Creating Safe and Supportive Schools for Students with Disabilities During Delta
Since the start of the pandemic, COVID-19 has posed a disproportionate health risk for children with special health care needs, such as children with physical, intellectual, and developmental disabilities or chronic conditions like asthma or diabetes.
And with the surge of the highly contagious Delta variant coinciding with the start of the new school year and a return to in-person learning for many students, families and educators of students with disabilities have become increasingly concerned about creating safe and healthy learning environments.
We spoke with three experts to learn more about the Delta variant, how it is impacting the 2021-2022 school year for students with disabilities and special health care needs, and what schools and families can do to support this population of students.
Keeping Students with Disabilities and Special Health Care Needs Safe From the Delta Variant
There has been a surge of children being hospitalized with COVID-19 in recent weeks. What makes the Delta variant different from previous forms of COVID-19 and is it more dangerous for children?
It's unclear if the Delta variant is more dangerous for children. There are certainly clinicians at the bedside who have felt as though the children are presenting sicker and faster, but that hasn't been confirmed yet through research. What is clearly driving some of what we're seeing is the increased transmission. The R-naught [a mathematical term that indicates how infectious a disease is] of the Delta variant is eight, which means for every person who's infected with the Delta variant somewhere, they will infect approximately eight other people. This makes the Delta variant as transmissible as chickenpox. And thus, with the increased transmission, more children get infected. And as more children get infected, more children obviously are going to go on to the hospital and into intensive care and then to long-term morbidity.
And how does the Delta variant specifically impact students with disabilities and special health care needs?
The children that are in what we in North Carolina often call the adapted curriculum, those children are at decidedly higher risk of acquiring infection, primarily because in that separated classroom setting the mask adherence is different than it is in the mainstream settings. The mask adherence in the mainstream setting can be driven to 95 to 99 percent with monitoring and frequent reminders—school leadership having a universal mask mandate in place, school leadership leading by example to model good behavior. In the adapted curriculum, we have not studied this as thoroughly as we have with the mainstream curriculum, but what we have seen is that you get about 50 to 80 percent of those kids who are able to mask with reasonable fidelity. So sometimes the mask might drop down under their nose or sometimes they might need some more mask breaks, which you can do outside. And some of those kids really cannot mask at all.
How can schools do a better job of protecting students with disabilities who are unable to mask up for medical reasons?
Schools can do five things. First, vaccinate everyone who is eligible as soon as they are eligible. Second, mask the adults and all the children who can mask. Third, rapid testing, because you want the rapid turnaround time, and you want to test more than once weekly if it's going to be effective. Sending off a PCR once a week that comes back a couple of days later is not helpful. Fourth, eat outside and spend as much time outside as possible provided that can be done safely. And fifth, indoor ventilation and distancing are probably worthwhile if you can manage in this group—but unfortunately, Delta is so transmissible, those options may not do much.
An increasing number of states are now requiring educators to be vaccinated against COVID-19 or else take weekly COVID-19 tests. How could this policy impact school safety for vulnerable students?
Well, really, the teachers should be vaccinated. And, you know, if you want to get into a policy where you do vaccination or testing, they should be tested multiple times per week with a rapid test.
The FDA may soon authorize the Pfizer and BioNTech COVID-19 vaccine for children ages 5 to 11. How could this help protect students with disabilities and what should families know?
Well, they definitely want the vaccine if it's authorized. It looks preliminarily like the data are going to show that it's effective for children 5 to 11, and there's no reason to think otherwise. The mortality and morbidity risk are reduced by over 90 percent. The vaccine—even with the Delta variant—makes COVID-19 less a threat to children than influenza, substantially less. So, far and away the thing you want to do is vaccinate your children.
In the meantime, what are some steps that families can take to make their school a safer place for students with disabilities and special health care needs?
A big thing that parents can do is advocate to their school district to work with a neutral third party such as ourselves. ABC Science Collaborative will help them for free. We will help them make these kinds of decisions. We'll help them analyze their own data and we'll help them compare their data to school districts throughout the country. And we encourage them: “OK, compared to other school districts that mask, you guys could use a little help. Here are five or six things that the other school districts are doing that you're not doing that you could consider doing.” Or, “here is a time when it’s likely to be safe to take off masks in school”. We call this program “decision support” because the school makes all the decisions and we just help them think through their data so that they can make informed medical decisions. Because really, that’s what these school boards are doing—they are making medical decisions for thousands of children, and wouldn’t you want medical decisions made with some help from people who went to medical school? That is a very important intervention that parents can advocate for.
Supporting the Academic Needs of Students with Disabilities During the Delta Variant
With the Delta variant surging, many families of students with disabilities are torn between remote and in-school learning. What have been some of the academic impacts of remote learning on students with disabilities?
It's really, really difficult to speak in generalities around this population, which is so diverse. But I would say that students with more significant disabilities who frequently required more one-on-one intervention in a school setting at times struggled with both accessing and being successful with remote instruction. We had students who weren't able to successfully access academic instruction, so reading, language arts, mathematics instruction, whether it was from an inability to use technology, whether it was lack of wireless capability—depending on where they were located—or whether it was the need for more intensive support provided in person. While families identified concerns and while school districts attempted to problem-solve around those, we didn't find solutions for some students and some students didn't make progress or didn't access education for an extended period of time, which is not acceptable.
So how are schools in Washington currently helping to support these students who struggled with equitable access to instruction?
We are requiring for all students with an IEP, during IEP meetings each team carefully considers the services that were provided during the pandemic and whether the student made adequate progress on IEP goals. For students who did not make progress, there will be recovery services or additional Special Ed services that are needed for that student in order to be able to recover that learning opportunity.
What are a few actions that schools can take to support students with disabilities and their families during the Delta variant?
One of the things that we've heard from families is that they either received increased and improved communication from their schools during COVID or that there were large gaps in communication from schools during COVID. But for those that had increased communication, they're telling us that they've learned a great deal about their own students’ learning by having the opportunity to work with them in remote instruction, see what their students are doing, and provide support. Families have always been supportive of their child and the learning of their child, and they're eager to share those insights with school personnel and IEP team members. So this is really an opportunity for school leaders to encourage school staff and help them leverage those learnings with families to support learning acceleration and continued success.
Supporting the Social, Emotional, and Mental Health Needs of Students with Disabilities During the Delta Variant
What are some of the emotional and psychological impacts of the pandemic and the Delta variant on children with disabilities and special health care needs?
We've seen an increase in irritability and fluctuation in moods, oftentimes due to the unpredictability of our day-to-day circumstances and some of the limitations that the pandemic has placed upon us. Decreases in self-esteem and self-efficacy are just really very, very prevalent, as well as increases in the experience of anxiety, depression, acting out behaviors. These are all commonly observed because sometimes some of our students are not able to fully to process and verbalize their feelings of confusion, distress, and being overwhelmed when it comes to everything that relates to the pandemic.
COVID-19 has disrupted many daily routines and structures for students with disabilities. How can educators and families help these students cope with disrupted routines?
It's important to maintain routines as much as possible. However, when it's not possible, preparing the student ahead of time is very beneficial because that really allows the child time to anticipate the upcoming routine change, then process any sort of hesitation or feelings that they might have about it and to adjust cognitively to the upcoming change. But when it's not possible to prepare for that transition, just reassuring the child in the moment that it'll be OK and offering them some alternative options that would help them increase their comfort level. Furthermore, I think consistent communication between teachers and parents also helps to minimize the distress, because if everyone addresses the challenge or the distress in a similar way, then that also helps to provide some consistency and predictability for the child.
How can educators and families best comfort children with disabilities and special health care needs who may be frightened or distressed about the pandemic—especially during the Delta variant surge?
If students are frightened, I think first and foremost, it's important to validate and normalize their fears without dismissing that these are important and valid feelings that they're experiencing. Then, coming up with a list of objects or strategies that may be comforting to them when they feel stress—such as having a soothing object or a toy with them—that is reassuring depending on their developmental level. Also, teaching them breathing skills can be helpful. Using visual tools such as a pinwheel is helpful when teaching those exercises.
What can schools do to ensure that students who have remained remote still feel connected with their teachers, peers, and school communities?
It's a substantial challenge because many peers have returned to the classroom and so creating opportunities for classroom relationship building is important, even with students that are learning from home. So when there are relationship-building groups, for students that are working at home, allowing them to be on video conferencing, to participate in some of these activities. Also, the opportunity to have one-to-one teacher time at some point during the week would be really important so that they still feel that connection to their teacher, to their classmates, and to their school overall.
Interviews have been edited and condensed for clarity.