Supporting children with developmental and health difficulties in school settings: Exploring the perspectives of education experts

Year: 2019

Author: Garvey, William, O'Connor, Meredith, Quach, Jon, Goldfeld, Sharon

Type of paper: Abstract refereed


1 in 5 children start school with developmental and health difficulties that require additional supports to be provided to them by the school.1 Prevalence rates are even higher in vulnerable populations, such as low income families, placing these children at greater risk for poor health and education outcomes2. Children with developmental and health difficulties also have increased school absence, poor engagement and motivation, and increased disruptive behavior.3Furthermore, not all these students qualify for individual funding, hence schools are required to provide reasonable adjustments using existing resources and/or expertise.

Despite many children starting school with developmental and heath difficulties, how best to support these children in the school setting requires further investigation. This study investigates the views of education system experts on what differentiates the most effective primary schools.


Qualitative interviews were conducted with n=9 school system experts, responsible for managing or improving practice across a range of schools or school regions in Victoria. Using a positive deviance approach, the semi-structured interviews aimed to elicit instances of good practice that already exist within the school system. Interviews were analysed using inductive content analysis.


Education experts reported high variability across schools, and a number of factors differentiating those they perceived as most effective. This included the presence of: strong support by the school leadership team; explicit and documented processes to guide the practice of teachers and ensure consistency at a whole school level; inclusive relations ships and environments supporting all children; participation and knowledge sharing between medical, allied health and other stakeholders in the care team; and an evidenced-based approach to allocating resources to programs and strategies.


Education experts report substantial variability in how well schools support children with developmental and health difficulties. Exploring instances of good practice can generate novel insights into complex problems. The factors identified as differentiating effective schools could be further explored in intervention research.


1. O'Connor, M., O'Connor, E., Quach, J., Vashishtha, R., & Goldfeld, S. (in press). Trends in the prevalence and distribution of teacher-identified special health care needs across three successive population cohorts. Journal of Paediatrics and Child Health.

2.Van Dyck, P. C., Kogan, M. D., McPherson, M. G., Weissman, G. R., & Newacheck, P. W. (2004). Prevalence and characteristics of children with special health care needs. Archives of pediatrics & adolescent medicine, 158(9), 884-890.

3.Forrest, C. B., Bevans, K. B., Riley, A. W., Crespo, R., & Louis, T. A. (2011). School outcomes of children with special health care needs. Pediatrics, peds-2010.