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