Wednesday, August 15, 2012

CEP822 Literature Review


Literature Review
Gary J Brumbelow

Introduction
The Topic:
            We all hope and pray that every young infant is born healthy and without incident. We hope and pray that every child grows up to enjoy a life filled with happiness, love, and good health. However, the reality is that many children are born with, or develop, long-term or life-long illnesses that require repeated hospitalization and acute care. This begins a life of doctors, nurses, care givers, tests, treatments, procedures, and hospital stays. It is a life that many do not consider or give much thought to if they are not directly affected or know of a family with this stark reality.
            While the health and mental well being of each and every child is at the forefront of our care and concern, we must also consider the educational needs of the child. With repeated illness, hospitalization, care needs, procedures and tests, treatments, and travel time, students and their families must balance a life of academics with a life in and out of medical facilities. The question is; how do we, as an educational community, ensure that these students are provided with sound and supportive educational opportunities?

General Overview of Literature:
            In my search for source material, I found that very little research has been done in the area of on-line education for chronically ill children. Within this narrow band of research dealing with on-line education for these children, none that I have found have dealt with K-12 curriculum. The bulk of the research being conducted over the last eight to fifteen years has centered on the needs of students who are integrated into the K-12 public school systems through inclusionary programs. This demonstrates a strong need for investigation and research into the effective use of online educational programs for K-12 curriculum for children suffering from long-term illnesses.

Rational:
            My exploration has shown little research has been done on the potential effectiveness of technology-based online K-12 educational resources that can be made available to students and parents. Nor, did my research result in any studies specifically dealing with online K-12 education for children suffering from a long-term chronic illness. Therefore, in reviewing the available source material, I looked for studies that either focused on the effectiveness of on-line tools for chronically-ill children or studies that focused on the educational needs of children who suffered from a long-term illness with repeated hospitalizations and medical care needs.

Body
Kinds of work reviewed:
            My search for published material in the area of chronically-ill children with long-term diseases, in regards to their education, produced a limited number of sources. However, in the pertinent material discovered, I was able to select strong resources from varying sources. Of the six sources I chose, one is a published doctoral dissertation, four are published journal articles based on studies that have some direct correlation to a specific area of my proposed research, and one is an article reviewing a wide-range of school integration programs for children with cancer in the United States. Each source provides a unique perspective of the issues within my proposed research and provides strong evidence to support my hypothesis. The fact that my research produced a limited number of resource materials only strengthens my case that further research is warranted in this area.

Description of selected important works:
            Part of my proposed research is an online interactive support network where students with long-term illnesses can communicate and discuss schoolwork, as well as life issues, with their online classmates. It is my opinion that this network will provide students with an outlet where they can openly communicate with one another, which will in turn provide a stronger, more stable learning environment. By having a platform where they can interact with other students facing the same issues they are, they will feel more at ease and be more focused on their education rather than the social stigma of their illness often dealt with in the public school environment. The article Hopkins Teen Central: Assessment of an Internet Based Support System for Children with Cystic Fibrosis references research conducted on the benefits of Electronic Support Groups (ESG’s) for childhood patients with chronic debilitating illnesses. The information provided through this study shows an increase in communication between the children in the ESG, and the participants felt that at the end of this study they had more friends with whom they could relate to. This study is positive evidence that ESG’s are a viable and worthwhile avenue for students with chronic life-long illnesses and would provide a benefit when coupled with an on-line K-12 educational program.
            While I feel an online support network for students is integral to the success of my proposal, the online K-12 educational program is the main focus of my research. A study entitled Effects of STARBRIGHT World on Knowledge, Social Support, and Coping in Hospitalized Children with Sickle Cell Disease and Asthma published in Children’s Health Care in 2002 supports the idea of an online educational system for chronically ill children. This study reviews the effectiveness of STARBRIGHT World, a private online computer network for hospitalized children that provides interactive health education in over 95 hospitals, as well as opportunities to meet online and socialize with children that are dealing with the same medical issues. This study reviews children who received health education for either Sickle Cell Disease (SCD) or Asthma via STARBRIGHT and participated in online activities while in the hospital and compares the overall effectiveness of that education to the control group that received the information via traditional hospital training methods and interactive activities. The findings show that through the online instructional methods and activities, students demonstrated a greater depth of knowledge for teens with asthma, and greater support for students with SCD. These findings provide evidence that online educational and support programs in general K-12 education would benefit students overall educational progress, while providing a stronger and more supportive learning environment for children with long-term diseases.
            My research has found that the primary option for students and parents today is integration into the public school systems during and after treatment. In order to understand the issues that students are facing, and evaluate the merit of my proposal, I looked for research conducted on the positive effects and negative issues faced by chronically ill children who are educated through inclusion in the public school systems. Project School Care: Integrating Children Assisted by Medical Technology into Educational Settings  is a comprehensive study looking at the needs of children assisted by medical technology as they re-enter the public school setting. This research looks into the planning required by medical staff, the parents and child, and the school system leading up to the student’s enrollment into the classroom. The study was conducted with participation by doctors and nurses involved in the ongoing care of the student, the parents and the child involved, and the members of the participating school district (teachers, building principals, counselors, and district administrators). The findings showed, that while there was great detail, time, and resources dedicated to providing the student with a positive and safe transition back into the public school system over the period of the study, there was still a great deal that needed to be done in order to ensure that this was a positive solution to the child’s educational needs. This study provides a strong look at the issues facing chronically ill children as they continue their education in a public school setting and provides support for research on alternative online school platforms.
            A key factor in the educational success of children suffering from long-term illnesses is the student themselves. Supporting Pupils in Mainstream School with an Illness of Disability: Young People’s Views is study that looks at the educational issues and needs of students with long-term chronic illnesses. Not from the point of view of the parent, the medical staff, or the school, but rather from the students themselves. Through carefully constructed interviews, researchers questioned students on the issues, needs, and successes of inclusion in the public school system. The students stated that they were able to manage their education; however, there was need of assistance from outside sources (parents, teachers, medical staff, counselors, etc.). Further investigation showed that in fact, students suffered in dealing with repeated absences, issues with falling behind in school work, social exclusion with peers, exclusion from curriculum, difficulty with teachers who did not understand the needs of the students, and exclusion from school social functions and student groups. This gives evidence to the need for research and consideration in alternative instructional styles such as virtual or on-line classrooms and ESG’s where the students can fully participate in their classes and interact socially, while in and out of the hospital.
            In order to support my theories and provide evidence towards the need for a pilot online K-12 program, I will cite data collected and published in Educational Late Effects in Long-Term Survivors of Acute Leukemia in Childhood. This dissertation studies the effects of childhood cancer patients. Within this study, there is factual research and discussion on the overall educational effects on the students both personally and academically while in treatment. This study not only reports on the academic growth and performance on standardized tests, it also looks at areas such as absence from school, social acceptance in the classroom while the student has lingering physical symptoms stemming from treatment, family issues, and mental well-being. All of this information is directly pertinent to my research topic. The information contained supports my thoughts and questions surrounding the issues of educational stability and quality for children while receiving treatments and undergoing repeated hospitalizations for long-term diseases.
            The final article I chose entitled, A Review of School Reintegration Programs for Children with Cancer, is a review of various school integration programs throughout the US for children with cancer. In this review, federal regulations regarding the rights of students with chronic illnesses to educational and support services are discussed. Along with this, the importance of school attendance, the difficulties surrounding the return to school, as well as components for reintegration programs are presented and thoroughly discussed. This article gives a broad view of programs provided for cancer patients who are of school age. This also provides information pertinent to the investigation of the potential need and success of a nationalized health program for chronically ill children.

Conclusion
            It is my opinion, with the increased use of technology in education and the advances in online classrooms, that a program can be put in place to guide, assist, and support both the student and their family, as well as the teacher and school district with this issue. My research shows that there are private online systems in place for health education and emotional support for children with these health needs. However, I have found nothing of this kind for K-12 curriculum. I believe the studies and articles cited demonstrate a valid need for investigation into the potential positive effects that online education can have on the lives of children who suffer from long-term illnesses that require repeated hospital stays and acute care.
  

Cited Sources

Hazzard, A. Celano, M., Collins, M.  (2002). Effects of STARBRIGHT World on Knowledge, Social Support, and Coping in Hospitalized Children with Sickle Cell Disease and Asthma. Children’s Health Care, 31(1) 69-86.

Johnson, K. B., Ravert, R. D., Everton, A.  (2001). Hopkins Teen Central: Assessment of an Internet-Based Support System for Children With Cystic Fibrosis. PEDIATRICS, 107(2).

Lightfoot, J., Wright, S., Sloper, P.  (1999). Supporting Pupils in Mainstream School with an Illness of Disability: Young People’s Views. Child: Care, Health, and Development,  25(4), 267-283.

Palfrey, J. S., Haynie, M, et al. (1992). Project School Care: Integrating Children  Assisted by Medical Technology into Educational Settings. The Journal of School Health, 62(2), 50.-54.

Peckham, V. C.  (1986) Educational Late Effects in Long-Term Survivors of Acute Leukemia in Childhood. (Doctoral Dissertation).

Prevatt, S. F., Heffer, R. W., Lowe, P. A.  (2000). A Review of School Reintegration Programs for Children with Cancer. Journal of School Psychology, 38(5), 447-467.



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