Does academic achievement during childhood and adolescence benefit later health?

Association Between Adverse Childhood Experiences and Academic Performance Among Children and Adolescents: A Global Meta-Analysis

This study was conducted to quantify the association of adverse childhood experiences (ACEs) and the academic performance of children and adolescents. The literature was systematically searched in six electronic databases, and a meta-analysis was conducted. Twenty studies with a total of 1,196,631 children and adolescents from five countries were included. Meta-analysis showed that ACE score was positively associated with poor academic achievement, grade repetition, and special education support. Compared with children and adolescents without any ACE, those with one or more ACE had a significantly higher risk of poor academic achievement (pooled odds ratio [OR]: 1.45, 95% confidence interval [CI] [1.13, 1.85], I2 = 82.6%) and grade repetition (pooled OR: 1.36, 95% CI [1.29, 1.43], I2 = 71.0%). Moreover, all types of ACEs were positively associated with poor academic achievement and grade repetition. In addition, there was a significant dose-response relationship between the ACE score and the risk of poor academic achievement. This study supported that ACE had a significant impact on the academic performance of children and adolescents. Based on these findings, we recommend that early screening of ACEs for children and adolescent is critical and appropriate support and prevention in education should be developed for those with ACEs. Further studies are needed to further explore the long-term effect of ACEs on education and its gender differences.

The bidirectional longitudinal association between academic performance and cardiovascular disease risk factors in adolescents

INTRODUCTION

The limited prior research examining the association between academic performance and cardiovascular disease (CVD) risk factors in youth did not explore the reciprocal association between these constructs, and analyzed CVD risk factors individually. Thus, the aim of the present study was to explore the bidirectional longitudinal association between clustered CVD risk score and academic performance in adolescents over a 24-month interval.

METHODS

A total of 237 adolescents (45.6% girls), aged 13.9 ± 0.3 years old at baseline, from DADOS (Deporte, ADOlescencia y Salud) study were included in this study. A clustered CVD risk score was created by calculating the mean age- and gender-standardized z-scores of waist circumference, systolic blood pressure, total cholesterol to high-density lipoprotein cholesterol ratio, triglycerides, homeostatic model assessment of insulin resistance, and cardiorespiratory fitness (inversed). Academic performance was assessed through the final academic grades and the test of educational abilities.

RESULTS

Our results showed that the clustered CVD risk score at baseline was not associated with academic performance 24 months later (all p > .05). Nevertheless, except for physical education, academic grades at baseline were inversely associated with clustered CVD risk score at follow-up in adolescents (β ranged from -0.140 to -0.102; all p < .05). No associations were found between academic abilities at baseline and clustered CVD risk score at follow-up (all p > .05).

CONCLUSION

Academic grades could help predict CVD risk 24 months later during adolescence. Education professionals should foster adolescents' academic performance not only to improve academic results but also to maximize future cardiovascular health benefits.

Direct and indirect effects of physiological, psychological and cognitive variables on academic achievement in children

BACKGROUND

Associations between cardiorespiratory fitness (CRF), screen time, psychological well-being, executive functions, and academic achievement have been reported, however, few studies have analysed models considering the effect of all these variables on academic achievement. This study aims to analyse the direct and indirect associations of mothers' education level, CRF, screen time, psychological well-being, executive functions, with academic achievement in schoolchildren, by sex.

METHODS

This was a cross-sectional analysis of MOVI-daFit! study including 519 schoolchildren (49.52% girls) aged 9-11 years old. Executive functions were assessed with the NIH Toolbox, CRF with the 20-m shuttle run test, academic achievement through the final academic grades in language and mathematics and mother's education level, screen time and well-being by questionnaires.

RESULTS

Structural equation modelling revealed that in boys cognitive flexibility had a significant direct effect on academic achievement and screen time a total significant effect on academic achievement. In girls, CRF was associated with inhibition and psychological well-being, and this was associated with academic achievement.

CONCLUSIONS

Physiological, psychological, and behavioural variables act together to impact academic achievement, and that differences by sex might exist. Thus, strategies to enhance academic achievement in schoolchildren should consider psychological well-being, CRF, screen time, and sex differences.

IMPACT

Physiological, psychological, and behavioural variables, such as cardiorespiratory fitness, screen time, psychological well-being, and cognition all together have an impact on academic achievement, with differences by sex. Previous studies have demonstrated the separate effect of these variables, however, to date, this is the first study that analyses all together in the same model their impact on academic achievement, by sex. This study shows that in boys cognitive flexibility and screen time impact academic achievement. In girls, cardiorespiratory fitness is highly associated with psychological well-being, and this, in turn, was associated with academic achievement.

Bidirectional longitudinal associations of mental health with academic performance in adolescents: DADOS study

BACKGROUND

The dual-factor model of mental health (i.e., the presence of psychological well-being along with the absence of distress) and its association with academic performance over time has been barely studied in the adolescent population, as most of the prior research focuses on psychological well-being or distress indicators in isolation. The current study analyzed the bidirectional longitudinal association between the dual-factor model of mental health and academic performance in adolescents, comprising a longitudinal assessment 2 years apart.

METHODS

A total of 266 secondary school students (13.9 ± 0.3 years at baseline) from Deporte, ADOlescencia y Salud study were assessed. Mental health was assessed through the Behavior Assessment System for Children and Adolescents. Academic performance was assessed through academic grades and the Test of Educational Abilities. A cross-lagged modeling approach was used to examine the bidirectional longitudinal association between mental health and academic performance.

RESULTS

Higher academic performance at baseline was associated with better mental health over time, but not vice versa, since this association was not bidirectional.

CONCLUSION

Results suggest that academic performance is an important target for developing educational interventions, as it shapes adolescents' mental health at 2 years of follow-up.

IMPACT

The overall picture of students' mental health and academic performance was analyzed. Academic performance may be a predictor of adolescents' mental health status. Mental health may not be a predictor of adolescents' academic performance. Good mental health should be promoted among youth with low academic performance.

A longitudinal examination of school-related and mental health mediators linking emotion regulation to academic achievement

Emotion regulation is assumed to underlie academic achievement through different mechanisms (e.g., a positive orientation toward school and schoolwork, better mental health). However, few studies have contrasted these mediating mechanisms within a longitudinal analytic framework, which is necessary to determine which mechanism(s) are most likely to translate emotion regulation into academic success over time. The present study addressed this gap by examining whether children's emotion regulation capacities were associated with later academic achievement through school-related (i.e., school bonding and academic motivation) and mental health mediators (i.e., internalizing and externalizing symptoms). Participants included 300 4- and 8-year-old children (n = 150 in each age cohort; 50% female) and their caregivers from Canada. Measures were collected over 4 years. Path analyses indicated that higher emotion regulation (T1; age 4/8 years) was associated with better academic achievement 3 years later (T4; age 7/11 years) through stronger school bonding and lower internalizing symptoms in the interim (T2; age 5/9 years; the indirect effect through internalizing symptoms held after controlling for initial levels of internalizing symptoms). Significant effects were derived from both caregiver and child informants when applicable and indirect effects held across age cohorts and genders. Findings highlight the interplay of social-emotional, academic, and mental health development across childhood, as well as the potential benefits of extending academic interventions to the social-emotional and mental health domains.

School Attendance Following Receipt of Care From a School-Based Health Center

PURPOSE

School-based health centers (SBHCs) may mitigate barriers to health care access and improve students' academic outcomes, but few studies test this hypothesis. We examined whether school attendance improved after students received care at an SBHC.

METHODS

We conducted a secondary analysis of data from 17 SBHCs affiliated with a single large urban school district and demographic and attendance data from SBHC users (N = 14,030) and nonusers (N = 230,046) from August 2015-February 2020. We examined the percent of full school days present each month for three years before and after students' first SBHC visit and a proxy visit date for SBHC nonusers. Propensity weighted linear regression models tested whether visiting an SBHC was associated with a change in the attendance trajectory compared to a matched sample of SBHC nonusers.

RESULTS

Among SBHC users, attendance trajectories declined more steeply prior to their first SBHC visit than after the first visit (preslope -0.71%, postslope -0.05%), whereas SBHC nonusers had a similar attendance trajectory over the entire period (preslope -0.18%, postslope -0.17%), with difference-in-difference 0.65. Changes in trajectories were more pronounced for students with a mental health encounter. Prior to the first SBHC mental health visit, SBHC users displayed a marked decline in monthly attendance (preslope -1.02%). After the first mental health visit, attendance increased (postslope 1.44%), with difference-in-difference 2.33.

DISCUSSION

SBHC utilization was associated with improved school attendance over time, particularly for students with a mental health diagnosis. Investing in SBHCs may reduce school absenteeism and support student health.

Adolescent endocrine disrupting chemical exposure and academic achievement

BACKGROUND

Epidemiologic studies support associations of exposure to endocrine disrupting chemicals (EDCs), such as some phthalates, phenols, and parabens with a wide range of cognitive and behavioral traits. While many of these traits are associated with academic achievement, the relationship of EDC exposure specifically with academic achievement in adolescence has not yet been studied.

OBJECTIVE

We assessed the association of urinary biomarker concentrations of EDCs with academic achievement in adolescents as well as the potential for psychosocial factors to modify associations.

METHODS

We quantified urinary concentrations of select EDCs in 205 adolescent participants from the New Bedford Cohort (NBC), a prospective birth cohort of children born to mothers residing near the New Bedford Harbor Superfund site in Massachusetts, and estimated associations between EDCs and adolescent academic achievement assessed with the Wide Range Achievement Test (WRAT). Measures of socioeconomic status and the home environment were used to estimate psychosocial stress.

RESULTS

Urinary concentrations of antiandrogenic phthalates were inversely associated with Math Computation scores. For example, each doubling of the concentration of antiandrogenic phthalate metabolites in urine was associated with a 1.94 point decrease (95% CI: 3.84, -0.05) in Math Computation scores, indicating poorer performance. For the most part, associations were stronger in adolescents with more, as compared to less, social disadvantage, but most of these differences did not achieve statistical significance.

CONCLUSION

Our findings support the potential for adolescents' exposure to antiandrogenic phthalates to correlate with poorer academic achievement in math, particularly among participants with greater psychosocial stress.

The role of social adversity on emotional dysregulation during infancy and early childhood

PURPOSE

The purpose of this study was to investigate if social adversity is associated with mother reported emotional dysregulation behaviors and trajectories during infancy and early childhood.

DESIGN & METHODS

A secondary data analysis from the Durham Child Health and Development study study included 206 child-mother dyads. Three models were used to explore the relationship between social adversity and mother reported emotional dysregulation during infancy (Infant Behavior Questionnaire-Revised) and early childhood (Child Behavior Checklist - Dysregulation Profile). Linear mixed effects models were adopted to investigate if social adversity was associated with mother reported emotional dysregulation longitudinally. Regression analysis was conducted to explore if social adversity was associated with maternal reported emotional dysregulation trajectory slope scores and maternal reported emotional dysregulation trajectory class. Maternal psychological distress and the child's sex assigned at birth were included as covariates in each analysis.

RESULTS

Infants with greater social adversity scores had significantly higher maternal reported fear responses across the first year of life. Social adversity was associated with maternal reported distress to limitations trajectory, dysregulated recovery class, and dysregulated distress to limitations class. During early childhood social adversity was significantly associated with maternal reported emotional dysregulation but not trajectories which showed little variability.

CONCLUSION & PRACTICAL IMPLICATIONS

Our results indicate that social adversity is associated with maternal reported emotional dysregulation during infancy and early childhood. Nursing and other professionals can participate in early screening to determine risk and provide intervention.

Aligning Organizational Priorities and System Policies to Support Implementation Scale-Up of a Tailored Classroom-Based Physical Activity Intervention in Low-Resource Schools

BACKGROUND

A mismatch between organizational priorities and system-level policies can negatively impact implementation and sustainment of classroom-based physical activity (PA) interventions. The purpose of this study was twofold: (1) present methods to systematically identify organization- and system-level implementation barriers, and (2) align organizational priorities and system policies by designing multi-level implementation strategies. This alignment will support implementation scale-up of a tailored PA intervention in one low-resource intermediate school district (ISD; 16 districts, 32 schools) in central Michigan.

METHODS

Multi-level assessments of organizational readiness were conducted using the Hexagon Discussion and Analysis Tool to assess intervention-context fit, the Wellness School Assessment Tool 3.0 to evaluate district PA policy strength and comprehensiveness, and semi-structured interviews were conducted to assess administrative support and priorities related to PA programming.

RESULTS

Our assessments revealed three implementation barriers: limited structural capacity to sustain teacher training, limited resources across districts and school buildings to support teachers, and misalignment of ISD and district PA policies and priorities.

CONCLUSIONS

Greater attention to organizational capacity and existing infrastructure should be considered a priori to support effective implementation and sustainment of PA interventions in low-resource schools.

The bidirectional longitudinal association between health-related quality of life and academic performance in adolescents: DADOS study

PURPOSE

Although previous evidence has suggested a relationship between health-related quality of life (HRQoL) and academic performance, the directionality of this association is understudied and remains to be clarified. Thus, the primary objective of this study was to explore the bidirectional association between HRQoL and academic performance in adolescents between two timepoints with a 24-month interval. A secondary aim was to analyze whether this association varies between boys and girls.

METHODS

This is a bidirectional longitudinal analysis with 257 adolescents (13.9 ± 0.3 years at baseline) from the DADOS study. HRQoL was measured using the KIDSCREEN-10 questionnaire. Academic performance was assessed through academic grades and the Spanish version of the Science Research Associates Test of Educational Ability.

RESULTS

Cross-lagged analyses revealed that HRQoL at baseline was not associated with academic performance 24 months later, while all the academic grades and the overall score of academic abilities at baseline were positively associated with HRQoL at follow-up in adolescents. Results of the stratified analyses by sex were largely similar. Specifically, in girls, math, language, physical education, and grade point average at baseline were positively associated with HRQoL 24 months later, while in boys, all the academic grades indicators (except physical education), numeric ability, and the overall score of academic abilities at baseline were positively associated with HRQoL at follow-up.

CONCLUSION

These findings suggest that academic performance in early adolescence may predict HRQoL 24 months later. Health and education professionals could benefit from collaborating to achieve both improved academic performance and HRQoL in youth.

Risk of depression mediates the association between cardiorespiratory fitness and academic performance in adolescent boys and girls: DADOS study

This study aims to analyze the mediating role of risk of depression in the association between cardiorespiratory fitness and academic performance in a sample of adolescents and to test the moderation effect of sex. A total of 263 adolescents (125 girls, 13.9 ± 0.3 years) from the DADOS (Deporte, ADOlescencia y Salud) study were included in the analysis. Cardiorespiratory fitness was assessed by the 20-m shuttle run test. Academic performance was assessed through the final academic grades and the test of educational abilities. Risk of depression was evaluated through the Behavior Assessment System for Children and Adolescents. Mediation analyses were performed to determine the direct and indirect associations between cardiorespiratory fitness, risk of depression, and academic performance. Indirect effects with confidence intervals not including zero were interpreted as statistically significant, and percentages of mediation were calculated in order to know how much of the association was explained by the mediation. Our findings indicated a significant mediating effect of risk of depression in the association between cardiorespiratory fitness with final grades in math, language, and grade point average (percentages of mediation: 26%, 53%, and 29%, respectively). These analyses were not moderated by sex (all confidence intervals included 0).

CONCLUSION

Risk of depression acts as a possible underlying mechanism in the association between cardiorespiratory fitness and academic grades in adolescents. Educational and health institutions could benefit from our findings since the promotion of higher cardiorespiratory fitness levels might reduce the risk of depression with potential benefits on adolescents' academic performance.

WHAT IS KNOWN

• Cardiorespiratory fitness is positively associated with academic performance in adolescents. Nevertheless, the psychological mechanisms underlying this association are poorly understood.

WHAT IS NEW

• Risk of depression mediates the association between cardiorespiratory fitness and academic performance in adolescents, independently of sex. • Our findings may improve the efficacy of mental health and educational programs by promoting the enhancement of cardiorespiratory fitness levels, which may reduce risk of depression with potential benefits on academic performance.

Culturally relevant stressors as moderators of intergenerational transmission of mother-adolescent executive function in Mexican immigrant families

The intergenerational transmission of executive function may be enhanced or interrupted by culturally salient environmental stressors that shape the practice of executive function in the family. Building upon past research, the current study tests whether culturally relevant stressors such as economic stress and foreigner stress have a direct effect on adolescent executive function, as well as whether they modify the intergenerational transmission of mother–child executive function (i.e., working memory, inhibitory control, and shifting) in low-income Mexican immigrant families. The sample consists of 179 Mexican American adolescents (M_age = 17.03 years; SD_age = 0.83; 58% females) and their Mexico-born mothers (M_age = 43.25 years; SD_age = 5.90). Results show that mothers’ perceived economic stress is associated with poor inhibitory control in adolescents. Low levels of mothers’ perceived foreigner stress related to a stronger association between mothers’ and adolescents’ working memory, while high levels of mothers’ perceived foreigner stress related to enhanced intergenerational transmission of poor shifting ability. Study findings demonstrate the prominence of perceived foreigner stress as a contextually relevant factor moderating the intergenerational transmission of mother–child executive function in low-income Mexican immigrant families.

An examination of the association between risk of depression and academic performance according to weight status in adolescents: DADOS study

BACKGROUND

The early identification of emotional and psychological problems during adolescence seems helpful to improve academic performance (AP). However, the association between risk of depression and AP, as well as the role of health-related factors in this association remain to be elucidated. Therefore, the aims of this study were to analyze the association between risk of depression and AP in adolescents; to examine this association according to weight status; and to test the mediating role of weight status in this association.

METHODS

A sample of 265 adolescents (125 girls) aged 13.9 ± 0.3 years old from the DADOS (Deporte, ADOlescencia y Salud) study was included in the analyses. Risk of depression was self-reported through the Behavior Assessment System for Children and Adolescents. AP was assessed through academic grades and the Spanish version of the Science Research Associates Test of Educational Ability. Weight status was assessed by body mass index (BMI) (kg/m²) and dichotomized according to the international age- and sex-specific BMI cut-offs (non-overweight vs. overweight).

RESULTS

Linear regression analyses showed an inverse association between risk of depression and academic grades (all p<0.05). Further linear regressions analyzing risk of depression and AP (dependent variable) stratified by weight status showed stronger associations among overweight adolescents. Additionally, mediation analyses revealed that weight status acted as a mediator of this association.

LIMITATIONS

The cross-sectional design prevents from interfering causal relationships.

CONCLUSIONS

Educational institutions should promote the early identification of depression as well as the promotion of healthy weight status as strategies to enhance AP in adolescents.

Family Structure Stability and Transitions, Parental Involvement, and Educational Outcomes

The family environments children live in have profound effects on the skills, resources, and attitudes those children bring to school. Researchers studying family structure have found that children who live with two married, opposite-sex, biological parents, on average, have better educational outcomes than children living in alternate family structures, perhaps due to higher resources, lower stressors, or different selectivity patterns. Socioeconomic stratification plays a major role in family structure, with low-income families seeing more instability. We argue that the impact of family structure is attenuated by transitions in and out of family structures that may decrease a specific resource important to child academic outcomes: parental involvement. This may contribute to increased academic differences already noted across class gaps. Using waves 1 to 6 of the Growing Up in Australia: Longitudinal Study of Australian Children (LSAC) data, we examine the relationship of family stability and transitions from birth to age 10/11 years on parental involvement and educational outcomes, adjusted for resource, stressor, and selectivity covariates. We find that changes in parental involvement are only apparent for families that experience both a transition and single parenting, and that these differences in parental involvement impact academic outcomes.

Qualification for upper secondary education in individuals with autism without intellectual disability: Total population study, Stockholm, Sweden

This study used the Stockholm Youth Cohort, a total population cohort (N = 364,957), to describe patterns and predictors of qualification for upper secondary education, defined by passing graduation grades in core compulsory school subjects in contemporary young individuals diagnosed with autism spectrum disorders without intellectual disability (n = 6138). At the expected age for graduation, 16 years, 29% (adjusted rate difference 95% confidence interval (28.0–30.0)) fewer autistic than non-autistic individuals were qualified for upper secondary education (57% and 86%, respectively). Comorbid attention-deficit hyperactivity disorder further increased this difference. Within the group of autistic students without intellectual disability, female sex and lower family income were associated with non-qualification for upper secondary education. The proportion of students with autism without intellectual disability who qualified for upper secondary education increased at age 20. These findings underline the need for improved support for students with a diagnosis of autism without intellectual disability in mainstream education.

Circulating inflammatory biomarkers and academic performance in adolescents: DADOS study

OBJECTIVE

The present study aimed (1) to examine the association between circulating inflammatory biomarkers and academic performance in adolescents, and (2) to identify the ability of circulating inflammatory biomarkers to predict low academic performance.

METHODS

A total of 244 adolescents (13.9±0.3 years, 112 girls) from the DADOS study were included in the analysis. Four inflammatory biomarkers were quantified: white blood cell (WBC) count, interleukin-6, tumor necrosis factor-α (TNF-α), and C-reactive protein (CRP). Academic performance was assessed through academic grades and the Spanish version of the Science Research Associates Test of Educational Abilities.

RESULTS

TNF-α was inversely associated with math, Spanish and grade point average (β ranging from -0.166 to -0.124; all p<0.05), while CRP was inversely associated with verbal ability (β = -0.128; p<0.05). Overall, receiver operating characteristic (ROC) curves analyses showed discriminatory ability of WBC and TNF-α in identifying low academic performance (all p<0.05). Moreover, logistic regression analyses indicated that students with levels of WBC and TNF-α above the ROC cut-offs values showed between 78% to 87% increased likelihood of lower academic performance (p<0.05).

CONCLUSIONS

Our findings suggested that some circulating inflammatory biomarkers were associated with academic performance in adolescents. Further larger longitudinal and interventional studies are needed to clarify the short-term and long-term relationship between inflammation and academic performance in youths.

Gestational and childhood urinary triclosan concentrations and academic achievement among 8-year-old children

BACKGROUND

Early life exposure to triclosan, an antimicrobial chemical and suspected endocrine disruptor, may adversely affect neurodevelopment. No studies have examined gestational and early childhood exposure to triclosan and children's academic achievement.

METHODS

Using data from 193 mother-child pairs from the HOME Study, we quantified triclosan in maternal and child urine samples up to nine times between the second trimester of gestation (16-weeks) and age 8 years. At age 8 years, we administered the reading and math components of the Wide Range Achievement Test-4 (WRAT-4) to children. Using multiple informants models, we estimated covariate-adjusted associations of triclosan concentrations during each time period with WRAT-4 scores. We also tested whether associations differed by exposure period and child sex.

RESULTS

There was evidence that timing of exposure modified the associations between triclosan and reading composite scores (triclosan-exposure period interaction p-value = 0.20), but not math scores (interaction p-value = 0.72). Each 10-fold increase in triclosan concentrations at delivery was associated with lower reading composite scores (β:-2.6; 95 % CI:-5.0, -0.1). Additionally, we observed weaker and less precise inverse association of math scores with triclosan concentrations at delivery (β:-1.9; 95 % CI:-4.6, 0.8) and at age 1 year (β:-2.0; 95 % CI:-6.0, 2.1). There was not strong evidence that child sex modified the pattern of associations between repeated triclosan measures and WRAT-4 reading composite or math scores (sex-triclosan-exposure period interaction p-values>0.20).

CONCLUSION

Urinary triclosan concentrations at delivery and at age 1 year, but not other times during gestation or childhood, were associated with lower reading composite and to a lesser extent math test scores at age 8 years in this cohort of U.S. children.

Association Between Screen Media Use and Academic Performance Among Children and Adolescents: A Systematic Review and Meta-analysis

IMPORTANCE

The health consequences of excessive screen media use in children and adolescents are increasingly being recognized; however, the association between screen media use and academic performance remains to be elucidated.

OBJECTIVES

To estimate the association of time spent on screen-based activities with specific academic performance areas in children and adolescents and to examine this association separately in these populations.

DATA SOURCES

MEDLINE, Scopus, Web of Science, Cochrane Database of Systematic Reviews, and ERIC were searched from database inception through September 2018.

STUDY SELECTION

Cross-sectional studies of the association between time or frequency of screen media use and academic performance in children and adolescents were independently screened by 2 researchers. A total of 5599 studies, published between 1958 and 2018 from 23 countries, were identified.

DATA EXTRACTION AND SYNTHESIS

Data were processed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Random-effects models were used to estimate the pooled effect size (ES).

MAIN OUTCOMES AND MEASURES

Academic performance areas included composite scores, language, and mathematics. Screen media measurements included time or frequency of computer, internet, mobile phone, television, video game, and overall screen media use.

RESULTS

In total, 58 cross-sectional studies (1.0%) of 5599 articles were included in the systematic review, of which 30 (52%) were included in the meta-analysis. The systematic review studies involved 480 479 participants aged 4 to 18 years, ranging from 30 to 192 000 people per study, and the meta-analysis studies involved 106 653 total participants, ranging from 70 to 42 041 people per study. Across studies, the amount of time spent on overall screen media use was not associated with academic performance (ES = -0.29; 95% CI, -0.65 to 0.08). Individually, television viewing was inversely associated with composite academic performance scores (ES = -0.19; 95% CI, -0.29 to -0.09), language (ES = -0.18; 95% CI, -0.36 to -0.01), and mathematics (ES = -0.25; 95% CI, -0.33 to -0.16). Video game playing was inversely associated with composite scores (ES = -0.15; 95% CI, -0.22 to -0.08). Subgroup analyses found that television viewing was inversely associated with language only in children (ES = -0.20; 95% CI, -0.26 to -0.15), whereas both television viewing (ES = -0.19; 95% CI, -0.30 to -0.07) and video game playing (ES = -0.16; 95% CI, -0.24 to -0.09) were inversely associated with composite scores only in adolescents.

CONCLUSIONS AND RELEVANCE

Findings from this study suggest that each screen-based activity should be analyzed individually for its association with academic performance, particularly television viewing and video game playing, which appeared to be the activities most negatively associated with academic outcomes. Education and public health professionals should consider supervision and reduction to improve the academic performance of children and adolescents exposed to these activities.

Independent and combined influence of healthy lifestyle factors on academic performance in adolescents: DADOS Study

BACKGROUND

Few studies have analyzed the combined effect of lifestyle factors on academic performance (AP) in adolescents. The aim of this study was to analyze the independent and combined effects of weight status, screen time, sleep quality, daily meal frequency, cardiorespiratory fitness, and physical activity (PA) on AP in adolescents.

METHODS

A total of 262 adolescents (13.9 ± 0.3 years) from the DADOS study were included in the analysis. Weight status was assessed through body mass index (kg/m²). Participants completed questionnaires to evaluate screen time, sleep quality, and daily meal frequency. Cardiorespiratory fitness was assessed by the 20-m shuttle run test. PA was evaluated by a wrist-worn GENEActiv accelerometer. AP was assessed through the final academic grades and a validated questionnaire.

RESULTS

Non-overweight status, low screen time, good sleep quality, and proper meal frequency showed independent, positive influence on AP. Moreover, adolescents achieving at least three healthy lifestyles were more likely to be in the high-performance group for academic grades than those achieving ≤1 (math OR: 3.02-9.51, language OR: 3.51-6.76, and grade point average OR: 4.22-9.36).

CONCLUSIONS

Although individual healthy lifestyles are independently and positively associated with AP, the cumulative effect of multiple healthy lifestyles have a stronger impact.

Cognitive Performance in Adolescence: Links With Early Maternal Stimulation and Children's Anxious Behaviors

This study tested a developmental model of cognitive performance in adolescence and explored potential mechanisms explaining the relations of early maternal stimulation and children's anxious behaviors with adolescents' cognitive performance. We utilized the NICHD SECCYD dataset (n = 1,112). Measures included questionnaires, coded observations, and self-report measures from infancy to adolescence. Results revealed that children who experienced greater early maternal stimulation and less anxious behaviors had better cognitive performance at age 15. Children's English self-efficacy, the quality of child-teacher relationships, and children's behavioral classroom engagement in middle childhood mediated the relation between early maternal stimulation and adolescent cognitive performance. Identifying pathways from earlier maternal and children's characteristics to children's later cognitive performance is an important step toward further understanding why early precursors have a long lasting impact on cognitive performance, and has implications for educational settings.

Cardiorespiratory fitness and academic performance association is mediated by weight status in adolescents: DADOS study

The aim of our study was to examine the mediation effect of weight status on the association between cardiorespiratory fitness (CRF) and academic performance (AP). Two hundred sixty-nine adolescents (140 boys) aged 13.9 ± 0.3 years old from the DADOS study were included in this cross-sectional analysis. CRF was assessed by the 20-m shuttle run test and estimated maximum oxygen uptake was used in the analysis. AP was assessed through the final academic grades and the Science Research Associates Test of Educational Abilities for assessing reasoning, verbal, and numeric abilities. Weight status was assessed by body mass index (kg/m²). Boot-strapped mediation procedures were performed and indirect effects (IE) with confidence intervals (CI) not including zero were considered statistically significant. Mediation analysis revealed that weight status acted as a mediator of the relationship of CRF with reasoning ability (IE = 0.039; CI = 0.001; 0.091) and the final grades in Math (IE = 0.011; CI = 0.002; 0.025), Language (IE = 0.013; CI = 0.004; 0.027), and GPA (IE = 0.011; CI = 0.003; 0.023).

CONCLUSIONS

Our data show that the influence of CRF on academic performance is mediated by weight status in adolescents. We suggest that our data could be considered by educators, families, and policy makers, so that active lifestyles might be promoted when designing programs aimed to improve AP among adolescents. What is Known: • Academic performance is associated with both, cardiorespiratory fitness and weight status. • The role of weight status in the association between cardiorespiratory fitness and academic performance is poorly understood. What is New: • We support the scarce research investigating the mediating role of weight status as mechanism in the association between fitness and academic performance in youth. • Previous knowledge is expanded by suggesting that cardiorespiratory fitness is related to weight status which in turn may positively influence academic performance in adolescents.

School Functions in Unaffected Siblings of Youths with Autism Spectrum Disorders

This study investigated school functioning among unaffected siblings of youths with autistic spectrum disorder (ASD) and identified the correlates for school maladjustment. We recruited 66 youths with a clinical diagnosis of ASD, aged 8-19, their unaffected siblings and 132 typically developing controls (TD). We found that ASD youths had poorer school functions than unaffected siblings and TD. Unaffected siblings had poorer attitude toward schoolwork and more severe behavioral problems at school than TD. Several associated factors for different scholastic functional domains (i.e., academic performance, attitude toward school work, social interactions, behavioral problems) in the siblings included IQ, autistic traits, inattention/oppositional symptoms, sibling relationships, etc. Our findings suggest the need of assessing school functions in unaffected siblings of ASD.

TRIAL REGISTRATION

Clinical trial registration identifier: NCT01582256.

Adolescent reserve capacity, socioeconomic status and school achievement as predictors of mortality in Finland - a longitudinal study

Background

Despite robust evidence on the inverse relationship between socioeconomic status (SES) and mortality, deviations from expected results have been observed likely due to school achievement and psychosocial resources, termed as “reserve capacity.” Since adolescence is a critical period in developing sound psychological and behavioural patterns and adolescent markers of SES were seldom used, we determine if family SES in adolescence predicts later mortality. We also study how reserve capacity (perceived health, health-promoting behaviour and social support) and school achievement modify this relationship and reduce the negative effects of low SES.

Methods

A longitudinal study was designed by linking baseline data on 12 to 18 year-old Finns in 1985–95 (N = 41,833) from the Adolescent Health and Lifestyle Surveys with register data on mortality and SES from Statistics Finland. Average follow-up time was 18.4 years with a total of 770,161 person-years. Cox regression models, stratified by sex, were fitted to determine the effects of variables measured during adolescence: family SES, reserve capacity and school achievement on mortality risk.

Results

All reserve capacity dimensions significantly predicted mortality in boys. Perceived health and social support predicted that in girls. Adolescents with the lowest school achievement were more than twice at risk of dying compared to those with better school performance. Low SES increased the risk of death in boys (Hazard ratios: 1.6, 95% CI 1.1–2.4) but not in girls. Reserve capacity and school achievement weakened the effects of low SES on boys’ risk of death.

Conclusions

High reserve capacity and good school achievement in adolescence significantly reduce the risk of mortality. In boys, these also mitigate the negative effect of low SES on mortality. These findings underscore the roles of reserve capacity and school achievement during adolescence as likely causal or modifying factors in SES-health inequalities.

Associations of health behaviors, school performance and psychosocial problems in adolescents in The Netherlands

School-based health-promoting interventions show promising results in improving various health outcomes of adolescents. Unfortunately, much is still unknown about the relations between health behaviors and school performances, while improving these would give schools a stronger incentive to invest in health promotion. This paper presents the associations of several health behaviors with school performances and studies the mediating effects of psychosocial problems. Health behavior and socio-demographic data were gathered from 905 Dutch high school students via an online survey, completed in-class. These data were matched with school records of the students' overall grade average (GA) on the three core subjects in Dutch high schools (Dutch, English and Math). The associations between health behaviors and school performances, and the potentially mediating effects of psychosocial problems, were studied via mixed-effects regression models. Smoking, being bullied, compulsive and excessive internet use and low physical activity were directly associated with lower school grades. Additionally, being bullied, bullying, smoking, excessive and compulsive internet use were associated with students' grades via mediation of psychosocial problems. This means that lower school grades were (also) associated with those behaviors through the effects of psychosocial problems in those students. This study showed the strong links between health behaviors and academic achievements among adolescents. Schools and health promoters should be educated more on these relations, so that they are aware of this common interest to get more support for health-promoting interventions. Additionally, the role of psychosocial problems in the relations between behaviors and school performances should be studied further in future research.

Does Sedentary Behavior Predict Academic Performance in Adolescents or the Other Way Round? A Longitudinal Path Analysis

This study examined whether adolescents' time spent on sedentary behaviors (academic, technological-based and social-based activities) was a better predictor of academic performance than the reverse. A cohort of 755 adolescents participated in a three-year period study. Structural Equation Modeling techniques were used to test plausible causal hypotheses. Four competing models were analyzed to determine which model best fitted the data. The Best Model was separately tested by gender. The Best Model showed that academic performance was a better predictor of sedentary behaviors than the other way round. It also indicated that students who obtained excellent academic results were more likely to succeed academically three years later. Moreover, adolescents who spent more time in the three different types of sedentary behaviors were more likely to engage longer in those sedentary behaviors after the three-year period. The better the adolescents performed academically, the less time they devoted to social-based activities and more to academic activities. An inverse relationship emerged between time dedicated to technological-based activities and academic sedentary activities. A moderating auto-regressive effect by gender indicated that boys were more likely to spend more time on technological-based activities three years later than girls. To conclude, previous academic performance predicts better sedentary behaviors three years later than the reverse. The positive longitudinal auto-regressive effects on the four variables under study reinforce the 'success breeds success' hypothesis, with academic performance and social-based activities emerging as the strongest ones. Technological-based activities showed a moderating effect by gender and a negative longitudinal association with academic activities that supports a displacement hypothesis. Other longitudinal and covariate effects reflect the complex relationships among sedentary behaviors and academic performance and the need to explore these relationships in depth. Theoretical and practical implications for school health are outlined.