JMIR--Online Schools and Children With Special Health and ...

Original Paper

Online Schools and Children With Special Health and Educational Needs: Comparison With Performance in Traditional Schools

Lindsay A Thompson¹, MS, MD; Rick Ferdig², PhD; Erik Black¹, PhD

¹Department of Pediatrics, University of Florida, Gainesville, FL, United States
²Research Center for Educational Technology, Kent State University, Kent, OH, United States

Corresponding Author:
Erik Black, PhD

Department of Pediatrics
University of Florida
1701 SW 16th Avenue, Building A
Gainesville, FL, 32608
United States
Phone: 1 352 334 1357
Fax: 1 352 334 1357
Email:

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ABSTRACT

Background: In the United States, primary and secondary online schools are institutions that deliver online curricula for children enrolled in kindergarten through 12th grade (K-12). These institutions commonly provide opportunities for online instruction in conjunction with local schools for students who may need remediation, have advanced needs, encounter unqualified local instructors, or experience scheduling conflicts. Internet-based online schooling may potentially help children from populations known to have educational and health disadvantages, such as those from certain racial or ethnic backgrounds, those of low socioeconomic status, and children with special health care needs (CSHCN).
Objective: To describe the basic and applied demographics of US online-school users and to compare student achievement in traditional versus online schooling environments.
Methods: We performed a brief parental survey in three states examining basic demographics and educational history of the child and parents, the child?s health status as measured by the CSHCN Screener, and their experiences and educational achievement with online schools and class(es). Results were compared with state public-school demographics and statistical analyses controlled for state-specific independence.
Results: We analyzed responses from 1971 parents with a response rate of 14.7% (1971/13,384). Parents of online-school participants were more likely to report having a bachelor?s degree or higher than were parents of students statewide in traditional schools, and more of their children were white and female. Most notably, the prevalence of CSHCN was high (476/1971, 24.6%) in online schooling. Children who were male, black, or had special health care needs reported significantly lower grades in both traditional and online schools. However, when we controlled for age, gender, race, and parental education, parents of CSHCN or black children reported significantly lower grades in online than in traditional schooling (adjusted odds ratio [aOR] 1.45, 95% confidence interval [CI] 1.29?1.62 for CSHCN, P < .001; aOR 2.73, 95% CI 2.11?3.53 for black children, P < .001.) In contrast, parents with a bachelor?s degree or higher reported significantly higher online-school grades than traditional-school grades for their children (aOR 1.45, 95% CI 1.15?1.82, P < .001).
Conclusions: The demographics of children attending online schools do not mirror those of the state-specific school populations. CSHCN seem to opt into online schools at a higher rate. While parents report equivalent educational achievement in online and traditional classrooms, controlling for known achievement risks suggests that CSHCN and black children have lower performance in online than in traditional schools. Given the millions of students now in online schools, future studies must test whether direct assistance in online schools, such as taking individualized education plans into consideration, will narrow known disparities in educational success. Only then can online schools emerge as a true educational alternative for at-risk populations.

(J Med Internet Res 2012;14(3):e62)
doi:10.2196/jmir.1947

KEYWORDS

Virtual schooling; schools; K-12; children with special health care needs; online learning; education, adolescent health services, special education

Asking about educational attainment in the primary care setting is common, since educational success is a culmination of children?s health and well-being. However, while much has been written, research and clinical interventions have not consistently narrowed educational disparities [1-6], mostly because there are few resources by which to quantitatively measure education as a health outcome. Educational outcomes for health are often relegated only to school days missed or appropriate grade level for age [7,8]. A relatively new educational innovation in the United States, kindergarten to 12th grade (K-12) online schooling, constitutes an online means by which children can maintain or further their educational progress. This Internet-based educational opportunity is ideally situated to providing an opportunity for improved educational and health outcomes and would allow for a centralized means to measure both health and educational progress.

The phenomenon of online schooling is not limited to the United States, although its definition and approach lack uniformity both internationally and across US states. For example, a variety of terms are used to describe online learning, including distance education, online schools, online learning, e-learning, and electronic learning. In general, however, the common understanding is that this type of learning simply takes place over the Internet [9]. Over a million US students participate, choosing online classes for a variety of reasons, including credit recovery, advanced preparation, schedule conflicts, home schooling supplementation, and the lack of local qualified instructors. Originating in the United States in 1995, state-funded online K-12 education now exists in 44 states [10,11]. Although school administrators, policy makers, parents, and students have questioned the effectiveness of K-12 online schooling compared with traditional, face-to-face schooling [12,13], numerous studies have documented evidence of their educational equivalence [14,15].

International efforts have developed similarly. In a recent survey of online education practices in 50 different countries, nearly 60% of respondents reported government funding for online programs at the primary and secondary school levels (5?18 years of age). Examples of growth and adoption include China?s online-schooling initiative, which has expanded from 1 institution in 1996 to more than 200 online schools, with enrollments exceeding 600,000 students. In British Columbia, Canada, approximately 12% of the student population participates in some form of online learning [9]. While more-developed nations (Australia, China, Denmark, Mexico, Canada, and the United Kingdom, for example) have more-advanced programs, online programs are emerging or have emerged in Africa (Egypt), Asia (Indonesia, Malaysia, Singapore, and Uzbekistan), Europe (Belgium, Finland, France, Germany, and Italy), Eastern Europe (Slovenia, Albania, Romania, and Serbia), the Middle East (Turkey and Israel), and South America (Argentina, Peru, and Uruguay) [9].

Both nationally and internationally, online schools have adopted many different models for course delivery to primary and secondary education students. Some offer the opportunity for students to earn a diploma and take all of their coursework online. Others only supplement traditional face-to-face schools. Course format also varies; some institutions allow students to self-pace, meaning the student is required to complete a requisite amount of work to earn credit for the course. Whether the student is able to do so in 6 weeks or 6 months is entirely up to the student. Other institutions may offer a format that is more traditional, in which the student has a fixed time during each school day to work through curricular content. It remains unknown, however, how online schooling may serve children from populations known to have health and educational challenges, such as those from certain racial or ethnic backgrounds, those with socioeconomic disadvantages, and children with special health care needs (CSHCN) [12,13,16,17]. Nonetheless, the potential advantages of online schools are substantial, with self-pacing and class attendance from home or even a hospital bed.

Given these potential advantages and the current popularity of online schooling, the purpose of this study was to describe and quantify who uses online schools and why. Drawing from parental survey results from three states, this study aimed to clarify four goals: (1) to establish a knowledge of the basic demographics of online-school users, (2) to gain an understanding of the educational background and success of online-school students, (3) to determine whether there is a high prevalence of CSHCN enrolled in online schooling, and (4) to determine how children perform in online schooling compared with their prior experiences in traditional school. Online schools may potentially allow US students known to have both educational and health challenges, such as those from certain racial or ethnic backgrounds, those with socioeconomic disadvantages, and CSHCN, to better succeed.

Survey Participants

We performed an observational study in three of the states that have established state-led online-school programs, all of which are in the southeastern region of the United States. A multidisciplinary team from the University of Florida, Colleges of Education and Medicine, contacted parents via email, with three sequential invitations, to participate in a brief, online survey that could be accessed via an embedded link. The three participant states and their state-led online schools were invited to participate from the 21 state participants in the Virtual School Clearinghouse [18], ?a collaborative research project sponsored by the AT&T Foundation? that provides state-led online schools ?with data analysis tools and metrics vital for school improvement.? Unlike cyber-charter schools or school district-oriented programs, state-led online schools are associated with state departments of education, which provides some similarity in the scope and nature of their operations.

The three participating state-led online schools were required to supply email contact information for the parents of enrolled students. Using only these email addresses, this study achieved a response rate of 14.73% (1971/13,384) (state ranges 10.1%?20.3%). This response rate is in keeping with other parent-oriented email-based surveys, and, coupled with its lack of incentive for participation, is within an acceptable range for this population [19]. As Figure 1 illustrates, of the 13,384 individuals solicited, 740 had email addresses on record that were no longer in use or invalid. A small number (n = 142) chose to opt out of the survey using an embedded link within the email solicitation to remove their name and email address from the mailing list. There were 20 respondents who were contacted inappropriately (in a majority of cases these were a school counselor listed as a child?s contact) and 2 who did not want to complete the survey online. Five more recipients had technical difficulties precluding their ability to fill out the survey. We excluded an additional 23 respondents, as they filled out the survey but stated that they were not the parent of the child or that their child had not yet taken an online course.

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