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Students with disabilities (SWD) who are Black or Hispanic have been reported to be more likely to be placed primarily outside of general education classrooms while attending U.S. schools. Federal law and regulation require monitoring of special education placement based on race or ethnicity. Yet, whether and to what extent racial or ethnic disparities in placement are explained by bias or by other explanatory factors is currently unclear. We evaluated for racial and ethnic bias in special education placement by analyzing longitudinal data from two independent samples of SWD (N values range 590-1,130) attending U.S. elementary schools. We statistically controlled for plausibly exogenous sociodemographic, academic, and behavioral risk factors measured in kindergarten in analyses of the students as they attended first, third, and fifth grades between the 1999-2000 and 2015-2016 school years. Of the resulting 12 Black or Hispanic grade-year-specific tests, 11 (i.e., 92%) indicated that controls for kindergarten explanatory factors-particularly significant academic difficulties-fully explained the risk initially attributable to race or ethnicity. We observed little evidence that bias explains racial or ethnic disparities in special education placement in U.S. elementary schools.

We analyzed a population-based cohort (N = 10,922) to investigate the onset and stability of racial and ethnic disparities in advanced (i.e., above the 90th percentile) science and mathematics achievement during elementary school as well as the antecedent, opportunity, and propensity factors that explained these disparities. About 13% to 16% of White students versus 3% to 4% of Black or Hispanic students displayed advanced science or mathematics achievement during kindergarten. The antecedent factor of family socioeconomic status and the propensity factors of student science, mathematics, and reading achievement by kindergarten consistently explained whether students displayed advanced science or mathematics achievement during first, second, third, fourth, or fifth grade. These and additional factors substantially or fully explained initially observed disparities between Black or Hispanic and White students in advanced science or mathematics achievement during elementary school. Economic and educational policies designed to increase racial and ethnic representation in STEM course taking, degree completion, and workforce participation may need to begin by elementary school.

We examined to what extent subgroups of students identified with learning disabilities (LDs; N = 630) in the Early Childhood Longitudinal Study, Kindergarten Class of 1998 to 1999 (ECLS-K): 1998 national longitudinal study displayed heterogeneity in longitudinal profiles of reading and mathematics achievement from first to eighth grades. Multivariate growth mixture modeling yielded four classes of combined reading and mathematics trajectories for students with LD. The largest class of students with LD (Class 2, 54.3%) showed mean T-scores for both achievement domains that averaged about 1 SD below the mean, with modest decline over time. Almost a quarter of the sample (Class 1, 22.3%) displayed mean T-scores in both achievement areas near the peer-normed average; these students were mostly White, from higher socioeconomic status (SES) backgrounds, and had experienced earlier identification as having an LD as well as shorter duration of LD service. Classifying heterogeneity in longitudinal trajectories of both achievement areas shows promise to better understand the educational needs of students identified with an LD.

We analyzed a population-based cohort of 11,780 US children to identify risk and protective factors by kindergarten predictive of being frequently verbally, social, reputationally, or physically victimized during the upper elementary grades. We also stratified the analyses by biological sex. Kindergarten children displaying externalizing problem behaviors were at consistently higher risk of being frequently victimized during third-fifth grade (odds ratios [OR] for verbal = 1.82, social = 1.60, reputational = 1.85, physical = 1.67, and total = 1.93). Hispanic children (OR range = 0.51 to 0.68) and those from higher income families (OR range = 0.73 to 0.83) were less likely to experience victimization. Boys were more likely than girls to be physically victimized (OR = 1.38) but less likely to be verbally (OR = 0.83), socially (OR = 0.66), or reputationally (OR = 0.83) victimized or to experience total victimization (OR = 0.82). Other variables predictive of increased risks for frequent victimization included having a disability, experiencing cognitively stimulating parenting, and displaying lower academic achievement.

BackgroundArea-level socioeconomic characteristics have been shown to be related to health status and mortality however, little is known about the association between residential community characteristics in relation to postpartum women's health.MethodsData from the longitudinal, multi-site Community Child Health Network (CCHN) study were used. Postpartum women (n = 2510), aged 18-40 were recruited from 2008 to 2012 within a month of delivery. Socioeconomic data was used to create deprivation indices. Census data were analysed using principal components analysis (PCA) and logistic regression to assess the association between deprivation indices (DIs) and various health indicators.ResultsPCA resulted in two unique DIs that accounted for 67.5% of the total variance of the combined all-site area deprivation. The first DI was comprised of variables representing a high percentage of Hispanic or Latina, foreign-born individuals, dense households (more than one person per room of residence), with less than a high-school education, and who spent more than 30% of their income on housing costs. The second DI was comprised of a high percentage of African-Americans, single mothers, and high levels of unemployment. In a multivariate logistic regression model, using the quartiles of each DI, women who reside in the geographic area of Q4-Q2 of the second DI, were almost twice as likely to have more than three adverse health conditions compared to those who resided in the least deprived areas. (Q2vs.Q1:OR = 2.09,P = 0.001,Q3vs.Q1:OR = 1.89,P = 0.006,Q4vs.Q1:OR = 1.95,P = 0.004 respectively).ConclusionsOur results support the utility of examining deprivation indices as predictors of maternal postpartum health.

We examined the extent to which disparities in the receipt of special education services for speech or language impairments (SLIs) on the basis of race, ethnicity, or language use by kindergarten--when the delivery of these services might be expected to be most effective--have changed over a 12-year period in the United States. Logistic regression modeling of 2 nationally representative cohorts (N = 16,800 and 12,080) indicated that children who are Black (covariate-adjusted odds ratios = 0.39 and 0.54) or from non-English-speaking households (covariate-adjusted odds ratios = 0.57 and 0.50) continue to be less likely to receive services for SLIs. Hispanic children are now less likely to receive these services (covariate adjusted odds ratio = 0.54) than otherwise similar non-Hispanic White children. Disparities in special education service receipt for SLIs attributable to race, ethnicity, and language presently occur in the United States and are not explained by many potential confounds.

Purpose: We sought to identify factors predictive of or associated with receipt of speech/language services during early childhood. We did so by analyzing data from the Early Childhood Longitudinal Study-Birth Cohort (ECLS-B; Andreassen & Fletcher, 2005), a nationally representative dataset maintained by the U.S. Department of Education. We addressed two research questions of particular importance to speech-language pathology practice and policy. First, do early vocabulary delays increase children's likelihood of receiving speech/language services? Second, are minority children systematically less likely to receive these services than otherwise similar White children? Method: Multivariate logistic regression analyses were performed for a population-based sample of 9,600 children and families participating in the ECLS-B. Results: Expressive vocabulary delays by 24 months of age were strongly associated with and predictive of children's receipt of speech/language services at 24, 48, and 60 months of age (adjusted odds ratio range = 4.32-16.60). Black children were less likely to receive speech/language services than otherwise similar White children at 24, 48, and 60 months of age (adjusted odds ratio range = 0.42-0.55). Lower socioeconomic status children and those whose parental primary language was other than English were also less likely to receive services. Being born with very low birth weight also significantly increased children's receipt of services at 24, 48, and 60 months of age. Conclusion: Expressive vocabulary delays at 24 months of age increase children's risk for later speech/language services. Increased use of culturally and linguistically sensitive practices may help racial/ethnic minority children access needed services.

We examined the age of onset, over-time dynamics, and mechanisms underlying science achievement gaps in U.S. elementary and middle schools. To do so, we estimated multilevel growth models that included as predictors children's own general knowledge, reading and mathematics achievement, behavioral self-regulation, sociodemographics, other child- and family-level characteristics (e.g., parenting quality), and school-level characteristics (e.g., racial, ethnic, and economic composition; school academic climate). Analyses of a longitudinal sample of 7,757 children indicated large gaps in general knowledge already evident at kindergarten entry. Kindergarten general knowledge was the strongest predictor of first-grade general knowledge, which in turn was the strongest predictor of children's science achievement from third to eighth grade. Large science achievement gaps were evident when science achievement measures first became available in third grade. These gaps persisted until at least the end of eighth grade. Most or all of the observed science achievement gaps were explained by the study's many predictors. Efforts to address science achievement gaps in the United States likely require intensified early intervention efforts, particularly those delivered before the primary grades. If unaddressed, science achievement gaps emerge by kindergarten and continue until at least the end of eighth grade. [This article was published in "Educational Researcher" (EJ1091880).]

To examine whether special education racial risk ratios reported by U.S. school districts are explained by district-level confounds, particularly, racial achievement gaps, we analyzed merged data (N = 1,952 districts for Black-White comparisons; N = 2,571 districts for Hispanic-White comparisons) from the U.S. Department of Education's Office of Civil Rights, Stanford Educational Data Archive, and Common Core data sets. Regression analysis results indicated that Black- and Hispanic-White district risk ratios were strongly related to Black- and Hispanic-White district achievement gaps. These results reconcile findings from district-level data with those from student-level data and support the finding that, when compared to otherwise similar White students by controlling for group differences in achievement, non-White students are on average underrepresented in special education. That is, non-White overrepresentation in special education in most districts is explained by racial achievement gaps in these districts. Residuals from the regressions provide a more accurate way to monitor for outlier districts than the current practice required in federal regulations of using unadjusted risk ratios.

Whether students of color are more or less likely to be identified as having disabilities than similarly situated students who are White in U.S. states with histories of de jure and de facto racial segregation is currently unknown. Unadjusted analyses of large samples of students attending elementary and middle schools in the U.S. South yielded little evidence of minority overrepresentation in special education. In analyses adjusted for strong confounds (e.g., family income, student-level achievement), students of color were "less" likely than White students to be identified as having disabilities. Underidentification was evident (a) for the U.S. South in aggregate, (b) across 11 Southern states that we separately examined, (c) in cross-sectional samples assessed in 2003 and 2015, and (d) for specific disability conditions. Black and Hispanic students attending schools in the U.S. South have been and continue to be less likely to be identified as having disabilities than otherwise similar White students.

We examined whether U.S. schools systemically discriminate when suspending or otherwise disciplining students with disabilities (SWD). Eighteen studies met inclusion criteria. We coded 147 available risk estimates from these 18 studies. Of four studies including individual-level controls for infraction reasons, over half of the available estimates (i.e., 14 of 24, or 58%) failed to indicate that SWD were more likely to be suspended than otherwise similar students without disabilities. Of the seven available estimates adjusted for the strong confound of individual-level behavior, most (i.e., five of seven, or 71%) failed to indicate that SWD were more likely to be suspended. The other two estimates indicating SWD were more likely to be suspended were from one study. We also examined whether SWD were less likely to be suspended than otherwise similar students without disabilities. There was no strong evidence of this. Empirical evidence regarding whether U.S. schools discriminate when disciplining SWD is currently inconclusive.

Whether and to what extent kindergarten children's executive functions (EF) constitute promising targets of early intervention is currently unclear. This study examined whether kindergarten children's EF predicted their second-grade academic achievement and behavior. This was done using (a) a longitudinal and nationally representative sample (N = 8,920, M[subscript age] = 97.6 months), (b) multiple measures of EF, academic achievement, and behavior, and (c) extensive statistical control including for domain-specific and domain-general lagged dependent variables. All three measures of EF--working memory, cognitive flexibility, and inhibitory control--positively and significantly predicted reading, mathematics, and science achievement. In addition, inhibitory control negatively predicted both externalizing and internalizing problem behaviors. Children's EF constitute promising targets of experimentally evaluated interventions for increasing academic and behavioral functioning. [For the corresponding grantee submission, see ED583821.]

Objective: Whether and to what extent racial/ethnic disparities in attention-deficit/hyperactivity disorder (ADHD) diagnosis occur across early and middle childhood is currently unknown. We examined the over-time dynamics of race/ethnic disparities in diagnosis from kindergarten to eighth grade and disparities in treatment in fifth and eighth grade. Methods: Analyses of the nationally representative Early Childhood Longitudinal Study, Kindergarten Class of 1998-1999 (N = 17 100) using discrete-time hazard modeling. Results: Minority children were less likely than white children to receive an ADHD diagnosis. With time-invariant and -varying confounding factors statistically controlled the odds of ADHD diagnosis for African Americans, Hispanics, and children of other races/ethnicities were 69% (95% confidence interval [CI]: 60%-76%), 50% (95% CI: 34%-62%), and 46% (95% CI: 26%-61%) lower, respectively, than for whites. Factors increasing children's risk of an ADHD diagnosis included being a boy, being raised by an older mother, being raised in an English-speaking household, and engaging in externalizing problem behaviors. Factors decreasing children's risk of an ADHD diagnosis included engaging in learning-related behaviors (eg, being attentive), displaying greater academic achievement, and not having health insurance. Among children diagnosed with ADHD, racial/ethnic minorities were less likely than whites to be taking prescription medication for the disorder. Conclusions: Racial/ethnic disparities in ADHD diagnosis occur by kindergarten and continue until at least the end of eighth grade. Measured confounding factors do not explain racial/ethnic disparities in ADHD diagnosis and treatment. Culturally sensitive monitoring should be intensified to ensure that all children are appropriately screened, diagnosed, and treated for ADHD.

We investigated whether and to what extent minority children attending elementary and middle schools in the U.S. are over- or under-identified as disabled and so disproportionately represented in special education. To address existing limitations in the field's knowledge base, we (a) analyzed multi-year longitudinal data, (b) used hazard modeling to estimate over-time dynamics of disability identification across five specific conditions, and (c) extensively corrected for child-, family-, and school-level potential confounding variables (e.g., child-level academic achievement and behavior, family-level socioeconomic status, school-level state location). Despite long-standing and on-going federal legislative and policy efforts to reduce minority over-representation in special education, our analyses indicated that this has not been occurring in the U.S. Instead, minority children are less likely than otherwise similar White, English-speaking children to be identified as disabled and so receive special education services. From kindergarten entry to at least the end of middle school, racial and ethnic minority children are less likely than otherwise similar White children to be identified as having (a) learning disabilities, (b) speech or language impairments, (c) intellectual disabilities, (d) health impairments, or (d) emotional disturbances. Language minority children are less likely to be identified as having (a) specific learning disabilities or (b) speech or language impairments.

We conducted a best-evidence synthesis of 22 studies to examine whether systemic bias explained minority disproportionate overrepresentation in special education. Of the total regression model estimates, only 7/168 (4.2%), 14/208 (6.7%), 2/37 (5.4%), and 6/91 (6.6%) indicated statistically significant overrepresentation for Hispanic, Asian, Native American, and English language learner (ELL) or language-minority children, respectively. Among studies with the strongest internal and external validity, none of the 90 estimates (i.e., 0%) indicated overrepresentation attributable to racial or ethnic bias. Of the 18 estimates for language-minority and ELL children combined, only 3 (16.7%) indicated overrepresentation attributable to language use. Two of the 4 ELL-specific estimates (50%) indicated that children receiving English-as-a-second-language services may be overrepresented in special education. Overall, and replicating findings from a prior best-evidence synthesis, this synthesis indicated that children are underidentified as having disabilities based on their race or ethnicity and language use.

Purpose: Develop and test a measurement framework of mammogram facility resources, policies, and practices in Appalachia. Methods: Survey items describing 7 domains of imaging facility qualities were developed and tested in the Appalachian regions of Kentucky, Ohio, Pennsylvania, Virginia, and West Virginia. Medicare claims data (2016‐2018) were obtained on catchment area mammogram services. Construct validity was examined from associations with facility affiliation, community characteristics, mammogram screening uptake, and market reach. Analyses were performed with t‐tests and ANOVA. Results: A total of 192 (of 377) sites completed the survey. Five factors were initially selected in exploratory factor analysis (FA) and refined in confirmatory FA: capacity, outreach & marketing, operational support, radiology review (NNFI =.94, GFI = 0.93), and diagnostic services (NNFI = 1.00, GFI = 0.99). Imaging capacity and diagnostic services were associated with screening uptake, with capacity strongly associated with catchment area demographic and economic characteristics. Imaging facilities in economically affluent versus poorer areas belong to larger health systems and have significantly more resources (P <.001). Facilities in economically distressed locations in Appalachia rely more heavily on outreach activities (P <.001). Higher facility capacity was significantly associated (P <.05) with larger catchment area size (median split: 48.5 vs 51.6), mammogram market share (47.4 vs 52.7), and screening uptake (47.6 vs 52.4). Conclusions: A set of 18 items assessing breast imaging services and facility characteristics was obtained, representing policies and practices related to a facility's catchment area size, market share, and mammogram screening uptake. [ABSTRACT FROM AUTHOR]

Federal legislation and policy increasingly seek to address minority overrepresentation in special education due to concerns that U.S. schools are misidentifying children as disabled based on their race or ethnicity. Yet whether and to what extent this is occurring is currently in dispute. We estimated racial disparities in disability identification using very large (e.g., Ns = 183,570, 165,540, and 48,560) student-level, nationally representative data sets and multivariate logistic regression including school fixed effects models along with tabulations of percentage with a disability among racial or ethnic groups across academic achievement deciles. Among children who were otherwise similar in their academic achievement, poverty exposure, gender, and English language learner status, racial or ethnic minority children were consistently "less" likely than White children to be identified as having disabilities. Minority children's disability underidentification was evident (a) in elementary, middle, and high school; (b) across racially diverse groups and specific disability conditions; and (c) throughout the achievement distribution. Contrary to federal regulatory and policy efforts, minority children have been less likely than otherwise similarly achieving White children to receive special education services in the United States since at least 2003.

We synthesized empirical work to evaluate whether Black children are disproportionately overrepresented in special education. We identified 22 studies that met a priori inclusion criteria including use of at least 1 covariate in the reported analyses. Evidence of overrepresentation declined markedly as the studies included one or more of 3 "best-evidence" methodological features (i.e., analyses of individual-level data, a nationally representative sample, a control for individual-level academic achievement). Among 48 coefficient estimates from studies with the strongest internal and external validity, only 1 (2.1%) indicated significant overrepresentation. This coefficient suggested a school characteristic (a high percentage of minority students) that may help explain underrepresentation. None of the remaining 47 (97.9%) regression coefficients indicated that Black children's overrepresentation in special education was explained by misidentification based on race or ethnicity. Instead, the best evidence indicates that Black children are significantly less likely than otherwise similar White children to receive special education services.

Health disparities are large and persistent gaps in the rates of disease and death between racial/ethnic and socioeconomic status subgroups in the population. Stress is a major pathway hypothesized to explain such disparities. The Eunice Kennedy Shriver National Institute of Child Health and Human Development formed a community/research collaborative-the Community Child Health Network-to investigate disparities in maternal and child health in five high-risk communities. Using community participation methods, we enrolled a large cohort of African American/Black, Latino/Hispanic, and non-Hispanic/White mothers and fathers of newborns at the time of birth and followed them over 2 years. A majority had household incomes near or below the federal poverty level. Home interviews yielded detailed information regarding multiple types of stress such as major life events and many forms of chronic stress including racism. Several forms of stress varied markedly by racial/ethnic group and income, with decreasing stress as income increased among Caucasians but not among African Americans; other forms of stress varied by race/ethnicity or poverty alone. We conclude that greater sophistication in studying the many forms of stress and community partnership is necessary to uncover the mechanisms underlying health disparities in poor and ethnic-minority families and to implement community health interventions.

Health disparities are large and persistent gaps in the rates of disease and death between racial/ethnic and socioeconomic status subgroups in the population. Stress is a major pathway hypothesized to explain such disparities. The Eunice Kennedy Shriver National Institute of Child Health and Human Development formed a community/research collaborative-the Community Child Health Network-to investigate disparities in maternal and child health in five high-risk communities. Using community participation methods, we enrolled a large cohort of African American/Black, Latino/Hispanic, and non-Hispanic/White mothers and fathers of newborns at the time of birth and followed them over 2 years. A majority had household incomes near or below the federal poverty level. Home interviews yielded detailed information regarding multiple types of stress such as major life events and many forms of chronic stress including racism. Several forms of stress varied markedly by racial/ethnic group and income, with decreasing stress as income increased among Caucasians but not among African Americans; other forms of stress varied by race/ethnicity or poverty alone. We conclude that greater sophistication in studying the many forms of stress and community partnership is necessary to uncover the mechanisms underlying health disparities in poor and ethnic-minority families and to implement community health interventions.

We sought to identify which kindergarten children are simultaneously at risk of moderate or severe symptomatology in both attention-deficit/hyperactivity disorder (ADHD) and conduct disorder (CD) as adolescents. These risk factor estimates have not been previously available. We conducted multinomial logistic regression analyses of multiinformant ratings by the end of middle school of a population-based, longitudinal sample of children followed from kindergarten to eighth grade (N = 7,456). Kindergarten children from low SES households, those raised by mothers with depressive symptoms or experiencing emotional problems or substance abuse, or those who were punished by spanking were significantly more likely to later display severe levels of ADHD-CD symptomatology in eighth grade. Kindergarten children frequently engaging in ADHD-CD-type behaviors were more likely to later experience both moderate (covariate adjusted OR = 2.37) and severe (covariate adjusted OR = 3.63) ADHD-CD symptomatology. Low academic achievement uniquely increased the risk of both moderate and severe symptomatology (adjusted OR range = 1.7 to 2.24). The results should guide early screening and school-based intervention efforts for ADHD-CD. Reducing children's risk for adolescent ADHD-CD symptomatology may require remediating low behavioral and academic functioning by the end of kindergarten. When these 2 modifiable factors occur together they increase kindergarten children's odds of experiencing severe ADHD-CD symptomatology in eighth grade by a multiplicative factor of 8.1.

We analyzed two nationally representative, longitudinal data sets of U.S. children to identify risk factors for persistent mathematics difficulties (PMD). Results indicated that children from low socioeconomic households are at elevated risk of PMD at 48 and 60 months of age, as are children with cognitive delays, identified developmental delays or disabilities, and vocabulary difficulties. In contrast, children attending preschool either in Head Start or non-Head Start classrooms are at initially lower risk of PMD. Kindergarten-aged children experiencing either low socioeconomic status or mathematics difficulties are at greatest risk for PMD across third, fifth, and eighth grades. Also at risk for PMD between third and eighth grades are children displaying reading difficulties or inattention and other learning-related behaviors problems, children with identified disabilities, and those who are retained. Educationally relevant and potentially malleable factors for decreasing young children's risk for PMD may include increasing children's access to preschool, decreasing their risk of experiencing vocabulary or reading difficulties, and avoiding use of grade retention.

Data were analyzed from a population-based, longitudinal sample of 8,650 U.S. children to (a) identify factors associated with or predictive of oral vocabulary size at 24 months of age and (b) evaluate whether oral vocabulary size is uniquely predictive of academic and behavioral functioning at kindergarten entry. Children from higher socioeconomic status households, females, and those experiencing higher quality parenting had larger oral vocabularies. Children born with very low birth weight or from households where the mother had health problems had smaller oral vocabularies. Even after extensive covariate adjustment, 24-month-old children with larger oral vocabularies displayed greater reading and mathematics achievement, increased behavioral self-regulation, and fewer externalizing and internalizing problem behaviors at kindergarten entry.