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Society’s Forgotten Children Find Care and a Voice

Children and adolescents with special health care needs require health services that can extend far beyond those required by children generally. Dr. Diane Magyary is co-director of a federally funded program that is enriching graduate level education for nurses and clinicians involved with this population. Magyary is a professor of Psychosocial & Community Health.

"Although 20% of children have some type of mental health issue or disorder, 80% of them are not getting the services they need" notes Dr. Diane Magyary, co-author and co-director with Dr. Patti Brandt of a federally-funded training grant that is teaching nurses and clinicians to be "leaders and change agents" in the health care system. Funded by the Bureau of Maternal and Child Health, this very competitive five-year grant prepares graduate nurses to assume leadership roles in providing services and designing programs that address the needs of marginalized populations. These include children with chronic physical, developmental, behavioral or emotional disabilities, as well as children living in poverty or in stressful home situations.

While noting that the "whole emphasis of graduate education is community outreach," Magyary explained that this training grant supports the development of leadership skills that can enhance clinical outcomes and improve policies that affect larger populations. Since the grant was instituted, twenty-two specialty master’s students and five doctoral students have graduated. Ninety-two percent of the master’s graduates are providing services to children or adolescents with special needs, and 81% are working in "medically underserved communities."

A "leadership portfolio" of past graduates notes that "the consistent theme demonstrated by the majority of the master’s prepared graduates is that they have taken the initiative to create new nursing roles that integrate clinical expertise with leadership functions." Graduates of the program have initiated 22 new community-based projects for children with special needs. "Their work proves the success of our educational programs," notes Magyary.

The training grant also helped to fund the development of an "Attention Deficit Hyperactivity Disorder Manual" to enhance both the assessment and choice of interventions for children with behavior problems who come to primary care providers or mental health specialists. The manual contains a "decision tree" and suggests strategies for assessment, management and follow-up. It has been endorsed by the National Institute of Mental Health and the Maternal Child Health Bureau.