Running Head: SPECIAL NEEDS CHILDREN IN LOW-INCOME FAMILIES 1

Raising a Special Needs Child in a Low-Income Family

Jessica A. Bowers

Regent University
SPECIAL NEEDS CHILDREN IN LOW-INCOME FAMILIES 2

Abstract

Children with special needs raised in a low-income family are impacted daily by various risk

factors which they are often unable to influence or control. This includes factors generally

associated with poverty, along with the excessive public and private costs of their care. Families

in this category are commonly forced to choose between full time employment, and reliance on

government assistance; notably, single mothers are parents of a special needs child more

frequently when compared with other family demographics. Government assistance policies and

their geographical variance (e.g. Medicaid) continually effect the childs access to medical care,

therapeutic services, and what is available to the family. Educators can better assist these

children by creating a meaningful family-friendly environment within schools in collaborating

with educational and other local professionals. This can be accomplished through personal

awareness of current policies combined with the establishment of a student advocacy committee,

geared toward improving lifelong stability for child and family alike.
SPECIAL NEEDS CHILDREN IN LOW-INCOME FAMILIES 3

Special Needs Children in Low-Income Families

Children with special needs who are born into a family of low socioeconomic status

(SES) experience extreme hardship as a result of excessive risk factors including divided homes,

the familys burden of obvious and hidden costs of care, as well as geographic variance in

available government funding (Fulda et al., 2012, p.509). In order to address these individual

issues, a collaboration between micro- and mesosystems (e.g. the child, family, school, and

government) must exist to ensure not only needs of the child are met, but also their care

providers (Bronfenbrenner as cited in Bergin & Bergin, 2015, p.14; Meyers, et al., 2000, p. iv;

Porterfield & McBride, 2007, p. 323; Hanson et al., 1995, p. 204). Educators must be aware of

these children and families for the sake of creating meaningful relationships, leading to more

effective school programs, provided services, and compelling advocacy.

For the purposes of this paper, the phrase special needs will refer to the Federal

definition of a child with a disability as:

Having mental retardation, a hearing impairment (including deafness), a speech or

language impairment, a visual impairment (including blindness), a serious emotional

disturbance (emotional disturbance), an orthopedic impairment, autism, traumatic brain

injury, a specific learning disability, deaf-blindness, or multiple disabilities, and who, by

reason thereof, needs special education and related services. (Department of Education,

2004)

The current Federal Poverty Level is currently at $24,300 for a family of 4, and is defined up

to a family of 8 (Health Care, 2016). As of 2003, 16 percent of the low-SES population had a

child with special needs, which is nearly 50 percent higher than the rate among higher-

income families (Childrens Defense Fund, p. 111).

SPECIAL NEEDS CHILDREN IN LOW-INCOME FAMILIES 4

Risk Factors

Poverty is an umbrella term for those who live in low-income households and are thus

adversely affected across a wide and often lifelong spectrum. This occurs as a result of

accumulating risk factors such as divorce, low levels of education, less employment, poor living

conditions, (e.g. nutritional deficits or increased neighborhood crime) and an increased

dependence on government welfare (Porterfield & McBride, 2007, pp. 1, 3; Meyers et al., 2000,

pp. iii, 1; Lygnegrd et al., 2013, p. 298; Bergin & Bergin, 2015, pp.24-25). Children living in

these conditions are notably affected, presenting a greater likelihood of dropping out of school,

of grade level retention, and placement in special needs education (Prince & Howard, 2002, p.

27; Lygnegrd et al., p.297; Porterfield & Tracey, 2003, pp. 1-2; Fujiura & Yamaki, 2000).

Children with special needs pose an even greater difficulty for families struggling with the above

factors due the inevitable costs of their care (Meyers et al., pp. iii); frequently, it is a single

mother at the helm of such a household (Lee et al., 2002, p.3; Meyers et al., p.74; Porterfield &

Tracey, p.3; Hanson & Carta, 1995, p.203). Meyers, Brady, and Soto (2000) noted the unique

struggles of these children in accordance with their life of poverty-related compromises

(p.1), including their difficulty of acquiring appropriate care and positive stimulation (Hanson &

Carta, p. 207).

The Special Needs Child

Despite the lack of research from a childs direct perspective, it should be noted that their

difficulties implicate negative consequences for their health and future, most if not all of which

are out of their control (Lygnegrd et al., 2013, p. 298; Meyers et al., p. 7). Shonkoff and Phillips

(2012) refer to the correlation between every childs innate awareness of emotions or curiosity

with the significance of their early environmentand nurturing relationships (p.1); this
SPECIAL NEEDS CHILDREN IN LOW-INCOME FAMILIES 5

includes the prenatal care accessible and adhered to by the mother (Hanson & Carta, 1995,

p.207). If a special needs child does not have a sense of security both from their caregiver and

physical environment, their hardships will only increase as they age (Childrens Defense Fund,

2003, p. 112; Meyers et al., 2000, p. 7). Special needs children of a low-SES who do not have

their basic needs met undoubtedly struggle as they experience a lack of appropriate health care,

educational interventions, or therapeutic services (Maslow as referenced in Bergin & Bergin,

2015, p.44; Porterfield & McBride, 2007, pp. 327-328; Porterfield & Tracey, 2003, p.3; Meyers

et al., p.1, 12; Fujiura & Yamaki, 2000, p.188 Lygnegrd et al., 2013, p. 297; Prince & Howard,

2002, p. 28). These children typically grow up in a single-parent household, and often with a

single-mother.

Single Mothers as a Risk Factor

Single mothers are already at risk for experiencing low income and its associated

difficulties, and thus have a higher probability than other family demographics to bear a child

with special needs (Lee et al., 2002, p.3; Fujiura & Yamaki, 2000, p. 187). A 2003 report by the

Childrens Defense Fund attributes 46% of single mothers to having a special needs child, and

even a disability themselves (p. 111; Meyers et al., 2000, p. 12). Many of the mothers have not

finished high school, are less likely to be employed and thus increasingly welfare dependent

(Thurston & Navarette, 2003, p.39, 40; Porterfield & Tracey, 2003, p.323). As a result, these

mothers often struggle with shame and are thus are less likely to seek or engage in offered

services, or even be aware of their existence (Hanson, 1995, p.202; Thurston & Navarette, p. 40;

Porterfield & Tracey, p.323). These risk factors implicate a conflict for the child regarding their

existing vulnerability related to difficult living conditions and the mothers lack of financial

security (Fujiura & Yamaki, pp. 188-189; Lee et al., 2002, p. 6; Meyers et al., 2000, p. v).
SPECIAL NEEDS CHILDREN IN LOW-INCOME FAMILIES 6

A need for empathy. Regardless of these existing risk factors, Thurston and Navarette

(2003) emphasize the societal need of awareness for these mothers lives as individuals rather

than holding to common stereotypes or false presumptions (p.40). One must remember these

women, despite their obvious hardships, frequently demonstrate remarkable persistence and

ingenuity in support of their families (Thurston & Navarette, p.45). This resilience is a

necessity when it comes to navigating the glut of costs accrued when caring for their special

needs child.

Financial Implications

The costs of raising a child with special needs are significant, considerably more for a

low-income family, with obvious and hidden ramifications (Price & Oliverio, 2016, p. 25;

Porterfield & McBride, 2007, p. 327; Meyers et al., 2000, p.iii, viii-ix; Porterfield & Tracey,

2003, p. 2). They present both as medical and nonmedical costs, and include the time spent in

caring for the child (Loprest & Davidoff, 2004, p. 171; Meyers et al., p. 1, 7). It is important to

be aware of the toll they may take on a low-SES family, constantly forcing a choice between the

next copayment and food on the table.

Obvious Costs

Children with special needs require extensive medical care and other treatment services.

This includes but is not limited to specialist physicians, therapies (e.g. occupational, physical, or

speech), dietary requirements, specialized equipment or home modifications, and prescription

medications (Price & Oliverio, 2016, p. 25-26, p. 27; Meyers et al., 2000, p. 23; Loprest &

Davidoff, 2004, p.171; Porterfield & McBride, 2007, p.325). Low-income parents are less likely

to pursue or even secure these services due to a lack of health insurance, an inability to make the

copayment, or out-of-pocket expense (Porterfield & McBride, p. 327; Meyers et al., p.23; Fulda
SPECIAL NEEDS CHILDREN IN LOW-INCOME FAMILIES 7

et al., 2012, p.510). There is a plethora of private costs which indirectly effect children and the

entire family unit.

Hidden Costs

A child with special needs care will take a toll on a familys mental and emotional

wellbeing (Meyers et al., p.7). Parents are forced to work less as a result of the time costs

incurred as primary caregiver, thus continuing the cycle of poverty and welfare dependency

(Porterfield & Tracey, 2003, p.2; Meyers et al., p. 16, 23; Hanson & Carta, 1995, p. 205). The

parent is often forced to make a choice between paying a bill, buying groceries, or their childs

appointments (Meyers et al., p. 16; Hanson & Carta, p. 207). Whatever income these families do

earn is spent quickly as it is poured into the significant medical costs accumulated (Meyers et al.,

p.16, 55). Government assistance is available, however its geographic variance from state to state

in regards to eligibility and provision makes it a difficult solution.

Government Assistance

The most widely known form of assistance is Medicaid, medical coverage designed for

the low-income population, and the Childrens Health Insurance Program (CHIP), which assists

families who do not qualify for Medicaid but still experience income difficulties (Medicaid,

2016). Many receive Supplementary Security Income (SSI) which assists disabled, low-income

adults and children (Social Security Administration, 2015, pp. 4, 10; Lee et al., 2002, p. 1).

Lastly, there is Temporary Assistance for Needy Families (TANF), designed to help needy

families achieve self-sufficiency and independence of government aid through various offered

programs (Office of Family Assistance, 2015; Meyers et all, p. 19; Lee et al., p. 1). Fulda,

Johnson, Hahn, and Lykens claim that something must be done to reduce the disparity between

geographic regions, specifically coming to a unified definition of a child with special health care
SPECIAL NEEDS CHILDREN IN LOW-INCOME FAMILIES 8

needs (CSHCN) (p.510); this will encourage consistency of care, the integrity of services, as well

as a logical application of steps to reduce welfare dependency without causing further financial

difficulties in the process (Meyers et al., p. iv; Fulda et al., p.509).

Conclusion

The multiplicity of risk factors associated with living in poverty creates a vicious cycle of

a lack of income, sufficient medical care, a nutritious diet, a safe and stable environment, and

increased welfare dependency. For a child with special needs born into this type of world,

oftentimes with a single mother at the reigns, they are fighting an even larger uphill battle. The

excessive direct and hidden costs of their care often lead to the parent having to choose between

working to earn just enough to pay their bills, without much left for basic necessities, or

permanent reliance on governmental support. The child therefore faces an inconsistent day to day

life and care routine, indicating school may be their sole locus of stability. As a teacher, one must

be aware of these students and parents not only in your classroom, but in the school as a whole in

order to better prepare them in their eventual life and work transitions (Thurston & Navarette,

2003, p. 45).

This involvement does not imply a friendly greeting in the hallway, instead it demands

that educators take the time to get to know these families by providing a nurturing family-

friendly school environment (Thurston & Navarette, 2003, p. 45). One must seek out and be

willing to create respectful, meaningful relationships with parents, and to take ones involvement

from the periphery of their world to its knotted inside (Thurston & Navarette, p. 39). It is

important to acknowledge that many of these parents are already under a great deal of stress,

may have had negative experiences with schools in the past, could have a disability themselves,

and thus may be wary of assistance (Thurston & Navarette, 2003, p. 44). One can make a great
SPECIAL NEEDS CHILDREN IN LOW-INCOME FAMILIES 9

deal of progress in gently getting to know and appreciate their childs individual needs and

abilities first. For example, in taking the time to communicate successes and struggles the child

has, and in a patient manner that the parent can understand and feasibly act upon, you will

naturally forge a bond of trust. This will permit one to adjust and plan accordingly for future

communications and events with the family, and ideally outside services.

To effectively obtain needed services, consider collaboration with the school counselor

paramount. Consider creating an advocacy committee for this particular student group within

your school. Obtain board members from local charities that provide educational, medical,

therapeutic, and recreational services, for the child as well as the parent. This would create

opportunities for these services to be brought directly to your students at school, what Hanson

and Carta (1995) refer to as a coordinated interagency response (p. 207, 209). Having a team

of professionals with the same end goal equipping the student and family with the means to

function one day at a time will hopefully lead to a reduction of the cycle of dependence for

later success and financial stability (Thurston & Navarette, 2003, p. 45). This can also be

accomplished through the venue of advocacy in becoming familiar with current governmental

policies (e.g. TANF) that directly effect these students and parents (Thurston & Navarette, p. 45)

Educators may equip themselves to shape positive change in these families lives by

becoming intimately familiar with the challenges and legal boundaries they invariably face. This

requires reaching beyond the time spent in school walls to knowing what their exact needs are,

and which policies are currently effecting their family. In becoming a trusted voice who

advocates for better physical and financial care of your student, you are in turn promoting for

their increased stability and a better chance at success in later life (Thurston & Navarette, 2003,
SPECIAL NEEDS CHILDREN IN LOW-INCOME FAMILIES 10

p. 45). While ones example within the classroom is already powerful, what is done outside of it

can be just as, if not more, far-reaching.

SPECIAL NEEDS CHILDREN IN LOW-INCOME FAMILIES 11

Raising a Special Needs Child

in a Low-Income Family

Jessica A. Bowers
ETLC 541
Regent University

Special Needs: The Federal Definition

Having mental retardation, a hearing impairment (including
deafness), a speech or language impairment, a visual impairment
(including blindness), a serious emotional disturbance (emotional
disturbance), an orthopedic impairment, autism, traumatic brain
injury, a specific learning disability, deaf-blindness, or multiple
disabilities, and who, by reason thereof, needs special education and
related services.

Families and Their Children

The current Federal Poverty Level is currently at $24,300 for a family of

4, and is defined up to a family of 8.

As of 2003, 16 percent of the low-SES population had a child with special

needs, nearly 50 percent higher than the rate among higher-income
families.
SPECIAL NEEDS CHILDREN IN LOW-INCOME FAMILIES 12

Single Mothers and the Special Needs Child

A 2003 report by the Childrens Defense Fund attributes 46% of single

mothers to having a special needs child, and even a disability themselves.

Many of the mothers have not finished high school, are less likely
to be employed and thus increasingly welfare dependent.

These mothers often struggle with shame, being less likely to seek
or engage in offered services, or even be aware of their existence.

It is important to remember that these women, despite

their obvious hardships, can be incredibly persistent and
resilient in the ways they find to support their families.

Poverty & The Special Needs Child: Risk Factors

Poor
Nutrition

Medical Low
Costs Education

Appropriate
Care

Less Chance to Thrive

as an Adult

The Cost of Raising a Child with Special Needs

Obvious Hidden

Specialist Physicians Mental/Emotional Wellbeing

Therapy Services Time Costs
Dietary Requirements Choice of Work or Government
Assistance
Specialized Equipment
Home Modifications
Prescription Medication
SPECIAL NEEDS CHILDREN IN LOW-INCOME FAMILIES 13

Government Policies
Medicaid &
Medical coverage designed for low-income families.
Childrens Health
Insurance Program For families who do not qualify for Medicaid, but still
(CHIP) experience income difficulties.

Supplemental
Assists disabled, low-income adults and children.
Security Income
(SSI)

Temporary
Designed to help needy families achieve self-sufficiency
Assistance for Needy and independence of government aid through various
Families (TANF) offered programs.

Advice for Educators

Consider collaboration with the school counselor paramount.

Create a family-friendly school environment.

Many of these parents are already under a great deal of stress, may have had negative
experiences with schools in the past, or could have a disability themselves. They may be
wary of assistance.

Create respectful, meaningful relationships with parents, and take ones involvement
from the periphery of their world to its inside.

Communicate any successes and struggles the child has, and in a patient manner that
the individual parent can understand and feasibly act upon. You will naturally forge a
bond of trust

Advice for Educators

Be familiar with current government policies that may affect these

children and families.
Reach beyond the time spent in school walls to figure out what their exact needs
are (e.g. their employment status) .

Know which policies are directly affecting your students and families, and how you
can help in a broader capacity.
Start an advocacy committee for this particular student group in your
school.
Obtain board members from local charities that provide educational, medical,
therapeutic, and recreational services, for the child as well as the parent.

This would create opportunities for these services to be brought directly to your
students at school, and will hopefully lead to a reduction of the cycle of dependence
for later success and financial stability.
SPECIAL NEEDS CHILDREN IN LOW-INCOME FAMILIES 14

Any questions?
SPECIAL NEEDS CHILDREN IN LOW-INCOME FAMILIES 15

References

Bergin, C.C. and Bergin, D.A. (2015). Child and Adolescent Development in Your Classroom

(2nd ed.). Stamford, CT: Cengage Learning.

Centers for Medicare and Medicaid Services. (2016). Program History. Medicaid. Retrieved

from https://www.medicaid.gov/about-us/program-history/program-history.html

Childrens Defense Fund. (2003). Children with disabilities and other special needs:

opportunities to participate in quality programs must be expanded, pp.111- 117.

Retrieved from http://www.childrensdefense.org/library/data/children-disabilities-special-

needs-opportunities-participate-quality-programs-expanded.pdf

Department of Education. (2004). Building the legacy: IDEA 2004. Retrieved from

http://idea.ed.gov/explore/view/p/,root,regs,300,A,300%252E8,

Fujiura, G.T. and Yamaki, K. (2000). Trends in demography of childhood poverty and disability.

Exceptional Children, 66(2), pp. 187-199.

Fulda, K.G., Johnson, K.L., Hahn, K., and Lykens, K. (26 April, 2012). Do unmet needs differ

geographically for children with special health care needs? Maternal and Child Health

Journal, Volume 17, pp. 505-511.

Hanson, M.J., Carta, J.J. (1995). Addressing the challenges of families with multiple risks.

Exceptional Children, 62(3), pp. 201-212.

Health Care. (2016). Federal poverty level (FPL). Retrieved from

https://www.healthcare.gov/glossary/federal-poverty-level-FPL/

Lee, S.L., Sills, M., and Oh, G.T. (20 June, 2002). Disabilities among children and mothers in

low-income families. Institute for Womens Policy Research, #D449, pp. 1-7.
SPECIAL NEEDS CHILDREN IN LOW-INCOME FAMILIES 16

Loprest, P. and Davidoff, A. (September 2004). How children with special health care needs

affect the employment decisions of low-income parents. Maternal and Child Health

Journal, 8(3), pp. 171-182.

Lygnegrd, F., Donohue, D., Bornman, J., Granlund, M., and Huus, K. (1 January, 2013). A

systematic review of generic and special needs of children with disabilities living in

poverty settings in low-and-middle income countries. Journal of Policy Practice, Volume

12, pp. 296-315.

Meyers, M., Brady, H.E., and Seto, E.Y. (2000). Expensive children in poor families: the

intersection of childhood disabilities and welfare. San Francisco, CA: Public Policy

Institute of California.

Porterfield, S.L. and McBride, T.D. (February 2007). The effect of poverty and caregiver

education on perceived need and access to health services among children with special

health care needs. American Journal of Public Health, 97(2), pp. 323-329.

Porterfield, S.L. and Tracey, C. (25 March, 2003). Disentangling the dynamics of family poverty

and child disability: does disability come first? Center for Social Development: George

Warren Brown School of Social Work, Washington University, pp. 1-28.

Price, M.P.S. and Oliverio, P. (Spring 2016). The costs of raising a special needs child after

divorce. American Journal of Family Law, 30(1), pp. 25-31.

Prince, D.L. and Howard, E.M. (Fall 2002). Children and their basic needs. Early Childhood

Education, 30(1), pp. 27-31.

Office of Family Assistance. (29 October, 2015). About TANF. Administration for Children and

Families. Retrieved from http://www.acf.hhs.gov/programs/ofa/programs/tanf/about

SPECIAL NEEDS CHILDREN IN LOW-INCOME FAMILIES 17

Shonkoff, J.P. and Phillips, D.A. (2012). From Neurons to Neighborhoods: An Update.

Washington, DC: The National Academies Press.

Social Security Administration. (January 2015). Supplemental security income (SSI). Social

Security. Retrieved from https://www.ssa.gov/pubs/EN-05-11000.pdf

Thurston, L.P. and Navarrete, L.A. (Summer 2003). Rural, poverty-level mothers: a comparative

study of those with and without children who have special needs. Rural Special

Education Quarterly, 22(2), pp. 39-46.