomes for children with special health care needs after pediatric rehabilitation. The first phase of this research identifies a cohort of former patients from hospital records and assesses objective academic outcomes based on secondary analysis academic records maintained by the New Jersey Department of Education. The objective of the second phase of this research seeks to identify and understand the processes involved in return to school from focus groups with key stakeholders including parents, former patients between the ages of 13-and above and adulthood, and clinicians. Using focus group discussion and data, Phase II of the Return to School (RTS) project aims to:



Identify the processes underlying the school outcomes, including barriers and facilitators such as programs and services received in schools.

Explore the mechanisms associated with academic functional limitations for CSHCN posited in the literature including absenteeism, service use, and social difficulties.

Explore the impact of school difficulties on later quality of life for both the children and their families on young adult psychosocial outcomes such as continuing to higher education, employment, and social relationships.
description: Drs. Botticello and O'Neill conducted 11 focus groups and used a moderator guide. The focus groups were conducted virtually using a secure video-conferencing platform. Each group lasted approximately 90 minutes.
description: The topics discussed in focus groups include, but are not limited to: school re-entry experiences, barriers and supports, and mechanisms reviewed in the literature such as absenteeism, health complications, and social problems.
description: Participants were recruited using a combination of referrals and recruitment flyers. A purposive sample strategy was used. This is a sampling technique used in qualitative research to ensure representation of specific experiences and knowledge types by the participants.
description: Datasets: 
DS0: Study-Level Files
DS1: Children Focus Group 1
DS2: Children Focus Group 2
DS3: Children Focus Group 3
DS4: Children Focus Group 4
DS5: Children Focus Group 5
DS6: Parent Focus Group 1
DS7: Parent Focus Group 2
DS8: Parent Focus Group 3
DS9: Parent Focus Group 4
DS10: Clinician Focus Group 1
DS11: Clinician Focus Group 2
description: Parents of children with special healthcare needs who received acute inpatient pediatric rehabilitation, former patients (aged 13 and above), and rehabilitation specialists.
description: face-to-face interview; web-based survey