Homebound Education

This paper provides an overview of homebound educational services with focus on court rulings, eligibility for services, types of services, personnel, responsibilities for the services, and strategies to facilitate delivery. A working definition of homebound education based on literature review is included. In order to successfully implement homebound education, students, families, teachers, administrators, and medical personnel need training, access to homebound education strategies or activities, and support systems. Advantages and disadvantages in providing homebound educational services are presented.

Keywords Homebound Education; Homebound Services; Hospital Education; In-home Instruction; Service Delivery; Special Education

Overview

Homebound education is an educational placement option that receives limited attention in the literature. Students enrolled in public schools, in either regular or special education classrooms, may need to receive educational services outside of the school setting. Homebound education can be delivered in settings which include hospitals, rehabilitation centers, home, or juvenile facilities in which the student is incarcerated.

Homebound education can be defined as educational support by a school district in locations other than the school (Moore-Brown & Montgomery, 2001). Homebound education should not be confused with home schooling, which is a type of educational program where the parent is responsible for providing the educational instruction (Patterson & Petit, 2006; Zirkel, 2003).

The intent of homebound education is to provide temporary, ongoing educational services for students who are unable to attend schools for extended periods of time due to:

• Physical, psychiatric, or medical needs;

• Students that have been suspended or expelled; or

• Students who are incarcerated (Moore-Brown & Montgomery, 2001).

Typically, a medical physician must verify the reason for the incapacity to attend school. The focus of this paper is to provide an overview on court rulings, eligibility for services, types of services, personnel, responsibilities for the services, and strategies to facilitate the delivery of the services.

Goal of Homebound Education

The goal of homebound education is to allow students to continue their educational program while absent from school for extended periods of time due to special circumstances. Another goal of homebound education is to facilitate the student's transition back into the classroom setting as soon as medically indicated.

Eligibility for Homebound Education

Each student who is a resident of a school district, enrolled in the district and in need of homebound education due to absence from school for an extended amount of time should have access to educational services. The student is included on the class roster at the school the student would attend if not receiving homebound educational services. A student typically has to be confined to the home or hospital setting for an extended length of time to be eligible for homebound educational services. In general, school district policies and procedures use absence from school for more than ten school days as a criterion for eligibility (Moore-Brown & Montgomery, 2001).

Eligibility for services includes medical reasons such as pregnancy, psychological conditions, surgery, disease, and suspension or expulsion from school. However, homebound education should not be considered on a routine basis or a permanent option for individuals with emotional, behavioral, or special education needs.

School districts often require a medical physician to state in writing the need for the homebound educational service and its expected duration. Also, the student's medical physician must substantiate in writing the need for homebound services for longer than initially anticipated should an extension of services be required.

Another condition for eligibility is the level of physical incapacity as determined by the medical physician. The medical physician is often required to submit in writing a statement addressing the need for the service(s) and that a student is able to participate in and benefit from the homebound educational program. Once a determination for homebound services is made, implementation of services should be immediate.

Description of Services

A student receiving homebound education should receive an educational program that is as similar as possible to the program offered at the school. The student should have continued access to all available school district resources. Homebound education services are provided by teachers who are specially certified in this area. The homebound teacher is responsible for providing direct instruction to the student in a setting outside of the school, and for maintaining regular contact with the student, school principal, classroom teacher(s) and parents or guardians.

The major difference between the homebound teacher and the classroom teacher(s) is that the classroom teacher(s) maintains the overall responsibility of the planning of the student's educational program. The homebound teacher is a traveling teacher responsible for maintaining contact with all stakeholders and for providing instruction through face-to-face meetings, telephone/video conferencing, or via the Internet. If indicated, other school district personnel such as the speech-language pathologist, occupational therapist, physical therapist, or paraprofessional can provide homebound services (Patterson & Petit, 2006).

In order to be effective, it is imperative that effective collaboration, consultation, and service coordination occur. However, depending on the student's difficulties and the appropriateness of the homebound service, the student may be served through alternative educational plans such as mental health services.

A student usually does not receive homebound educational services for seven to eight hours of instruction per day. The number of instructional hours varies depending on the needs of the student. For example, elementary students (grades K to 5th) who qualify for homebound educational services may receive a minimum of five to ten hours of instruction per week. Middle and High school students (grades 6th to 12th) may receive a minimum of ten to fifteen hours of instruction per week (Moore-Brown & Montgomery, 2001). Instructional hours are dependent on the student's academic load and type of educational service (i.e., regular or special education).

Personnel

Homebound Teacher

Teachers who are assigned to homebound students should be certified in providing homebound instruction. Shea & Bauer (1985) state that due to the nature of providing educational services within the home environment teachers should also, minimally, demonstrate:

• The ability to work in a collaborative, consultative, or coordinated fashion with various stakeholders (e.g., parents, school district personnel, medical personnel and community agencies)

• Familiarity with the a wide range of school curriculum and resources

• Knowledge of human behavior, child development, and children with special needs

• The skills necessary to assess the educational needs of a student and to modify curriculum, adapt teaching techniques and materials to meet the student's specific needs

• Knowledge of technology enhanced instruction to include the internet, telephone/videoconferencing, e-mail, etc

• Knowledge of cultural diversity such as attitudes toward education, interpersonal communication styles, and characteristics of an individual's community.

The specific instructional role of the homebound teacher includes meeting with the regular education teacher(s) to obtain school assignments, delivering the assignments and instructional materials to the home, providing instruction, and returning completed assignments to the classroom teacher for grading or grading assignments and providing the classroom teacher(s) with a grade for the subject. Additionally, the homebound teacher confirms dates and times of home visits, who will be in attendance during the visits, and reports any behavioral, health, or safety issues to the school.

Classroom Teacher(s)

The classroom teacher(s) retains primary responsibility for the student's educational program, grades or assigns grades for work; serves as a resource for the homebound teacher and consults on an ongoing basis with the homebound teacher. As stated earlier, the student remains on the teacher(s) classroom roster.

Other School District Personnel

Other school district personnel may be involved in delivering homebound educational services (Moore-Brown & Montgomery, 2001; Patterson & Petit, 2006). For example, services may be provided by speech-language pathology, occupational therapy, physical therapy, or paraprofessionals (Patterson & Petit, 2006). As with the homebound teacher, each additional service provider should have training in homebound instructional services and collaborate with the homebound teacher and classroom teacher(s).

Responsibilities

School District

Schools districts should establish policies and procedures for homebound educational services. The established polices and procedures should address how and when to report student progress; the responsibilities of all stakeholders (e.g., parents, school administrators, related service personnel, homebound and school based teachers, and medical service providers); confidentiality of the student's educational and medical status; and, mechanisms for collaboration, consultation, and coordination of services with all stakeholders. Additionally, policies and procedures should state how to provide services to a student with communicable diseases or mental health issues, training programs for school district personnel, and the need for the parent or guardian to be present in the home during the delivery of instructional services.

School

The student's school should maintain close contact with the homebound teacher and provide the teacher with the appropriate materials and information to enable the student to keep up with his/her class. The school should assist in arranging meetings to review educational plans such as the need for Individualized Education Plan (IEP) modifications and/or changes. The school should obtain written parental authorization for obtaining or releasing information to school or medical personnel.

Parents or Guardians

Parents or guardians are responsible for initiating the need for services by informing the school principal and classroom teacher. The parent or guardian responsibilities include, but are not limited to, providing documentation regarding the student's medical condition and expected length of absence from school; identifying who will be present during instruction; providing contact information for emergency purposes; giving notification and arrangements for cancelled visits; and communicating significant changes in educational or health needs.

The student's parent or guardian should provide a home environment that is conducive to learning. For example, the work environment in the home or other setting should be as free as possible of distraction(s) such as the television, radio, telephone, visitors, or siblings (Special Report, 2003). The parent should ensure that a responsible adult is present when the homebound teacher is working with the student.

Parents or guardians should have the student prepared for the homebound service by making certain that the student is aware of the service and is physically prepared (i.e., dressed, awake, had medications, etc.) for the visit. In addition, every effort should be made to keep scheduled homebound instruction appointments.

Court Rulings

Over the years, court cases have addressed a variety of issues in providing homebound instruction. For example, a complaint was lodged in South Dakota against the Shannon County School District for failure to provide a free appropriate public education (FAPE). In this case, the court ruled that the school district made reasonable efforts to comply with the student's Individualized Education Plan (IEP) and that the lack of availability of the student for instruction prevented the FAPE, and not failure of the school district to provide FAPE (Special Education Law Monthly, 2007).

In Decker v. Chamberlain (1996), the courts found that the parents of a homebound student could not be held responsible for alleged injuries sustained by Decker, the homebound teacher, during the delivery of homebound services as there was no documented evidence that the parents knew the student was violent (West's Education Law Reporter, 1997).

The East Islip Union Free School District v. Andersen (1994) court case involved the school district's suspension of a student with learning disabilities and the provision of homebound educational services until further evaluations and an IEP review could be completed. The courts agreed with the school district as the student had threatened to harm teachers and fellow classmates (West's Education Law Reporter, 1994).

Homebound Education for Students with Disabilities

Since 1975, federal law has mandated that students with disabilities be provided educational services in a free appropriate public school environment. In some cases a student with disabilities may not be able to attend school as a result of a medical condition such as autoimmune disorder, diabetes, epilepsy (seizures) or other extensive illness. If the student was eligible for special education service(s) before the extended hospitalization, the individual remains eligible for the service(s) if they can physically benefit from the services (Hillman, 2000; Moore-Brown & Montgomery, 2001).

According to the Individuals with Disabilities Education Act of 2004 (IDEA, 2004), students with disabilities must be provided educational services in the least restrictive environment (LRE). Students with emotional, behavioral, health impairments, orthopedic impairments, traumatic brain injury, or multiple disabilities typically receive homebound educational services (Patterson & Tullis, 2007). However, it should be noted that permanent placement in the home is not considered the least restrictive environment for students with disabilities as this placement option does not allow interaction with non-disabled peers (Patterson & Tullis, 2007).

A student with an Individualized Education Plan (IEP) is eligible for homebound education if suspended from school for more than ten days or if expelled from school (Moore-Brown & Montgomery, 2001). If the student has been suspended, the student is entitled to homebound services until he/she returns to school or an alternative educational placement is found. If expelled from school, the student still retains his/her right to a free appropriate public education (FAPE) through homebound education.

Incarcerated students typically receive services at their detention facility (Moore-Brown & Montgomery, 2001). Prior to incarceration a student who received special education service(s) and had an IEP, remains eligible for special education service(s). Some states employ educators through the state government while others may rely on local school district personnel to provide educational services.

Students who have known emotional or behavioral disabilities can present a challenge to the delivery of homebound educational services. These disabilities can vary from mild to severe disturbances and can be exacerbated in the home environment (Patterson & Tullis, 2007). Thus, the homebound teacher must be well versed in the use of behavioral interventions such as a token system, behavioral contracts, or identifying the triggers of inappropriate behaviors (Patterson & Tullis, 2007).

Facilitation Strategies for Home Visits

Patterson & Tullis (2007) provide facilitation strategies for homebound teachers to assist with instructional visits. Prior to the first visit, the homebound teacher and classroom teacher(s) should review the student's current educational history. Teachers should determine if the student received special education services or has a history of emotional or behavioral issues. If either of these circumstances or an IEP exists, the types of services required and instructional strategies must be provided as documented in the IEP (Patterson & Tullis, 2007).

Interviewing current or previous teachers and related service personnel such as psychologists, behavioral interventionists, or counselors is also recommended. Reviewing and clarifying information contained within the student's educational record offers the homebound teacher insight into the unique needs of the homebound student.

The establishment of open communication is critical to the success of homebound educational services (Shea & Bauer, 1985). Communication strategies that will assist the homebound teacher in establishing and maintaining open communication include being an effective listener, focusing on the issue (not the person), creating an atmosphere of working together toward a common goal, being aware of verbal and non-verbal cues, and empathizing with the student, parent, or other professionals.

Patterson and Tullis (2007) provide a list of dos and don'ts for homebound education. The list of 'educational do's' include,

• Researching the student's educational background

• Providing services as outlined on the iep

• Providing services in the presence of the parent or guardian

• Establishing open communication

• Having alternative plans for visits

• Being creative with instructional materials and resources

• Being readily identifiable as school personnel

• Documenting and keeping records of all visits, activities, progress or lack of progress

Homebound 'educational don'ts' as offered by Patterson and Tullis include,

• Having a lackadaisical approach

• Providing services without appropriate planning

• Being late for appointments or visiting without a prearranged appointment

• Reviewing written work only

• Giving excessive assignments

• Neglecting the parent or guardian

• Failing to keep all stakeholders informed of the student's progress or status

While Patterson and Tullis provided strategies for physical visits to the individual's home, Hillman (2000) and Smith and Luckasson (1995) proposed the use of technology to assist in keeping the student a part of the classroom experience. Hillman (2000) discusses the use of tele/videoconferencing (video/voice capabilities) with the classroom in real time. Through the use of streaming video or web cams the student can participate in the discussion(s) occurring in the classroom(s). Smith and Luckasson (1995) advocated for the use of telephone conferences or videotaping classes to assist the student who is homebound. This use of technology allows the student to remain engaged in the classroom setting, maintain or foster relationships with peers, and sustain the student and classroom teacher(s) relationship (Hillman, 2000; Smith & Luckasson, 1995). Thus, technology can assist with the transition back to the school environment.

Viewpoints: Advantages & Disadvantages of Homebound Education

Homebound teachers have the advantage of developing insights into the student's home environment that the classroom teacher(s) may not be able to realize. For the homebound teacher, providing education in the home environment allows a unique perspective of the student and family dynamics. By providing education in the home, the homebound teacher can directly observe the effects of the impairment on the student's behavior (Patterson & Tullis, 2007). Also, due to the individualized type of instruction, the homebound teacher, parent or guardian, and student may develop stronger relationships.

The primary disadvantage of a student receiving homebound education is disengagement from the school environment. Isolation can be a factor that exacerbates a student's illness or disability. Another disadvantage can be the overuse of homebound educational services by school personnel to deal with a student's emotional or behavioral issues. If a homebound teacher feels that homebound education is not an appropriate placement decision he or she should advocate for addressing the unique and individual needs of the student in the school environment.

Patterson and Tullis (2007) cited disadvantages of providing homebound instruction to include lack of availability of certified teachers in homebound instruction, lack of research on effective teaching methods for homebound education outside of early childhood education, and failure of school districts to provide policies and procedures. Additionally, the home setting can present unexpected challenges in delivering the educational program. For instance, families may cancel appointments; the environment may meet only minimal standards of care such as limited heating or air conditioning; noisy or disruptive siblings or family members; and, the homebound teacher may feel that the instruction does not adequately address accountability standards.

Conclusions

Successful homebound educational services are dependent on well-planned coordinated activities dependent upon open communication with all stakeholders. Stakeholders (e.g. teachers, parents, students, medical personnel, etc) require consultation, collaboration, coordination and training in a team environment to deliver effective services to the individual in need of homebound educational services. Homebound services should not be used to manage children or the school environment when dealing with emotional, behavioral, or special needs. Carefully considered services can effectively return the student to the classroom by providing uninterrupted educational services.

Terms & Concepts

Behavioral Contracts: A behavioral contract is a written agreement between the child, teacher, and parent that outlines appropriate behavior and the consequences of inappropriate behavior.

Free Appropriate Pubic Education (FAPE): FAPE is a legal requirement that prescribes that individuals with disabilities are educated in the least restrictive environment (LRE).

Homebound Education: Homebound education can be defined as educational support by a school district in locations other than the school (Moore-Brown & Montgomery, 2001).

Home Schooling: The parent in the home environment provides educational services without the assistance of a certified teacher from the school district.

Individuals with Disabilities Education Act of 2004 (IDEA, 2004): IDEA is a federal law which mandates special education and related services to individuals with disabilities age birth to 21 years.

Individualized Education Plan (IEP): The IEP serves as the "road-map" of the why, when, how, and where of activities and services for the individual with a disability. The IEP is an individualized program for students three to 21 years of age, which must be developed for the individual identified as having a disability by a team. The IEP must have key components that communicate the needs of the individual and the services necessary for the individual to participate in the educational environment.

Least Restrictive Environment (LRE): The least restrictive environment is commonly defined as educating individuals with disabilities with their peers to the maximum extent possible in the regular classroom or extracurricular environment.

Token System: A token system is a behavioral management system that awards or removes physical tokens (chips, stickers, etc.).

Bibliography

Beeman, R.Y., & Henderson, C.J. (2012). Video-conferencing technology brings a homebound middle grades student to the classroom. Middle School Journal, 43, 26-33. Retrieved December 15, 2013, from EBSCO Online Database Education Research Complete. http://search.ebscohost.com/login.aspx?direct=true&db=ehh&AN=74649855&site=ehost-live

Boonen, H.H., & Petry, K.K. (2012). How do children with a chronic or long-term illness perceive their school re-entry after a period of homebound instruction?. Child: Care, Health & Development, 38, 490-496. Retrieved December 15, 2013, from EBSCO Online Database Education Research Complete. http://search.ebscohost.com/login.aspx?direct=true&db=ehh&AN=76302750&site=ehost-live

Decker v. Chamberlain (652 N.Y.S.2d 175). West's Education Law Reporter (1997), 115 64-65.

East Islip Union Free School District v. Andersen (615 N.Y.S.2d 852), West's Education Law Reporter (1994), 93, 875-877.

Hillman, R. (2000). Reach homebound students through technology. Multimedia Schools, 7 , 78-80. Retrieved June 18, 2007 from EBSCO Online Database Education Research Complete. http://search.ebscohost.com/login.aspx?direct=true&db=ehh&AN=2856245&site=ehost-live

Know differences between home instruction, homebound services. (2013). Special Education Report (LRP Publications), 39, 9. Retrieved December 15, 2013, from EBSCO Online Database Education Research Complete. http://search.ebscohost.com/login.aspx?direct=true&db=ehh&AN=90001395&site=ehost-live

Moore-Brown, B. J. & Montgomery, J. K. (2001). Making a difference for America's children: Speech-language pathologists in public schools. Eau Claire, WI: Thinking Publications.

Patterson, P. & Petit, C. (2006). Helping to make homebound instruction successful. The Exceptional Parent, 36 , 44-46. Retrieved June 18, 2007 from EBSCO Online Database Education Research Complete. http://search.ebscohost.com/login.aspx?direct=true&db=ehh&AN=22234012&site=ehost-live

Patterson, P. & Tullis, L. (2007). Guidelines for providing homebound instruction to students with disabilities. Preventing School Failure, 51 , 29-33. Retrieved June 18, 2007 from EBSCO Online Database Education Research Complete. http://search.ebscohost.com/login.aspx?direct=true&db=ehh&AN=24238657&site=ehost-live

Shannon County (SD) School District #65-1, 46 IDELR 229 (OCR, Kansas City (SD) 2006. Special Education Law Monthly (2007).

Shea, T. & Bauer, A. (1985). Parents and teachers of exceptional students: A handbook for involvement. Boston, MA: Allyn & Bacon Publishing.

Special Report (2003). Students with chronic illnesses: Guidance for families, schools, and students. Journal of School Health, 73 , 131-132. Retrieved June 18, 2007 from EBSCO Online Database Education Research Complete. http://search.ebscohost.com/login.aspx?direct=true&db=ehh&AN=9636395&site=ehost-live

Smith, D. & Luckasson, R. (1995). Introduction to special education: Teaching in an age of challenge (2nd ed). Boston, MA: Allyn & Bacon, Publishing.

Suggested Reading

Gargiulo, R. M. (2006). Special education in contemporary society: An introduction to exceptionality. (2nd ed.). Thomson Wadsworth Publishers.

Patterson, P. & Petit, C. (2006). Helping to make homebound instruction successful. The Exceptional Parent, 36 , 44-46.

Schwartz, D. (2005). Including children with special needs: A handbook for educators and parents. Portsmouth, NH: Greenwood Press.

Zirkel, P. (2003). Home-Schoolers: Rights to special education. Principal, 82 , 12-14.