Medicaid: A potential source of revenue for special education

Currently, over 4.3 million children are receiving special services within the nation's schools because of physical, developmental, and educational disabilities. It is estimated that twice this number would benefit from special education services. Public Law 94–142, the Education for the Handicapped Act, offered the first real opportunity for many children with disabilities to receive special health and educational services. Public schools have become a primary setting for provision of services to these children, however, many states have encountered difficulty in procuring funding. One federally mandated source of revenue is the Medicaid program. In the fall of 1991, all state Medicaid and special education programs were asked to provide information concerning current or planned use of Medicaid funds for special education services. Responses were received from 36 states. Only 19 states reported using Medicaid funding in any capacity, and of these, only four required schools to bill Medicaid for services rendered. The majority of these programs are in the pilot stages of development. Special education services covered by Medicaid vary widely, as do reimbursement mechanisms. All 19 states allow Medicaid coverage for speech, physical, and occupational therapy. Only about half of those states provide allowances for diagnostic evaluation and assessment, while coverage for psychological services is provided by three-fourths of those states, and EPSDT screens by half of the states. Only two programs had been evaluated formally at the state and/or federal level. Medicaid remains a largely untapped source of revenue that could be used to help fund services for disabled children.     

Attractiveness and Income for Men and Women in Management1

It is commonly believed that attractive people are more successful, but the empirical support for this belief is mixed. A number of role-playing, laboratory studies have demonstrated that more attractive men are more often hired, but the laboratory data for women are less consistent. Few studies have explored the effects of attractiveness on actual hiring and starting salaries for men or women. Even less work has been done on the impact of attractiveness once on the job. It was predicted that there would be positive effects for attractiveness and that the effects would be stronger as people worked longer on their jobs. To test this prediction, a sample of 737 male and female MBA graduates from the years between 1973 and 1982 was used to explore how facial attractiveness relates to starting and later salaries. Results indicated that more attractive men had higher starting salaries and they continued to earn more over time. For women, there was no effect of attractiveness for starting salaries, but more attractive women earned more later on in their jobs. By 1983, men were found to earn $2600 more on the average for each unit of attractiveness (on a 5-point scale) and women earned $2150 more. Implications for research in this area are discussed.     

The ecological validity of laboratory and analogue assessment methods of ADHD symptoms

An important question in the attempt to generalize laboratory findings on attention deficit-hyperactivity disorder (ADHD) children to clinical issues concerning their assessment, diagnosis, outcome, and treatment response is the ecological validity of the commonly used tasks and analogue behavioral observation procedures. This paper examines the concept of ecological validity and issues inherent in its evaluation. The evidence from a variety of sources is then reviewed on the relationship between laboratory methods of assessing inattention, impulsivity, and overactivity and measures of these same constructs in natural settings. Additional findings pertaining to this issue from a recent study of 140 ADHD and normal children and 159 ADHD and normal adolescents using a multimethod battery of tests are also reported. In general, the ecological validity of most methods is of a low to moderate degree, with some traditional laboratory tasks proving unsatisfactory. A few tasks demonstrated acceptable degrees of ecological validity but even these require improvement. It is concluded that future advances in ecological validity are likely to come from: (a) a greater reliance on assessments of the target behaviors in natural settings and (b) combining several of the more promising tasks and analogue methods into a battery that is taken over longer time intervals than has been customary and averaged across repeated administrations.An earlier version of this paper was presented at the International Symposium on Attention Deficit Hyperactivity Disorder, Amsterdam, The Netherlands, April 6 and 7, 1989. The author wishes to thank Charles E. Cunningham, Ph.D., Susan Campbell, Ph.D., Mark Rapport, Ph.D., Eric Mash, Ph.D., and Herbert Quay, Ph.D., for their comments on an earlier version of this paper, and to Marcel Kinsbourne, M.D., for his comments on the presentation itself. The author was supported by funds from NIMH grants 41464, 41583, and 42181 during the preparation of this review.     

Martin Buber's relevance to institutional mental health care

A Buberian perspective on problems related to the establishment of therapeutic environments on mental hospital wards is offered. Depersonalization and over-reliance on a medical treatment orientation in human relationships are identified as central problem areas in mental hospitals. The therapeutic community is identified as a major alternative model to respond to these problem areas. Difficulties in applying the therapeutic community model are identified. Buber's social philosophy, especially his interpretations of spiritual crisis, cultural crisis, structural renewal, and genuine dialogue, are identified as useful tools to clarify and resolve those difficulties.     

The role of individual bargaining behavior in the pay setting process: A pilot study

A model of initial salary detemination for professional and managerial employees is developed. That part of the model which concentrates on the role of employee salary negotiation behaviors and attitudes was investigated using a sample of 117 individuals. Significant variance in salary bargaining attitudes and behaviors was found; attitudinal and demographic differences between negotiators and non-negotiators were determined. Additionally, negotiating behavior was found to be positively related to salary, but only slightly related to salary growth.     

SOCIAL VALIDATION AND TRAINING OF EMERGENCY FIRE SAFETY SKILLS FOR POTENTIAL INJURY PREVENTION AND LIFE SAVING

A multifaceted behavioral program designed to teach emergency fire escape procedures to children was evaluated in a multiple-baseline design. Five children were trained to respond correctly to nine home emergency fire situations under simulated conditions. The situations and responses focused upon in training were identified by a social validation procedure involving consultation with several safety agencies, including the direct input of firefighters. Training, carried out in simulated bedrooms at school, resulted in significant improvements in both overt behavior and self-report of fire safety skills. The gains were maintained at a post-check assessment 2 weeks after training had been terminated. The results are discussed in relation both to the importance of social validation of targets and outcomes and the implications for further research in assessing and developing emergency response skills.