Funded Projects

Assemble for Children with Special Needs

Project Year

2026

City & State

Providence, Rhode Island

Program Name

Planning

Topic

School Health

Program Description

Problem- Coordinated care is critical for supporting children with special health care needs (CSHCN) in their education setting, where they spend much of their time receiving academic and therapeutic services. Effective health care coordination ensures optimal use of resources, fosters family-centered care and enhances satisfaction for both patients and healthcare providers (Cohen et al., 2012). Collaboration among families, clinicians and schools can prevent redundant evaluations, enable timely assessment and provision of services and targeted treatment plans. Yet, despite widespread recognition of its importance, family-provider-school coordination remains limited. In fact, a nationally representative study found that only 38% of parents of CSHCN reported any communication between their child’s pediatrician and school (Geffel et al., 2022)

Primary Setting – Providence, the capital of Rhode Island and the third-largest city in New England, faces significant challenges affecting children, especially CSHCN and their families. In 2019, an independent review revealed profound systemic dysfunction within the Providence School Department severely limiting educational opportunities for students (Johns Hopkins, 2019). As a result, the district has been under state control the past six years. Beyond education, safety in Providence fall below state averages with higher rates of child neglect, abuse and exposure to domestic violence. Financial hardship is also widespread- 28% of children in the city live below the federal poverty line (RI KIDSCOUNT, 2025).

Number of children affected – As of June 2024, 18% of Rhode Island’s K-12 students – approximately 23,574 children – received special education services through public schools. Among these students, 79% qualified due to learning disabilities, speech and language impairments, autism spectrum disorder, developmental delays, emotional disturbances, or intellectual disabilities – conditions commonly managed within Developmental Behavioral Pediatrics practice.

Project goal – Assemble for Children with Special Needs (ACSN) is a community-based planning initiative designed to strengthen care coordination and communication among families, pediatric providers and schools who serve CSHCN- particularly those with developmental and behavioral challenges in Providence Public Schools.

Proposed Intervention – We will achieve this goal through a three step approach: (1) collecting data through family surveys and focus groups with engagement of school staff and families; (2) convening a coalition of key stakeholders involved in the care of CSHCN – including family members, school psychologists, nurses, social workers, special education teachers, administrators, community primary care pediatricians and developmental behavioral pediatricians; and (3) using the collective input from these steps to design solutions during coalition meetings.

Anticipated outcomes – Through these interventions, we seek to identify barriers to effective communication among families, pediatric providers, and schools within our target community. Coalition meetings will foster interdisciplinary collaboration and promote cultural humility across diverse work settings. Ultimately, these efforts will lead to family-centered, culturally competent and sustainable communication platforms and processes. Using an iterative approach, the solutions proposed during each coalition meeting will be reviewed in the subsequent focus group session, which will in turn inform the agenda and priorities for the next coalition meeting.

Project Goal

Identify barriers to effective care coordination among families, pediatric providers, and schools to guide the creation of family-centered, culturally responsive, and sustainable communication systems and processes

Project Objective 1

By April 2027, we will conduct six focus group discussions to explore perceptions of family–provider–school care coordination.

Project Objective 2

By April 2027, we will distribute and collect 125–150 surveys from caregivers of children with special needs.

Project Objective 3

By May 2027, we will hold four coalition meetings to review focus group and survey findings; and develop recommendations to address emerging concerns.

AAP District

District I

Institutional Name

Brown University

Contact 1

Jnev Biros, MD, MPH