Health services in New York public schools contribute to the goals of the education system and the healthcare system daily by giving medications and treatments, providing specialized education courses, providing health education and counseling, offering screenings and referrals for specialized testing, administering medications and treatments, and even providing first aid. These services are heavily utilized by school districts in Western New York, and see as many as one-in-five students for various reasons (Good, 2019). Several of these important services include cafeteria services, physical education, Niagara BOCES, Occupational Therapy, Physical Therapy, and inclusion. Due to the high volume of students receiving services, many are only able to be seen once or twice per week but would benefit with a higher frequency. Each crucial health service that will be discussed in this text are the most frequently used by elementary-aged students at Geraldine J. Mann Elementary School in the Niagara Falls City School District, and have the most potential for positive change.
The Orleans/Niagara Board of Cooperative Educational Services (BOCES) is used by the Niagara Falls City School District and offers many programs and services to students. These include special education, vocational education, academic and alternative programs and summer schools. (OnBOCES). Orleans/Niagara BOCES provides the educational programs for special needs students of the Niagara Falls City School District. According to the 2018 Niagara Falls Census, 2,385 children from the ages of five to eighteen in Niagara Falls have a disability. Most of these students will receive health services through public schools and BOCES.
The programs that BOCES assist with include ‘self-contained’ classroom services to “individual students including classes for students whose needs are so unique, or whose handicaps are so severe that they cannot be successfully helped by their local school district special education programs”. This program is offered to thirteen school districts in Western NY and each student is re-evaluated yearly and return to their “home” elementary school when they are ready. There were two students who had returned this year to G. J. Mann from their specialized classroom and perhaps could have benefitted for additional assistance. A possible solution for this is to offer one or two specialized classrooms in each elementary school, so when the students are ready to return to a typical classroom it isn’t a drastic change in environment.
Many students at Geraldine J. Mann Elementary are taken out of the classroom throughout the day to attend occupational therapy and physical therapy. The school occupational therapists and occupational therapy assistants help the students participate in daily school functions and perform certain tasks that are necessary for learning. Occupational therapy is automatically provided to students with disabilities due to the Individuals with Disabilities Education Act that was passed in 1975. This law states that students with disabilities must have access to the occupational therapy if they need it to be successful in school. But occupational therapy can be made available to other children who are having specific problems in school like handwriting. A teacher might notice that a student cannot write legibly and refer them to an Occupational Therapist for further help. The occupational therapist can work with the teacher to evaluate the child to identify any other problems that may be contributing to the handwriting difficulty. They also take into account the school, home, and classroom environments to find ways to improve the handwriting or to identify other ways for the child to write, like using a computer.
There are two occupational therapists at G. J. Mann, and they provide help with both academic and non-academic problems, including math, reading and writing, and behavior management. They also assist in recess, participation in sports, and self-help skills for at home, and help students find extracurricular activities to participate in outside of the school setting. Occupational therapy services for students with special needs throughout the entire country are determined through the Individualized Education Program (IEP) process. School-based occupational therapy is only available for students who are eligible for special education. Occupational therapists complete several evaluations and assessments with each student, and then work with other members of the school to help determine what is needed for the student to receive a “free, appropriate public education in the least restrictive environment” (NYIEPgov). The team of therapists and school staff decide the services, modifications, and accommodations that are required for the student to learn without difficulty.
When the IEP team determines that occupational therapy is needed in order for a student to meet their educational goals, then occupational therapy will be included in the student’s IEP. In some cases, students who’s disability affects their participation in school but who do not qualify under the Individuals with Disabilities Education Act (IDEA), may be eligible to receive occupational therapy under other federal laws such as Section 504 of the Rehabilitation Act and the Americans with Disabilities Act (Wilkes, 2003). They learn about the student and then focus on the students’ strengths, and then they design a program to include the student in all classroom activities. The occupational therapists also meet with the student’s parents sometimes weekly to educate them on different activities to practice at home. Some activities that G. J. Mann students practiced in their occupational therapy sessions were building things out of play-doh to improve hand strength, sorting colors to promote sensory stimulation, and using tools like scissors and hole-punchers to improve fine motor skills. One aspect of this program that could be improved is providing it more than twice per week. Many students could benefit from daily practice with their fine motor skills especially before fourth grade.
Another critical service provided by the school district to students is the cafeteria service. According to Kevin Edwards, the Food Service Administrator of the Niagara Falls City School District, “The Niagara Falls City School District believes that one of the most important ways in which we can help our students perform better in their classrooms is to provide them with the nutrition that is necessary for the healthy growth of their minds and bodies. Therefore, we offer breakfast and lunch free to every student in our schools every day”.
Due to the socioeconomic status of the student body at G J Mann Elementary School and the NY State Community Eligibility Provision, all of the students are given free lunch because most students qualify for it. The lunches appeal to the students with healthy side options and there are additional snacks and treats available for purchase in the lunch line. In addition to the free lunch, most teachers provide a healthy snack during the day to students as a reward for good behavior in the classroom. Some teachers know that their students come to school hungry and only eat their meals in school, and on Friday’s pack bags of small unperishable meals to bring home with them for the weekends. This is one area that can be changed with enough community support and knowledge. According to the 2018 Niagara Falls census, 35.1% of children are born into poverty in Niagara Falls while the New York State average is a much-lower 19.1%. Out of these poverty-stricken families, 19.9% are a married-couple family, 21.9% are only unmarried men with children, and 58.2% are unmarried women with children. Due to these high levels of poverty, classrooms are full of students who need new clothes, winter boots, school supplies, and food, and the teachers are the ones who provide it out of their own salary. Some schools in other areas have designated rooms for donations where children can discretely enter, collect what they need in their backpack to bring home. Some even have a washing machine and dryer so the students can have clean clothes. I believe that this is an excellent program that would make the community feel empowered to help, and also give students and families the extra support that they need during hard times.
Physical Education is another very important health service provided by the public school system. The research that has been conducted pertains to a 2nd grade classroom. Physical Education is crucial to students success both inside and outside of the classroom. Outside of the classroom, physical education promotes healthy habits and social avenues for children to make friends while participating in physical activity. Inside the classroom, attention span of the students is dependent on physical activity and movement. According to the New York State Education Department, there are six standards for second graders to physically accomplish during the school year. Each standard is also reinforced in the classroom to promote a healthy attention span and movement throughout the day. Standard One is competency in basic motor skills through sports, games, dance activities and daily lifetime activities. Standard Two is related to movement and improving body mechanics.
Standard Three demonstrates knowledge of physical fitness and making healthy decisions. This teaches students how healthy behaviors influence a healthy life. Standard Four is exhibiting responsible and appropriate social behavior that respects other’s boundaries. Standard Five recognizes the value of physical activity, and demonstrates how exercise can be both fun and beneficial to kids and adults. Standard Six is the final standard for second grade, and demonstrates that students are aware of resources available in the community like sports and other activities to enjoy in their leisure time. This standard is usually taught and promoted towards the end of the school year to encourage students to engage in summer physical activities. The amount of physical education required by New York State for Elementary School is sixty minutes per week, in which students participate in two separate thirty-minute sessions during the week. From this second grade classroom observation, young elementary school students require a higher frequency of physical activity. The ability to focus and hold attention is crucial for a student to be successful in school. According to Dr. Myrtle D. Millares of the University of Toronto Childhood Development Program, “It is not surprising then that young students, with little experience, are not yet able to focus. Children appear not to have well formed “presets” that can help them distinguish any one task as worthier of attention than another.” Piaget’s cognitive development approach supports Dr. Millares, suggesting that the brain’s “executive” functions are crucial to our ability to make “informed decisions that result in controlled, appropriate responses to a given situation” (Millares, 21). In seven and eight year-old students, who find it difficult to control their own movements, it is unreasonable to expect “adult-like” attention spans.
In order to improve attention span in students during the school day, many teachers take their class out for recess but there is very little time. In inclement weather, teachers often have to fit in small bursts of additional exercise throughout the day in the form of songs and follow-along videos just to promote a longer attention span on their other subjects. A solution for this would be to reimagine the physical education curriculum by adding in an extra forty minutes a week for a total of 100 minutes of physical activity. This could be broken up into two-thirty minute sessions and three twenty-minute sessions of physical activity per-week at a designated time. This would allow for not only students to “recharge” and develop a longer attention span, but would also allow a small amount of time for teachers to reorganize and prepare for the rest of the school day without any student distractions.
According to the Center for Disease Control, schools “have direct contact with more than 95% of our nation’s young people aged 5 to 17 years, for about 6 hours per day and up to 13 critical years of their social, psychological, physical, and intellectual development”. This reiterates the fact that schools are one of the most influential factors in a child’s upbringing. Schools are one of the main places that teach children about health and promote lifelong healthy choices. Schools also encourage many extracurricular activities such as sports, which influence a child’s friend-group and attitude throughout life. When students are healthy, they are able to learn with ease and that education will propel them through life. School health services are crucial to our students to not only manage their chronic health conditions and help sick students, but to enrich healthy students and set them up for future success. When school health policies and practices like the ones that were discussed are put in place, healthy students can grow to be healthy and successful adults and the cycle continues from generation to generation with ease.