Effects of chronic health conditions on school adaptation
Fowler, G. Mary
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This study of children with chronic health conditions (CHC) assessed the relationship of demographic and health variables to school achievement and absenteeism. From July 1982 to June 1983 data were collected in 11 subspeciality clinics on 270 children followed at a tertiary care center. Academic performance and days absent for the prior year were obtained from schools. Physicians rated subjects' activity limitation. The CHC group was 61% male, 68% white, mean age 12 years. Children with cystic fibrosis, arthritis, sickle cell disease, hemophilia, and spina bifida averaged the most days absent (>20), while those with chronic lung and cardiac conditions averaged the least (10). Total CHC achievement scores were well below the state average (53rd vs. 63rd percentile). Group scores were highest for general hematology, hemophilia, chronic bowel and lung. Scores were lowest for epilepsy (39th), sickle cell (24th), and spina bifida (21st), and these groups had the highest rates of repeated grades and special services. Overall CHC group achievement was unrelated to school absence. A stepwise regression model related demographic and health variables to log of days absent and achievement scores. Achievement was correlated with socioeconomic status, race, grade failure, and type of CHC (r2=.44; p=.0001) while school absence was mainly related to health variables (activity limitation, number of clinic visits, specific CHC) and female sex (r2=.17; p=.0001). For CHC children, demographic factors were important predictors of academic performance. CHC children of low socioeconomic status were at double jeopardy for poor school achievement.
- Medical and Health Sciences