Health status of Victorian special school children

Objective : This study sought to determine the health status and health needs of a sample of students attending special schools for the intellectually disabled in Victoria, Australia. Methodology : Two hundred and forty-nine students not previously seen by a Community Child Health Medical Officer (CCHMO) were assessed at school. Data on student, parent and staff needs were obtained through personal interviews and documented on a standard questionnaire. Health status was documented using data obtained from parents and teachers as well as the clinical assessment. Results : Comparison of the number of problems reported by parents with the number confirmed at examination showed significant underreporting of vision, hearing and general medical problems. However, behaviour problems were nearly all reported. Many students had multiple problems with 63% having 2-4 problems and 11% having 5-8 problems. Ninety-nine (40%) of the 249 children seen had newly detected problems; vision (24), hearing (24) and obesity (9) were the most common. Two hundred and forty-four (98%) had known problems and 27% of these had insufficient information available from parents or staff to completely ascertain their health status. In 115 cases the primary problem was intellectual impairment of unknown cause. Down syndrome was the next most common underlying diagnosis (30) followed by autism (24), epilepsy (21) and cerebral palsy (15). The most common secondary diagnoses were asthma (16), congenital heart defects (12), seizures (8) and skin problems (8). Many students required referral for further management both for newly detected problems (64%) and known problems (18%). Parents required counselling and/or discussion on a number of issues for both newly detected problems (66%) and known problems (39%); when counselling had taken place parent and staff concerns had reduced significantly by the time of the follow-up assessment. Conclusions : This study demonstrated that in those students with known intellectual impairment there were many with other unrecognized health problems and unmet needs. These findings have implications for health services provided to children attending special schools.