DOD operates a worldwide school system to meet the educational needs of military dependent students and others, such as the children of DOD’s civilian employees overseas. DODEA oversees the management and operation of 196 schools in seven states; Puerto Rico and Guam; and 12 foreign countries. DODEA has organized its schools into three areas—the United States, Europe, and the Pacific—and multiple districts within each area. About 66 percent (130 of 196) of DOD schools are located overseas serving about 68 percent of the student population (approximately 58,000 of 85,000 children) (see fig. 1). The overseas schools are mainly concentrated in Germany and Japan, where the United States built military installations after World War II. Almost all the domestic schools are in the southeastern United States. DOD schools provide a comprehensive kindergarten through 12th grade curriculum.students received special education services in the 2011-12 school year. Approximately 12 percent (or about 10,200 students) of all As of January 2012, the most prevalent disabilities among children enrolled in DOD schools were communication impairments (such as speech and language impairments), specific learning disabilities, and developmental delays, cumulatively representing about 71 percent of this population (see fig. 2). Appendix II provides DOD’s categories and definitions of disabilities. While some children may have more than one type of disability, DODEA bases its criteria for determining eligibility for receiving special education services on the primary type of disability that has the greatest educational impact. Although DOD schools do not receive IDEA funding, DOD is required to provide in its educational programs the substantive rights, protections, and procedural safeguards for students with disabilities under IDEA.Specifically, DOD is required to provide these children early intervention services, and special education and related services. For children ages 3 to 21, this includes identifying and evaluating eligible children; developing and implementing an individualized education program (IEP) for such students (see fig. 3); and providing the students special education and related services.programs—are responsible for providing selected related services as well as completing evaluations for certain disabilities, such as autism or visual or hearing impairments, that may require medical expertise. Like public schools in the United States, DOD is required to provide special education and related services necessary to meet the unique needs of eligible students. As needed, DOD schools provide special education services in all schools worldwide and related services (such as occupational and physical therapy) in its domestic schools only. Overseas, each branch’s medical department provides related services to eligible students through its EDIS program. A child with a disability may receive services from some or all of the DOD entities shown in figure 4, depending on the family’s location. Services for children with disabilities in DOD schools may include consultation by special educators to general classroom teachers or instruction in a special education classroom for part or all of the school day. In addition to special and general education teachers, DOD schools employ paraprofessionals—who assist and support teachers— and specialists, such as speech and language therapists. DOD schools in the United States also provide related services, such as physical and occupational therapy. The military branches’ medical departments provide different types of services for children with disabilities through their EDIS programs. EDIS helps identify children with disabilities and delivers early intervention services to eligible infants and toddlers, from birth through age 2. EDIS also provides medical assessments necessary to determine children’s eligibility for special education services. For example, in order to provide special education services for children with emotional impairments or autism spectrum disorders, DODEA requires medical evaluations and diagnoses by qualified medical professionals, such as developmental pediatricians, psychologists, or psychiatrists. Although military families may use civilian providers in the United States, when stationed overseas, only military providers may provide these diagnoses for children attending DOD schools. Overseas, EDIS also provides related services for children enrolled in DOD schools. Domestic DOD schools provide special education for all types and levels of disabilities, mainly within DOD schools. However, according to DOD, in certain cases students may receive services from external service providers that DOD contracts with or they may be placed in local public schools. Overseas, the military branches and DODEA have implemented a system of specific, pre-established programs for different types of disabilities and levels of services in each school. For example, schools in Ramstein, Germany, have programs designed to serve children with all types of disabilities, whereas schools in Iwakuni, Japan, have programs that serve only a few types of disabilities, and the Seville Elementary School in Spain has no programs for any type of disability. Agency officials explained that this variation is a function of the size of the military community and the needs of the military. To help facilitate intra-agency communication about these differences, DOD developed a directory that indicates which pre-established programs are available in each school overseas. (See figure 5 for an excerpt of this directory.) Moreover, DOD schools provide different levels of service for each type of disability, as indicated by the circles in the DOD directory excerpt shown in figure 5. For example, Garmisch Elementary School in Germany has a program to provide services in the general education classroom for children with the mildest forms of specific learning disabilities. In contrast, Naples Elementary School in Italy is equipped to provide individualized instruction in a separate classroom setting for children with the most severe types of specific learning disabilities. Schools in Ramstein, Germany, are equipped to serve children with severe disabilities of any type. Nonetheless, consistent with IDEA requirements, it is DOD policy that all schools must provide special education services to all students with such needs, regardless of the types or severity of students’ needs or the school’s location. Because DOD schools in overseas communities are designated to serve children with certain types and levels of disabilities, the military branches and DODEA are required to coordinate the overseas assignment of servicemembers with families with special needs, including all children with IEPs. All family members who are seeking a move overseas must be screened by the relevant branch’s medical department for medical and educational needs in addition to other factors that might inhibit travel overseas, such as financial problems. If the medical screening identifies an EFM program-enrollable condition, the servicemember is referred for EFM program enrollment. Each branch implements its EFM program differently, and the branches’ screening and assignment coordination processes also vary somewhat. Generally, through a process referred to as EFM program assignment coordination, the servicemember’s personnel office coordinates with the medical department to verify the availability of medical services in the planned location overseas. During this process, the military branch is also required to coordinate with DODEA about the educational programs available. DODEA makes a recommendation based on the services available at the schools, and the branch’s medical department makes a recommendation about the availability of medical services. The military branch then determines whether the servicemember and his or her family should proceed to the planned location. Depending on the recommendations of both medical and educational reviewers, the servicemember may be approved for travel accompanied by family members, recommended to relocate to a different location, or allowed to take an unaccompanied tour. However, according to DODEA and one branch’s military officials, the installation’s command personnel may override a recommendation for an unaccompanied tour and allow the servicemember to bring the family if he or she has special skills that are needed at an installation. Each year, some military families with children with special educational needs are sent to locations that are not prepared to serve their children’s needs upon arrival. This may occur either due to a “screening failure” (i.e., when an educational screening did not occur) or an “assignment concern” (i.e., when the family was screened but the child was nonetheless enrolled in a school unequipped to meet his or her needs). DODEA records the number of screenings completed and assignment concerns, as well as the reasons for such concerns. DODEA data show that since school year 2008-09, there have been 93 instances when children were educationally screened, but still arrived at a school that did not have programs in place to meet their needs. This may have occurred because (1) the student’s needs were more severe than the educational or medical screening indicated, (2) the military overrode DODEA’s assignment recommendation, or (3) the servicemember was approved for one location but was reassigned to another. Moreover, several DODEA and school officials we interviewed confirmed that a number of children with special educational needs who were not screened have enrolled in their schools. For example, school officials in Naples said that a few years ago, the school received 44 incoming students with IEPs, but only four of those students had been educationally screened through the EFM program. According to OSN officials, schools are generally able to accommodate children with mild disabilities regardless of the location, and such cases would not be recorded as assignment concerns. However, DODEA officials overseas also stated that when children with severe disabilities are sent to locations that do not have appropriate pre-existing programs, even a very small number of these cases can require substantial additional resources. According to a Navy EFM program official at an installation we visited, screening and assignment coordination failures could cost the military up to $100,000 per incident. Although all four branches require EFM program enrollment for eligible servicemembers, underenrollment in and circumvention of EFM programs were cited repeatedly as concerns during our interviews and site visits. Senior OSN officials estimated that about half the families with children with special needs who are eligible to enroll in the EFM program have not done so.