1
|
Peterson JK, Gentry-Russell N, Francis L. School Readiness Among Children With Congenital Heart Disease. THE JOURNAL OF SCHOOL HEALTH 2024; 94:279-281. [PMID: 37345223 DOI: 10.1111/josh.13359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Accepted: 05/27/2023] [Indexed: 06/23/2023]
Affiliation(s)
| | | | - Lucine Francis
- Johns Hopkins University School of Nursing, Baltimore, MD
| |
Collapse
|
2
|
Wood ML, Gunning L, Relins S, Sohal K, Wright J, Mon-Williams M, Atkinson AL. Potential for England's statutory school entry assessment to identify special educational needs and reveal structural inequalities: a population-based study. Arch Dis Child 2023; 109:52-57. [PMID: 37827813 PMCID: PMC10804042 DOI: 10.1136/archdischild-2023-325590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 09/13/2023] [Indexed: 10/14/2023]
Abstract
OBJECTIVE To investigate at a population level whether England's universal assessment of 'school readiness' is associated with later identification of special educational needs (SEN). Also, whether ethnic differences exist in SEN identification (white British versus ethnic minority) and whether this varies as a function of school readiness. METHOD Analysis included 53 229 individuals aged 5-12 years from the Connected Bradford Database (2012/2013-2019/2020). Logistic regression analyses examined: (1) whether reaching a 'good level of development' on England's 'school readiness' assessment was associated with later SEN identification; and (2) whether interactions exist between school readiness and ethnicity. RESULTS 32 515 of 53 229 children reached a good level of development, of which 3036 (9.3%) were identified as having SEN. In contrast, 10 171 of 20 714 (49.1%) of children who did not reach a good level of development were later identified as having SEN. Children not reaching a good level of development had increased odds of being later identified as having SEN after controlling for covariates (OR: 8.50, 95% CI: 8.10 to 8.91). In children who did not reach a good level of development, white British children had higher odds of being identified as having SEN compared with ethnic minority peers (OR: 1.22, 95% CI: 1.11 to 1.34). No ethnic differences of having SEN were observed in children reaching a good level of development (OR: 1.04, 95% CI: 0.93 to 1.16). CONCLUSIONS School readiness assessments are associated with later SEN identification. Structural inequalities may exist in SEN identification in children not entering formal education 'school ready'. Such assessments could facilitate earlier identification of SEN and reduce structural inequalities in its identification.
Collapse
Affiliation(s)
- Megan L Wood
- School of Psychology, University of Leeds, Leeds, UK
- Bradford Institute for Health Research, Bradford, UK
| | - Lydia Gunning
- Bradford Institute for Health Research, Bradford, UK
| | - Sam Relins
- Bradford Institute for Health Research, Bradford, UK
| | - Kuldeep Sohal
- Bradford Institute for Health Research, Bradford, UK
| | - John Wright
- Bradford Institute for Health Research, Bradford, UK
| | - Mark Mon-Williams
- School of Psychology, University of Leeds, Leeds, UK
- Bradford Institute for Health Research, Bradford, UK
| | - Amy L Atkinson
- Department of Psychology, Lancaster University, Lancaster, UK
| |
Collapse
|
3
|
van Zwieten A, Teixeira-Pinto A, Lah S, Nassar N, Craig JC, Wong G. Special health care needs during childhood and academic achievement in secondary school. Child Care Health Dev 2022; 48:311-323. [PMID: 34806201 DOI: 10.1111/cch.12931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 09/23/2021] [Accepted: 11/07/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Secondary education has lifelong implications for wellbeing. We evaluated associations between the duration and timing of special health care needs (SHCN) across childhood and academic achievement in secondary school. METHODS Cohort design. The structured modelling approach was used to evaluate life-course models for associations between the duration and timing of SHCN (measured using a two-item SHCN screener across ages 4-5, 6-7, 8-9 and 10-11 years) and Grade 7 (median age 12.5 years) reading and numeracy achievement. Linear regressions were fitted for each life-course model: four critical period models (each including SHCN exposure in one period), one sensitive period model (including SHCN exposure in all periods) and two strict accumulation models (including the duration of SHCN exposure in linear form then categorical form). Interactions of SHCN with child sex and family socio-economic status (SES) were examined. RESULTS Of 3734 children, 1845 were female. The number of children with SHCN was 434 (11.7%), 458 (12.9%), 534 (14.7%), 551 (15.4%) at 4-5, 6-7, 8-9 and 10-11 years respectively. For both outcomes, the linear strict accumulation model fitted best, and interactions of SHCN with sex and SES were non-significant. The average decrease in school achievement z score (95% confidence interval) per period of having SHCN was 0.04 (-0.07 to -0.02) for reading and 0.08 (-0.11 to -0.05) for numeracy. CONCLUSIONS A longer duration of SHCN from age 4-11 years has small-sized cumulative associations with poorer Grade 7 reading and numeracy achievement. Each period of SHCN between 4 and 5 and 10-11 years was associated with nearly 0.05 and 0.1 of a standard deviation reduction in Grade 7 reading and numeracy scores respectively, and these associations did not appear to differ across sex or SES. These findings suggest that children with persistent SHCN are at risk of academic deficits and should receive focused interventions.
Collapse
Affiliation(s)
- Anita van Zwieten
- Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.,Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Armando Teixeira-Pinto
- Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.,Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Suncica Lah
- School of Psychology, University of Sydney, Sydney, New South Wales, Australia.,Australian Research Council Centre of Excellence for Cognition and its Disorders (ARC CCD), Macquarie University, Sydney, New South Wales, Australia
| | - Natasha Nassar
- Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Jonathan C Craig
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
| | - Germaine Wong
- Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.,Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, New South Wales, Australia.,Department of Renal Medicine, Westmead Hospital, Westmead, New South Wales, Australia
| |
Collapse
|
4
|
O'Connor M, Chong S, Quach J, Goldfeld S. Learning outcomes of children with teacher-identified emerging health and developmental needs. Child Care Health Dev 2020; 46:223-231. [PMID: 31845372 DOI: 10.1111/cch.12737] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Revised: 11/27/2019] [Accepted: 12/14/2019] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Children's additional health and developmental needs are often first identified by teachers when they begin school. This study estimates the Grade 3 literacy and numeracy outcomes of children with teacher-identified additional needs emerging in the first year of school, including the added burden conferred by socioeconomic disadvantage. METHODS Population linked data (n = 42,619) were analysed from the Australian Early Development Census, which include teacher reports on children's health and development at school entry, and the National Assessment Program-Literacy and Numeracy, a direct assessment of reading and numeracy skills at Grade 3. Linear regression analyses were used to estimate associations between emerging needs and learning outcomes, adjusted for sociodemographic characteristics. The combined effect of emerging needs and low maternal education (an indicator of socioeconomic disadvantage) on academic outcomes was examined by estimating the relative excess risk due to interaction (RERI). RESULTS Emerging health and developmental needs at school entry were associated with lower reading (b = -26.86, 95% CI = -29.19, -24.52) and numeracy (b = -24.39, 95% CI = -26.43, -22.35) outcomes at Grade 3. The combined effect of emerging needs and socioeconomic disadvantage was greater than expected when their individual effects are summed (RERI = 0.38, 95% CI 0.22, 0.55 for reading and RERI = 0.27, 95% CI 0.10, 0.43 for numeracy). CONCLUSION In the current study, emerging health and developmental needs identified by teachers at the outset of schooling were associated with poorer literacy and numeracy skills at Grade 3, and family socioeconomic disadvantage appeared to further amplify this effect. Meeting the needs of these children will require timely and coordinated supports across the health and education systems, particularly for those children who are also disadvantaged.
Collapse
Affiliation(s)
- Meredith O'Connor
- Centre for Community Child Health, Murdoch Childrens Research Institute, Royal Children's Hospital, Melbourne, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Australia.,ANU College of Arts & Social Sciences, Australian National University, Canberra, Australia
| | - Shiau Chong
- Centre for Community Child Health, Murdoch Childrens Research Institute, Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Jon Quach
- Centre for Community Child Health, Murdoch Childrens Research Institute, Royal Children's Hospital, Melbourne, Victoria, Australia.,Melbourne Graduate School of Education, University of Melbourne, Parkville, Melbourne, Australia
| | - Sharon Goldfeld
- Centre for Community Child Health, Murdoch Childrens Research Institute, Royal Children's Hospital, Melbourne, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Australia
| |
Collapse
|
5
|
Evans A, Dunstan F, Fone DL, Bandyopadhyay A, Schofield B, Demmler JC, Rahman MA, Lyons RA, Paranjothy S. The role of health and social factors in education outcome: A record-linked electronic birth cohort analysis. PLoS One 2019; 14:e0220771. [PMID: 31398202 PMCID: PMC6688802 DOI: 10.1371/journal.pone.0220771] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Accepted: 07/23/2019] [Indexed: 12/27/2022] Open
Abstract
Background and objective Health status in childhood is correlated with educational outcomes. Emergency hospital admissions during childhood are common but it is not known how these unplanned breaks from schooling impact on education outcomes. We hypothesised that children who had emergency hospital admissions had an increased risk of lower educational attainment, in addition to the increased risks associated with other health, social and school factors. Methods This record-linked electronic birth cohort, included children born in Wales between 1 January 1998 and 31 August 2001. We fitted multilevel logistic regression models grouped by schools, to determine whether emergency hospital inpatient admission before age 7 years was associated with the educational outcome of not attaining the expected level in a teacher-based assessment at age 7 years (KS1). We adjusted for pregnancy, perinatal, socio-economic, neighbourhood, pupil mobility and school-level factors. Results The cohort comprised 64 934 children. Overall, 4680 (7.2%) did not attain the expected educational level. Emergency admission to hospital was associated with poor educational attainment (OR 1.12 95% Credible Interval (CI) 1.05, 1.20 for all causes during childhood, OR 1.19 95%CI 1.07, 1.32 for injuries and external causes and OR 1.31 95%CI 1.04, 1.22 for admissions during infancy), after adjusting for known determinants of education outcomes such as extreme prematurity, being small for gestational age and socio-economic indicators, such as eligibility for free school meals. Conclusion Emergency inpatient hospital admission during childhood, particularly during infancy or for injuries and external causes was associated with an increased risk of lower education attainment at age 7 years, in addition to the effects of pregnancy factors (gestational age, birthweight) and social deprivation. These findings support the need for injury prevention measures and additional support in school for affected children to help them to achieve their potential.
Collapse
Affiliation(s)
- Annette Evans
- Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, Wales, United Kingdom
| | - Frank Dunstan
- Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, Wales, United Kingdom
| | - David L Fone
- Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, Wales, United Kingdom
| | | | - Behnaz Schofield
- Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, Wales, United Kingdom
| | - Joanne C Demmler
- Health Data Research UK, Swansea University, Wales, United Kingdom
| | | | - Ronan A Lyons
- Health Data Research UK, Swansea University, Wales, United Kingdom
| | - Shantini Paranjothy
- Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, Wales, United Kingdom
| |
Collapse
|
6
|
O'Connor M, O'Connor E, Quach J, Vashishtha R, Goldfeld S. Trends in the prevalence and distribution of teacher-identified special health-care needs across three successive population cohorts. J Paediatr Child Health 2019; 55:312-319. [PMID: 30161271 DOI: 10.1111/jpc.14192] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Revised: 06/13/2018] [Accepted: 07/06/2018] [Indexed: 11/30/2022]
Abstract
AIM Some children's special health-care needs (SHCN) are formalised at the start of schooling (established SHCN), but a larger proportion start with difficulties that are milder or not yet diagnosed (emerging SHCN). This study explores whether: (i) the prevalence of teacher-identified SHCN (both overall and according to type of needs) and (ii) distribution across disadvantaged communities have changed over three successive population cohorts of Australian children. METHODS We draw on repeated cross-sectional data from the Australian Early Development Census, a teacher-reported checklist completed on full populations of Australian school entrants in 2009, 2012 and 2015. It includes a measure of SHCN, as well as demographic information. RESULTS The proportion of children with emerging and established needs was mostly stable from 2009 to 2015 (emerging needs: 17.1-18.9%; established needs: 4.4-4.9%). Change over time was observed in the prevalence of some specific types of impairment. Speech impairment rose by 14.7% for children with emerging needs, and emotional problems rose by 13.7% for children with established needs. Children living in the most disadvantaged neighbourhoods had higher odds of SHCN in all years (e.g. emerging needs relative risk ratio 1.65 (99% confidence interval 1.55-1.75) in 2015; established needs relative risk ratio 1.88 (99% confidence interval 1.71-2.06) in 2015). CONCLUSIONS A large proportion of children starting school each year have SHCN. The types of SHCN that children present with increasingly reflect complex difficulties that require input from both the health and education sectors. Effective responses also need to consider the added impact of disadvantage.
Collapse
Affiliation(s)
- Meredith O'Connor
- Centre for Community Child Health, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
| | - Elodie O'Connor
- Centre for Community Child Health, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Jon Quach
- Centre for Community Child Health, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Victoria, Australia.,Melbourne Graduate School of Education, University of Melbourne, Melbourne, Victoria, Australia
| | - Rakhi Vashishtha
- Centre for Community Child Health, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Sharon Goldfeld
- Centre for Community Child Health, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
| |
Collapse
|
7
|
Allison MA, Attisha E, Lerner M, De Pinto CD, Beers NS, Gibson EJ, Gorski P, Kjolhede C, O’Leary SC, Schumacher H, Weiss-Harrison A. The Link Between School Attendance and Good Health. Pediatrics 2019; 143:peds.2018-3648. [PMID: 30835245 DOI: 10.1542/peds.2018-3648] [Citation(s) in RCA: 85] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
More than 6.5 million children in the United States, approximately 13% of all students, miss 15 or more days of school each year. The rates of chronic absenteeism vary between states, communities, and schools, with significant disparities based on income, race, and ethnicity. Chronic school absenteeism, starting as early as preschool and kindergarten, puts students at risk for poor school performance and school dropout, which in turn, put them at risk for unhealthy behaviors as adolescents and young adults as well as poor long-term health outcomes. Pediatricians and their colleagues caring for children in the medical setting have opportunities at the individual patient and/or family, practice, and population levels to promote school attendance and reduce chronic absenteeism and resulting health disparities. Although this policy statement is primarily focused on absenteeism related to students' physical and mental health, pediatricians may play a role in addressing absenteeism attributable to a wide range of factors through individual interactions with patients and their parents and through community-, state-, and federal-level advocacy.
Collapse
Affiliation(s)
- Mandy A. Allison
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Adult and Child Consortium for Health Outcomes Research and Delivery Science, School of Medicine, University of Colorado, and Children’s Hospital Colorado, Aurora, Colorado; and
| | - Elliott Attisha
- Detroit Public Schools Community District, Detroit, Michigan
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
8
|
Mattson G, Kuo DZ, Yogman M, Baum R, Gambon TB, Lavin A, Esparza RM, Nasir AA, Wissow LS, Apkon S, Brei TJ, Davidson LF, Davis BE, Ellerbeck KA, Hyman SL, Leppert MO, Noritz GH, Stille CJ, Yin L. Psychosocial Factors in Children and Youth With Special Health Care Needs and Their Families. Pediatrics 2019; 143:peds.2018-3171. [PMID: 30559121 DOI: 10.1542/peds.2018-3171] [Citation(s) in RCA: 57] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Children and youth with special health care needs (CYSHCN) and their families may experience a variety of internal (ie, emotional and behavioral) and external (ie, interpersonal, financial, housing, and educational) psychosocial factors that can influence their health and wellness. Many CYSHCN and their families are resilient and thrive. Medical home teams can partner with CYSHCN and their families to screen for, evaluate, and promote psychosocial health to increase protective factors and ameliorate risk factors. Medical home teams can promote protective psychosocial factors as part of coordinated, comprehensive chronic care for CYSHCN and their families. A team-based care approach may entail collaboration across the care spectrum, including youth, families, behavioral health providers, specialists, child care providers, schools, social services, and other community agencies. The purpose of this clinical report is to raise awareness of the impact of psychosocial factors on the health and wellness of CYSHCN and their families. This clinical report provides guidance for pediatric providers to facilitate and coordinate care that can have a positive influence on the overall health, wellness, and quality of life of CYSHCN and their families.
Collapse
Affiliation(s)
- Gerri Mattson
- Children and Youth Branch, Division of Public Health, North Carolina Department of Health and Human Services, Raleigh, North Carolina; and
| | - Dennis Z. Kuo
- Department of Pediatrics, University at Buffalo, Buffalo, New York
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
9
|
Barnett T, Giallo R, Kelaher M, Goldfeld S, Quach J. Predictors of learning outcomes for children with and without chronic illness: An Australian longitudinal study. Child Care Health Dev 2018; 44:832-840. [PMID: 30033587 DOI: 10.1111/cch.12597] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Revised: 06/28/2018] [Accepted: 07/01/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND Chronically ill children are at increased risk of poor learning outcomes. Knowledge of the predictors of learning outcomes for this group of people is important to inform the development of education supports that stand the best chance of being effective. This study explored the child, family, and school risk and protective factors during the child's transition to elementary school (aged 6-7 years) that were associated with learning outcomes when children were aged 10-11 years for both children with and without a chronic illness. METHODS Data from the Longitudinal Study of Australian Children were used. Predictor variables were entered into separate multivariate regression models for children with and without a chronic illness. RESULTS The strongest predictors of learning outcomes were the child's approach to learning, a consistent parenting style, and family socioeconomic position and were common for both children with and without a chronic illness but strongest for children with a chronic illness. CONCLUSION A child's approach to learning and a consistent parenting style during the period of the child's transition to elementary school are important and potentially modifiable factors that are predictive of academic performance in later childhood. These factors are particularly relevant for children with a chronic illness, their parents/caregivers, teachers both hospital and school based, and pediatricians and can be used to inform interventions.
Collapse
Affiliation(s)
- Tony Barnett
- Centre for Community Child Health, Murdoch Childrens Research Institute, Parkville, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Carlton, Victoria, Australia
| | - Rebecca Giallo
- Centre for Community Child Health, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
| | - Margaret Kelaher
- Centre for Health Policy, Melbourne School of Population and Global Health, University of Melbourne, Carlton, Victoria, Australia
| | - Sharon Goldfeld
- Centre for Community Child Health, Murdoch Childrens Research Institute, Parkville, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Carlton, Victoria, Australia
| | - Jon Quach
- Centre for Community Child Health, Murdoch Childrens Research Institute, Parkville, Victoria, Australia.,Graduate School of Education, University of Melbourne, Carlton, Victoria, Australia
| |
Collapse
|
10
|
Bristow S, Jackson D, Shields L, Usher K. The rural mother's experience of caring for a child with a chronic health condition: An integrative review. J Clin Nurs 2018; 27:2558-2568. [PMID: 29575208 DOI: 10.1111/jocn.14360] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/12/2018] [Indexed: 01/18/2023]
Abstract
AIMS AND OBJECTIVES To identify and review the literature on rural mothers' experiences in caring for a child with a chronic health condition. BACKGROUND Families living with a child who has a chronic health condition experience many challenges; these are often amplified for families living in rural areas, where issues such as the distance from services add further challenges the family must manage. Like many children, rural children with chronic health conditions are primarily cared for by their mothers. The additional strain of geography creates its own unique experiences for mothers who need to access the high-quality care that their child requires. DESIGN Integrative literature review using the Equator PRISMA guidelines. METHODS A search of databases; Cochrane, CINAHL, Ovid, PubMed, ProQuest Health and Medicine, Informit and Scopus for studies published between 2005-2016 using an integrative review approach. A total of 1,484 studies were identified with an additional six studies found through snowballing. The search resulted in seven studies being meeting the inclusion criteria after using the Critical Appraisal Skills Programme. RESULTS Data from the seven articles were analysed, and the mothers' experiences were synthesised into five themes: "struggling for resources," "barriers in accessing services," "strain of decision-making," "mother's physical and emotional breakdown" and "the daily management of family activities". These five themes formed the basis of this article. CONCLUSIONS The findings indicate that mothers from rural areas face additional barriers related to their rurality, including transportation difficulties, socioeconomic status and social isolation, and are challenged by limited access to specialty medical services, educators and allied health professionals. The literature review outcome will assist in informing nursing practice through identifying and allocating resources to reduce these barriers; rural mother experience will assist in enabling the child to reach their full developmental potential. RELEVANCE TO CLINICAL PRACTICE There is a need for health professionals to understand the challenges and barriers rural mothers face in accessing services. Nurses can assist rural mothers to navigate and access the appropriate services in order to reduce health inequity, increase accessibility to services and reduce rural disadvantage for their child. Nurses and health professionals are in an ideal position to develop future models of care that optimise health outcomes and enable equity and access to services for rural children with chronic conditions similar to those experienced by their urban counterparts.
Collapse
Affiliation(s)
- Sally Bristow
- School of Health, University of New England, Armidale, NSW, Australia
| | - Debra Jackson
- Faulty of Health University of Technology, Sydney, NSW, Australia
| | - Linda Shields
- Faculty of Science, Charles Sturt University, Bathurst, NSW, Australia
| | - Kim Usher
- School of Health, University of New England, Armidale, NSW, Australia
| |
Collapse
|
11
|
The Cumulative Effect of Health Adversities on Children's Later Academic Achievement. Acad Pediatr 2017; 17:706-714. [PMID: 28300654 DOI: 10.1016/j.acap.2017.03.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Revised: 02/28/2017] [Accepted: 03/05/2017] [Indexed: 11/21/2022]
Abstract
OBJECTIVE We aimed to determine whether the accumulation of physical, psychosocial, and combined health adversities measured at age 8 to 9 years predicts worsening of academic scores cross-sectionally at 8 to 9 and longitudinally at 10 to 11 years. METHODS Design: Longitudinal data from Waves 3 and 4 in the Longitudinal Study of Australian Children (83% of 4983 retained). Exposures (8-9 years): Physical health adversities (yes/no; summed range, 0-5): overweight, special health care needs, chronic illness, PedsQL Physical, and global health. Psychosocial health adversities (yes/no; summed range, 0-4): parent- and teacher-reported behavior, PedsQL Psychosocial, sleep problems. Combined health adversities (range 0-9). Outcomes (8-9, and 10-11 years): National academic standardized test scores. ANALYSIS Generalized estimating equations, accounting for multiple academic domains in each year and socioeconomic position and cognition. RESULTS At 8 to 9 years, 23.9%, 9.9%, and 5.3% had 1, 2, or ≥3 physical health adversities, respectively, while 27.2%, 9.5%, and 4.9% had 1, 2, or ≥3 psychosocial health adversities. For each additional health adversity at 8 to 9 years, academic scores fell incrementally in year 3 and year 5 (both P < .001), with reductions of at least 0.4 SDs for ≥3 health adversities. Number was more important than type (physical, psychosocial) of adversity. CONCLUSIONS The accumulation of health adversities predicts poorer academic achievement up to 2 years later. Interventions might need to address multiple domains to improve child academic outcomes and be delivered across the health-education interface.
Collapse
|
12
|
Lum A, Wakefield CE, Donnan B, Burns MA, Fardell JE, Marshall GM. Understanding the school experiences of children and adolescents with serious chronic illness: a systematic meta-review. Child Care Health Dev 2017; 43:645-662. [PMID: 28543609 DOI: 10.1111/cch.12475] [Citation(s) in RCA: 83] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Revised: 03/17/2017] [Accepted: 04/15/2017] [Indexed: 12/13/2022]
Abstract
BACKGROUND Serious chronic illness can have a detrimental effect on school attendance, participation and engagement, leaving affected students at risk of failing to meet their developmental potential. An improved understanding of factors that help to explain or mitigate this risk can help educators and health professionals deliver the most effective support. This meta-review critiqued the available evidence examining the link between six chronic illnesses (asthma, cancer, chronic kidney diseases, heart diseases, cystic fibrosis and gastrointestinal diseases) and children's and adolescents' school experiences and outcomes, as well as investigating the medical, school, psychosocial and sociodemographic factors that are linked to poorer or better school outcomes. METHODS We searched CINAHL, Cochrane Database, EMBASE, ERIC, MEDLINE, ProQuest Theses and Dissertations, and PsycINFO (2000-2015). Systematic and narrative reviews, and meta-analyses, of original studies examining students' subjective school experiences and objective school outcomes were eligible. We used the Preferred Reporting Items for Systematic Reviews and Meta-analyses criteria to critically appraise all systematic reviews. The Grading of Recommendations Assessment, Development, and Evaluation system guided our recommendations for practice and research. RESULTS Eighteen reviews of 172 studies including more than 40 000 students were eligible. Therefore, we chose to conduct a meta-review to provide an overview of the literature on the relationship between chronic illness and school experiences and outcomes. We also explored the associated medical, school, psychosocial and sociodemographic factors affecting the relationship between illness and school experiences and outcomes. CONCLUSION Students with chronic illness demonstrate mixed school experiences and outcomes that are often worse than students without chronic illness. Modifiable factors, such as students' engagement with school, may be novel yet appropriate targets of educational support to ensure that these students reach their full schooling potential.
Collapse
Affiliation(s)
- A Lum
- Kids Cancer Centre, Sydney Children's Hospital, Sydney, NSW, Australia.,Discipline of Paediatrics, School of Women's and Children's Health, UNSW Medicine, University of New South Wales, Sydney, NSW, Australia
| | - C E Wakefield
- Kids Cancer Centre, Sydney Children's Hospital, Sydney, NSW, Australia.,Discipline of Paediatrics, School of Women's and Children's Health, UNSW Medicine, University of New South Wales, Sydney, NSW, Australia
| | - B Donnan
- Kids Cancer Centre, Sydney Children's Hospital, Sydney, NSW, Australia.,Discipline of Paediatrics, School of Women's and Children's Health, UNSW Medicine, University of New South Wales, Sydney, NSW, Australia.,Ronald McDonald House Charities, Sydney, NSW, Australia
| | - M A Burns
- Kids Cancer Centre, Sydney Children's Hospital, Sydney, NSW, Australia.,Discipline of Paediatrics, School of Women's and Children's Health, UNSW Medicine, University of New South Wales, Sydney, NSW, Australia
| | - J E Fardell
- Kids Cancer Centre, Sydney Children's Hospital, Sydney, NSW, Australia.,Discipline of Paediatrics, School of Women's and Children's Health, UNSW Medicine, University of New South Wales, Sydney, NSW, Australia
| | - G M Marshall
- Kids Cancer Centre, Sydney Children's Hospital, Sydney, NSW, Australia.,Discipline of Paediatrics, School of Women's and Children's Health, UNSW Medicine, University of New South Wales, Sydney, NSW, Australia
| |
Collapse
|
13
|
O'Connor M, Rosema S, Quach J, Kvalsvig A, Goldfeld S. Special Health Care Needs Across the School and Family Contexts: Implications for Service Utilization. Acad Pediatr 2017; 17:687-693. [PMID: 28286135 DOI: 10.1016/j.acap.2017.02.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2016] [Revised: 02/22/2017] [Accepted: 02/26/2017] [Indexed: 10/20/2022]
Abstract
OBJECTIVE A fifth of children enter school with special health care needs (SHCN), many of whom have difficulties that are milder or not yet formally diagnosed (emerging SHCN). This study aimed to investigate how differing perceptions of children's emerging SHCN across the family and school contexts relates to service utilization. METHODS Sample: The nationally representative birth cohort of the Longitudinal Study of Australian Children, which includes parent reports on the abbreviated Children with Special Health Care Needs Screener. For a subsample of 2459 children teachers also completed the Australian Early Development Census, a measure of early childhood development at school entry that includes SHCN. ANALYSIS Logistic regression analyses were conducted adjusting for severity of condition, gender, language background, and disadvantage. RESULTS Overall 24.1% of children were identified by their parent and/or teacher as experiencing emerging SHCN. Compared with those with consistent reports, children with parent-only identified needs had lower odds of accessing school services (odds ratio [OR], 0.29; 95% confidence interval [CI], 0.10-0.81). Similarly, children with parent-only (OR, 0.39; 95% CI, 0.20-0.75) and teacher-only (OR, 0.25; 95% CI, 0.14-0.46) identified needs had significantly lower odds of accessing services in the community. CONCLUSIONS When parent and teacher perceptions of children's emerging SHCN were inconsistent, service use was lower at school and in the community. Further efforts are needed by health and education providers to ensure that common understandings about a child's needs at school are established early in children's educational careers.
Collapse
Affiliation(s)
- Meredith O'Connor
- Royal Children's Hospital and Murdoch Childrens Research Institute, and The University of Melbourne, Parkville, Victoria, Australia
| | - Stefanie Rosema
- De Bascule, Vrije University Medical Centre, Murdoch Childrens Research Institute, Duivendracht, The Netherlands
| | - Jon Quach
- Royal Children's Hospital and Murdoch Childrens Research Institute, and The University of Melbourne, Parkville, Victoria, Australia
| | - Amanda Kvalsvig
- Royal Children's Hospital and Murdoch Childrens Research Institute, and The University of Melbourne, Parkville, Victoria, Australia
| | - Sharon Goldfeld
- Royal Children's Hospital and Murdoch Childrens Research Institute, and The University of Melbourne, Parkville, Victoria, Australia.
| |
Collapse
|
14
|
O'Connor M, Rosema S, Quach J, Kvalsvig A, Goldfeld S. Parent and teacher perceptions of emerging special health care needs. J Paediatr Child Health 2016; 52:950-956. [PMID: 27168525 DOI: 10.1111/jpc.13188] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/16/2016] [Indexed: 12/01/2022]
Abstract
AIM A fifth of children enter school with special health care needs (SHCN) impacting on their physical, psychosocial or educational development, including many with emerging SHCN who often do not qualify for additional supports. This study aimed to compare the perceptions of parents and teachers on children's emerging SHCN, and explore correlates of conflicting reports. METHODS The Longitudinal Study of Australian Children (LSAC) is a nationally representative study of Australian children, which includes the abbreviated Children with Special Health Care Needs Screener. Data were analysed from a subsample of n = 720 children from the LSAC Kindergarten cohort (n = 4983) for whom teachers also completed the Australian Early Development Index checklist, a measure of early childhood development that includes teacher reported SHCN. RESULTS Teachers (n = 120, 17.34%) identified more emerging SHCN than parents (n = 74, 10.74%), and reports were often discrepant. Children were more likely to have consistent reports of emerging SHCN when their parents had high levels of involvement at school (OR 4.86; 95% CI 1.08-21.80; P < 0.05), whereas children who came from disadvantaged family backgrounds were more likely to have teacher-only identified difficulties (OR 3.66; 95% CI 1.17-11.50; P < 0.05). CONCLUSION Parents and teachers bring different perspectives to children's development and additional support needs, each of which is valuable. Greater attention should be given to ensuring that common understandings about a child's needs at school are established early in children's educational pathways.
Collapse
Affiliation(s)
- Meredith O'Connor
- Royal Children's Hospital, Murdoch Childrens Research Institute, and The University of Melbourne, Melbourne, Victoria, Australia
| | - Stefanie Rosema
- Royal Children's Hospital, Murdoch Childrens Research Institute, and The University of Melbourne, Melbourne, Victoria, Australia
| | - Jon Quach
- Royal Children's Hospital, Murdoch Childrens Research Institute, and The University of Melbourne, Melbourne, Victoria, Australia
| | - Amanda Kvalsvig
- Royal Children's Hospital, Murdoch Childrens Research Institute, and The University of Melbourne, Melbourne, Victoria, Australia
| | - Sharon Goldfeld
- Royal Children's Hospital, Murdoch Childrens Research Institute, and The University of Melbourne, Melbourne, Victoria, Australia.
| |
Collapse
|
15
|
Nasuuna E, Santoro G, Kremer P, de Silva AM. Examining the relationship between childhood health conditions and health service utilisation at school entry and subsequent academic performance in a large cohort of Australian children. J Paediatr Child Health 2016; 52:750-8. [PMID: 27439634 DOI: 10.1111/jpc.13183] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/12/2016] [Indexed: 11/27/2022]
Abstract
AIM Chronic health conditions are associated with poor academic outcomes. This study examines the relationship between health conditions, specialist health service utilisation and academic performance in Australian children. METHODS This was a quasi-longitudinal study where School Entrant Health Questionnaire (a survey tool with parent report on children's health) data for 24 678 children entering school in 2008 was matched with the 2011 National Assessment Program - Literacy and Numeracy (NAPLAN). Linear and logistic regressions were used to examine associations between health conditions, use of a specialist health service and reading and numeracy scores. RESULTS The study comprised 24 678 children. Children with allergies, very low birth weight, developmental delay, diabetes, spina bifida, cystic fibrosis, birth abnormality, speech problems, intellectual disability and attention-deficit/hyperactivity disorder had lower numeracy scores than those without any of these conditions (P < 0.05). The same children had higher odds (1.2-5.8) of being at or below the national minimum standard for numeracy. Children with developmental delay, epilepsy, dental problems, speech, intellectual disabilities and low birth weight had lower reading scores than those without these conditions (P < 0.05) and had higher odds of being at (odds ratio: 1.3) or below (odds ratio: 3.7) the national minimum standard for reading. Children with health conditions who had ever accessed specialist health services did not differ in their academic performance from those that had not used specialist health services. CONCLUSIONS Some health conditions put children at risk of poorer academic performance, and interventions to prevent this such as appropriate support services in schools should be considered.
Collapse
Affiliation(s)
| | | | | | - Andrea M de Silva
- Dental Health Services Victoria, Melbourne, Australia.,Melbourne Dental School, University of Melbourne, Melbourne, Australia
| |
Collapse
|
16
|
Bell MF, Bayliss DM, Glauert R, Harrison A, Ohan JL. Chronic Illness and Developmental Vulnerability at School Entry. Pediatrics 2016; 137:peds.2015-2475. [PMID: 27244787 DOI: 10.1542/peds.2015-2475] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/25/2016] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE This study examined the association between chronic illness and school readiness, by using linked administrative population data. METHODS The sample included children born in 2003-2004 who were residing in Western Australia in 2009 and had a complete Australian Early Development Census record (N = 22 890). Health and demographic information was also analyzed for 19 227 mothers and 19 030 fathers. The impact of child chronic illness on 5 developmental domains (social, emotional, language, cognitive, and physical) at school entry was analyzed. Analyses examined the association between child developmental outcomes and chronic illness generally, single or multiple chronic illness diagnosis, and diagnosis type. Logistic regression models estimated odds ratios for each outcome, adjusted for child, parent, and community sociodemographic variables. RESULTS In the adjusted models, children with a chronic illness had an increased risk of being classified as developmentally vulnerable on all domains, compared with children without a chronic illness (20%-35% increase in risk). There was no increased risk for children with multiple chronic illness diagnoses over those with a single diagnosis (all Ps > .05). There was no evidence of a disease-specific effect driving this risk. CONCLUSIONS Regardless of the number or type of conditions, chronic illness in young children is a risk factor for reduced school readiness. These effects were seen for health conditions not traditionally considered detrimental to school readiness, such as chronic otitis media. Thus, the implications of a broader range of chronic health conditions in early childhood on school readiness need to be considered.
Collapse
Affiliation(s)
- Megan F Bell
- School of Psychology, and Telethon Kids Institute, University of Western Australia, Perth, Western Australia; and
| | | | - Rebecca Glauert
- Telethon Kids Institute, University of Western Australia, Perth, Western Australia; and
| | | | | |
Collapse
|
17
|
Quach J, Jansen PW, Mensah FK, Wake M. Trajectories and outcomes among children with special health care needs. Pediatrics 2015; 135:e842-50. [PMID: 25780064 DOI: 10.1542/peds.2014-2431] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/26/2015] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Outcomes for children with special health care needs (SHCN) can vary by their patterns and persistence over time. We aimed to empirically establish typical SHCN trajectories throughout childhood and their predictive relationships with child and parent outcomes. METHODS The 2 cohorts of the nationally representative Longitudinal Study of Australian Children were recruited in 2004 at ages 0 to 1 (n = 5107, B cohort) and 4 to 5 years (n = 4983, K cohort). The parent-reported Children With SHCN Screener (Short Form) was completed at each of 4 biennial waves. Wave 4 outcomes were parent-reported behavior and health-related quality of life, teacher-reported learning, and directly assessed cognition. Both parents self-reported mental distress. We derived intracohort trajectories by using latent class analysis in Mplus. We compared mean outcome scores across trajectories by using linear regression, adjusting for socioeconomic position. RESULTS Four distinct SHCN trajectories were replicated in both cohorts: persistent (B 6.8%, K 8.7%), emerging (B 4.1%, K 11.5%), transient (B 7.9%, K 4.2%), and none (B 81.3%, K 75.6%). Every outcome was adversely affected except fathers' mental health. From infancy to age 6 to 7 years, the persistent and emerging groups had similarly poor outcomes. From age 4 and 5 to 10 and 11 years, outcomes were incrementally poorer on moving from none to transient to emerging and to persistent SHCN. Effect sizes were largest for behavior, learning, and psychosocial outcomes. CONCLUSIONS Adverse outcomes are shaped more by cumulative burden than point prevalence of SHCNs. In addition to providing care according to a child's need at any given time, prioritizing care toward persistent SHCNs may have the biggest benefits for children and parents.
Collapse
Affiliation(s)
- Jon Quach
- Murdoch Childrens Research Institute, Parkville, Victoria, Australia; The University of Melbourne, Carlton, Victoria, Australia;
| | - Pauline W Jansen
- Murdoch Childrens Research Institute, Parkville, Victoria, Australia; Erasmus Medical Center, Rotterdam, Netherlands; Erasmus University, Rotterdam, Netherlands; and
| | - Fiona K Mensah
- Murdoch Childrens Research Institute, Parkville, Victoria, Australia; The University of Melbourne, Carlton, Victoria, Australia; The Royal Children's Hospital, Parkville, Victoria, Australia
| | - Melissa Wake
- Murdoch Childrens Research Institute, Parkville, Victoria, Australia; The University of Melbourne, Carlton, Victoria, Australia; The Royal Children's Hospital, Parkville, Victoria, Australia
| |
Collapse
|
18
|
Goldfeld S, O'Connor M, Quach J, Tarasuik J, Kvalsvig A. Learning trajectories of children with special health care needs across the severity spectrum. Acad Pediatr 2015; 15:177-84. [PMID: 25441651 DOI: 10.1016/j.acap.2014.09.001] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2014] [Revised: 08/29/2014] [Accepted: 09/04/2014] [Indexed: 11/16/2022]
Abstract
OBJECTIVE A significant proportion of school-aged children experience special health care needs (SCHN) and seek care from pediatricians with a wide range of condition types and severity levels. This study examines the learning pathways of children with established (already diagnosed at school entry) and emerging (teacher identified) SHCN from school entry through the elementary school years. METHODS The Longitudinal Study of Australian Children (LSAC) is a nationally representative clustered cross-sequential sample of 2 cohorts of Australian children which commenced in May 2004. Data were analyzed from the LSAC kindergarten cohort (n = 4,983), as well as a subsample of 720 children for whom teachers also completed the Australian Early Development Index checklist, a measure of early childhood development at school entry that includes SHCN. RESULTS Latent class analysis was utilized to establish 3 academic trajectories from 4-5 to 10-11 years: high (24.3%), average (49.8%), and low (23.6%). Descriptive statistics revealed a trend for both children with established and emerging SHCN to fall into weaker performing learning pathways. Multinomial logistic regression focusing on those children with emerging SHCN confirmed this pattern of results, even after adjustment for covariates (relative risk 3.06, 95% confidence interval 1.03-9.10). Children who additionally had low socioeconomic standing were particularly at risk. CONCLUSIONS Even children with less complex SCHN are at risk for academic failure. Early identification, together with integrated health and educational support, may promote stronger pathways of educational attainment for these children. Achieving these better outcomes will require the involvement of both educational and health practitioners.
Collapse
Affiliation(s)
- Sharon Goldfeld
- Royal Children's Hospital, Melbourne, Victoria, Australia; Murdoch Childrens Research Institute, Melbourne, Victoria, Australia; University of Melbourne, Melbourne, Victoria, Australia.
| | - Meredith O'Connor
- Royal Children's Hospital, Melbourne, Victoria, Australia; Murdoch Childrens Research Institute, Melbourne, Victoria, Australia; University of Melbourne, Melbourne, Victoria, Australia
| | - Jon Quach
- Royal Children's Hospital, Melbourne, Victoria, Australia; Murdoch Childrens Research Institute, Melbourne, Victoria, Australia
| | - Joanne Tarasuik
- Royal Children's Hospital, Melbourne, Victoria, Australia; Swinburne University of Technology, Melbourne, Victoria, Australia
| | - Amanda Kvalsvig
- Royal Children's Hospital, Melbourne, Victoria, Australia; Murdoch Childrens Research Institute, Melbourne, Victoria, Australia
| |
Collapse
|