But the overall findings from the study were disheartening, Forrest said. Kids with special health care needs "have significant differences in their engagement in school and their school relationships, as well as academic achievement," he said. "It sets up a trajectory for these kids that's highly distressing."
The high proportion of low-income families living in the three districts studied could have contributed to the study results, Forrest noted, because higher-income schools may have more programs in place to help kids adjust to special needs before fourth grade.
"It's not a national study," he said. "Some communities may have better resources than others."
James Wendorf, executive director of the National Center for Learning Disabilities in New York City, praised the study, saying it "looked at the whole child."
"It certainly clarifies that learning disabilities, once again, are shown to have a demonstrable effect on children's achievement in school," Wendorf said. "We know that students with learning disabilities . . . have very distinct social and emotional challenges that can lead them into difficult situations. We also know many of these things intensify as children grow older."
And because the study used a cross-sectional design, Forrest said he was unable to rule out reverse causation -- that children with poor school outcomes may also be more likely to be labeled as having a special health care need.
Because the problems linked to these special needs can't be qualified as only health- or education-related, Forrest also questioned how communities can bring both systems together when each is funded by a separate stream of finances.
"I also believ
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