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chronic lung disease, cystic fibrosis, diabetes, epilepsy, hemophilia, sickle cell disease, and spina bifida.Children with epilepsy, sickle cell disease, or spina bifida scored the lowest on school achievement tests.They concluded that children with epilepsy were among three groups most at risk for academic difficulties;thus, they were more likely to receive special services, repeat a grade, or score more poorly onachievement tests than children with other chronic illnesses.Studies have indicated that academic achievement among children with epilepsy may be related tothe severity of the epilepsy condition. Austin and colleagues (Austin et al., 1998, 1999) have reported thatcondition severity is related to academic achievement. For example, in a 1998 case-control study, theyfound that condition severity was significantly related to composite and language scores among the 117children with epilepsy. Additionally, total adaptive functioning was significantly associated with composite,mathematics, and language scores (Austin et al., 1998). In a 1999 cohort study, Austin and colleaguesfound that subjects with high severity epilepsy on average scored 2 to 3 points below national norms whilethose with either inactive or low-severity epilepsy had mean scores comparable to national norms.Huberty et al. (Huberty et al., 2000) followed a sample of asthmatics and epileptics over four years andconcluded that change in condition severity was significantly related to change in mean academicperformance among their epileptic sample. Additional variables that are hypothesized to impact theinfluence of epilepsy on the academic achievement abilities of children include age of seizure onset,lifetime seizure frequency, seizure type, seizure control, and type of seizure medication. Individual levelfactors are hypothesized to include sex, age, behavioral problems and attention problems.Limitations. It does not appear that the challenges of diagnosis for epilepsy are as great as those fordiagnosis for asthma, but the population of children diagnosed with epilepsy is relatively small comparedto those with asthma or those who are overweight or at risk for overweight.Implications. While it appears that the severity of the epilepsy condition is strongly related to academicachievement, epilepsy affects a relatively small number of children. However, these children may be inneed of special services and management that is appropriate for targeted, indicated, health services andmental health services in the school setting rather than for a more universal program for the majority ofschool children.Sickle Cell AnemiaPrevalence. Sickle Cell Anemia has been diagnosed in over 2,000 Texas children since 1993. While 8 inevery 100,000 people develop sickle cell anemia, those most affected by the condition include African-American and Hispanic children. For example, one in every 400 African-American children and 1 in every1,200 Hispanic-American children are diagnosed with sickle cell anemia (Huberty et al., 2000; TexasChildren's Sickle Cell Center & Texas Children's Hospital, 2005). Individuals with sickle cell anemia areoften prone to episodes of pain that range from mild to extremely intense. Some of the precipitatingfactors of the pain include fatigue, strenuous activities, dehydration, exposure to cold, and stress. Theepisodes of pain can be managed with fluids, rest, heat, and pain medications as they are needed.Additional complications of sickle cell anemia can include acute chest syndrome, strokes, vision changes,hearing problems, infections, kidney problems, gallstones, and leg ulcers (Huberty et al., 2000; TexasChildren's Sickle Cell Center & Texas Children's Hospital, 2005).Sickle Cell Anemia and Academic Performance. Several researchers have examined whether childrenwith sickle cell anemia are more likely to suffer cognitive processing and academic functioning difficultiesthan their peers. Current literature has reported mixed findings (Bonner et al., 1999) (Brown et al., 1993).Fowler et al. (Fowler et al., 1988) compared neurological test results and academic functioning among 28children with sickle cell anemia and 28 matched controls. With one exception, results indicated that therewere no significant differences between groups on the overall verbal score, performance score, or the fullscaleintelligence quotient. However, children with sickle cell anemia scored significantly lower onassessments of reading, spelling, and on a group administered standardized achievement test than theirmatched controls. Additionally, students with sickle cell anemia were absent from school on moreE-11