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Chronically ill children are currently being served in every state in a number of early childhood education programs, including special education programs, Head Start, early intervention programs, and a variety of other center-based day care and preschool education programs. Although there are some mandates for serving some chronically ill young children in early education programs—the Education for All Handicapped Children Act (P.L. 94–142) and Head Start—only a small percentage of all chronically ill children under 6 years of age are currently enrolled in these programs. Care of chronically ill children in educational settings often entails the delivery of a variety of related services, for example, transportation; education-based health services; speech, physical, and occupational therapies; child and family counseling; and building and schedule modifications. Who should provide and pay for these related services is the focus of heated policy debates at local, state, and federal levels of government.

Characteristics of classroom placements were studied for a probability sample of approximately 950 special needs children enrolled in kindergarten through sixth grade in five major metropolitan school districts. Across all special education students, 58% spent the majority of their school day in a regular class, 38% spent the majority of their school day in a special class, and 4% attended special schools. The regular classes in which special education children were enrolled resembled other regular classes in overall size and student composition. By contrast, special classes were smaller and more heterogeneous, and classes in special schools were especially small and heterogeneous. The proportion of time spent in regular education varied significantly both by the child's primary handicap and the school district in which the child lived, but sizable variations also were found within disability groups and within districts. For learning-disabled, mentally retarded, and physically/multiply handicapped children, variations in placement were found to be associated with student socioeconomic status and race or ethnicity.

The number of days absent from school during the 1979-80 school year for 573 children aged 6-17 years in Berkshire County, Massachusetts was ascertained by parent reporting in a random household survey. Children with a wide range of chronic health impairments were reported as missing more school than their healthy peers (8.7 days vs. 5.8, p < .001). Although there was a trend for children reported as having functional impairments to miss more school than those with chronic conditions without functional impairments (11.0 vs. 8.1), the difference was not statistically significant. Children with a variety of reported psychosocial difficulties missed more school than those without psychosocial difficulties for the sample as a whole and for those with reported chronic conditions. These findings document support for the assumption that children with a wide range of physical and psychological problems miss more school than their healthy peers and illustrate that the etiology of school absences is multifactoral and reflects behavioral as well as purely physical phenomena.

A 2-year follow-up study assessed the stability of special education students' mobility, status, and classification labels. A total of 1,184 students were selected in fall 1982 from the elementary special education programs of three cities. Two years later, 92% remained in their school district. Of these, 71% stayed in special education with the same classification, 12% remained with a different classification, and 17% were no longer receiving special education services. The child's original primary classification was the strongest predictor of reclassification and termination. Family background contributed most to mobility. Implications for practice and research are discussed.

A comprehensive birth-to-kindergarten program was evaluated by classroom observa tions and teacher ratings of 132 participant children and 366 comparison children during fall and spring of the kindergarten year. The observations revealed significant advantages for the participants in both fall and spring on a majority of indices, particularly for behaviors categorized as social and use of time. The teacher ratings indicated few overall differences, with advantages for participants only in the fall on a prereading scale. A logistic regression model was used to adjust for possible effects of children's background characteristics; advantages for participants over comparison children were consistent across background characteristics. On the teacher ratings, the adjustments revealed significant interactions: advantages of participants over comparison children were found for subgroups traditionally associated with having difficulties in kindergarten.