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Teamwork creates school-based health centers by Megan Fink Public Relations Fatigue from poor nutrition, untreated asthma attacks and disruptive and aggressive behavior are becoming massive barriers to student learning and achievement.   Problems first noticed by MUSC nurse practitioners have turned into a mission among several MUSC colleges to help solve medical and behavioral problems at area Title I schools, which generally serve low-income students.   The College of Nursing, Department of Family Medicine and Division of Developmental Pediatrics have teamed up with the Charleston County School District to administer medical and behavioral health services to students in Title I schools.   The goal of the School-Based Health Center Program is to establish a constructive learning environment by treating acute physical conditions and chronic diseases like asthma and disruptive behavior. Goals include increased attendance rates, fewer suspensions and improved standardized test scores.   Researchers and practitioners are observing both physical and social aspects affecting children’s scholastic abilities. “The patient is not the child,” said Marilyn Laken, Ph.D., R.N. “The school is the patient.”   Tackling performance and behavioral obstacles is complex and multi-systemic, said Laken. “No one discipline has the knowledge base to address a problem this complicated. It’s not just a medical problem, a nursing problem or a school problem,” she said.   Initially, nurses were at the schools to conduct physical exams and treat chronic problems. They found that children suffered not only from physical ailments, but also struggled with behavioral issues. Other components like student depression and attention deficit hyperactivity disorder were then incorporated into the program. MUSC is diving deeper into the reasons why Title I students are performing lower than their peers. “It’s like an onion; once you peel it back, you see all the complex layers that are involved,” Laken said.   MUSC graduate and undergraduate nursing students also are learning from this experience. CON instructor Diana Inman was the first to be stationed at one of the five participating schools, Burns Elementary in North Charleston. She noticed some parents were not aware of their children’s behavior in the classroom. In addition, young teachers were unprepared to work with problem students and often reinforced the wrong behavior. Along with the student portion of the program, parents and teachers are included in behavioral assessments, training and case conferences. This fall, Jane Charles, M.D., plans to see children with special needs at North Charleston High School.   Most of the Title I students participate in a free breakfast and lunch service. Since diet and physical activity also is considered in the school-based health program, MUSC wants to see more fruits and vegetables included in school diets. One plan is to have a school garden started, which would serve a variety of positive purposes for the children.   States such as California have seen academic success with school gardens, because nutrition and overall physical health affect learning.   The College of Nursing illustrated their approach to school-based health in a poster to be displayed at the upcoming University Faculty Convocation, which is scheduled for Aug. 21. This year’s theme is “Creating Collaboration” and will highlight various clinical, research and educational projects undertaken as a group effort.      Friday, July 13, 2007 Catalyst Online is published weekly, updated as needed and improved from time to time by the MUSC Office of Public Relations for the faculty, employees and students of the Medical University of South Carolina. Catalyst Online editor, Kim Draughn, can be reached at 792-4107 or by email, catalyst@musc.edu. Editorial copy can be submitted to Catalyst Online and to The Catalyst in print by fax, 792-6723, or by email to catalyst@musc.edu. To place an ad in The Catalyst hardcopy, call Island Publications at 849-1778, ext. 201.