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Data reveal that insufficient progress has been made in increasing the number of students with severe disabilities who are educated in general education classes. Agran et al. asked why this is happening and discussed determinants that may be affecting placement decisions that serve to segregate students from their peers. This article is a review of the circumstances that have facilitated the movement of students with both severe disabilities and complex health care needs from hospitals and homes, and into school buildings. It also extends Agran et al.'s discussion to placement decisions that may be affecting this specific group of students.

This article describes a qualitative study that examined how 23 young adults with pervasive support needs and limited functional communication spent their time and how their parents ( n = 23) and direct support professionals (DSPs; n = 2) defined meaningfulness in relation to the young adults' experiences. Data were collected through semi-structured interviews with the parents and DSPs. Findings indicated that most of the young adults spent time in their communities, though typically without friends and not engaged in integrated employment. The participants defined meaningfulness according to three dimensions: community participation, individual indicators, and the nature of activities in the young adults' schedules. They also described both episodic and ongoing challenges that hindered their ability to focus on time spent meaningfully. Finally, their definitions, which reflected basic care needs and community participation goals, raised questions related to the awareness, availability, and utilization of services and supports in the adult developmental disabilities system.

Individuals with the most severe disabilities may be unsuccessful in effecting changes in their environment for various reasons. Because of limitations in cognitive and expressive language skills, their attempts at communicating may be overlooked or misunderstood, or may be knowingly or inadvertently obstructed. Consequently, self-determination is often dependent on our interpretation of what people with the most severe disabilities are communicating. This article explores the implications of making interpretations, the need for such interpretations, and the dangers. Current progress in supporting and promoting self-determination are acknowledged. It is suggested that although these procedures may be intended to increase self-determination, they do not automatically do so. In fact, they may function to limit self-determination. Strategies and methodologies must be critically evaluated to ensure that such efforts reflect the tenets and spirit of self-determination.

In the wake of the COVID-19 pandemic, schools shifted to nontraditional education overnight, disrupting learning for millions of children in the United States. Despite the broad impact of these shifts in schooling, its effects have not been uniform. How would the specialized instructional supports known to be effective in meeting the needs of students with extensive support needs (ESN) be provided remotely? We interviewed eight mothers of students with ESN to learn how nontraditional education impacted the educational experiences of students with ESN. Our findings included the overall perception that nontraditional education was highly unsuccessful and could not replace in-person learning for participants' children. Findings also highlighted challenges participants experienced when working to support their children's at-home learning, as well as the unexpected benefits participants reported from remote service delivery that may be considered as future recommendations of instructional practices for students with ESN.

What key issues and challenges affect the lives of people with severe disabilities todayâ€"and what should tomorrow's professionals do to address them? Aligned with the core values and agenda of TASH, this visionary text prepares professionals to strengthen supports and services for people with disabilities across the lifespan. Readers will fully examine more than a dozen critical topics in the lives of people with severe disabilities; explore necessary reforms to policy and practice; and set clear goals and priorities for improving early intervention, education, health care, behavior suppor