April 13, 2016 / 4:35 PM / in 2 years

School readiness eroded by chronic illness

(Reuters Health) - Kids who are constantly sick early in childhood may have a much harder time in school than their peers who don’t have a history of chronic illness, a recent study suggests.

Researchers assessed school readiness in almost 23,000 children in Western Australia by looking at motor skills and physical independence, social skills, emotional maturity and behavior, language and cognitive abilities and communication skills.

Compared with generally healthy children, chronically ill kids were 19 percent to 36 percent more likely to be developmentally delayed in these areas by the time they reached school age.

“Previous research has indicated that factors such as school absence and academic disengagement may play a role in older children with chronic illness having lower academic outcomes,” said lead study author Megan Bell of the University of Western Australia.

“Our study shows that chronic illness experienced in early childhood can increase the chances of a child starting school not ready to learn,” Bell added by email.

To explore the impact of illness on school readiness, Bell and colleagues examined government health data on children born in 2003 and 2004 who had developmental evaluations completed by teachers in 2009.

A total of 2,879 kids, or about 13 percent, had a diagnosed chronic illness. Nearly all of them had just one persistent medical problem, but 7.4 percent of this group had two or more chronic diagnoses, researchers report in the journal Pediatrics.

By far, the most common problem was ear infections, which accounted for 71 percent of the diagnoses, followed by respiratory diseases such as asthma at 27 percent.

About 3 percent of the children had epilepsy or anemia. One percent or less of the kids had other medical problems including cardiovascular disease, cancer, diabetes, malnutrition or obesity.

Illness appeared to take the biggest toll on physical and social development.

After adjusting for factors like the age, health and marital status of parents, as well as the children’s ethnicity, English abilities and socioeconomic status, researchers found chronic illness associated with 36 percent higher odds of delays in social skills.

Chronically ill kids were also 34 percent more likely to be delayed in physical abilities such as independent dressing, running and climbing, and drawing. These children also had 33 percent higher odds of delays in emotional maturity and 30 percent greater likelihood of lags in communication skills like storytelling and imaginative play.

Language and cognitive skills also suffered, with chronically ill children 19 percent more likely to have delays in these areas than their healthy peers.

One limitation of the study is that data on chronic illness came from hospital admissions, which might represent sicker children or kids without good access to primary care, the authors note. This might also mean some children classified as healthy in the study actually had chronic health problems that never resulted in hospitalization, and that some kids designated as sick might be more severely ill than other children with the same diagnosis.

Even so, the study adds to a growing body of evidence linking common childhood health problems like ear infections and asthma to developmental delays, said Michael Willoughby, a fellow in early childhood education at RTI International in Research Triangle Park, North Carolina, who wasn’t involved in the study.

“It is entirely conceivable that these two conditions are simply proxies for kids with pre-existing language and attention issues that are manifested at school entry,” Willoughby added by email, noting that these problems might be also be easier for teachers to spot.

At the same time, the study offers more evidence that academic success depends very much on health even at an early age, said Dr. Irwin Redlener, president and co-founder of the Children’s Health Fund and a researcher at Columbia University in New York.

“We need to really understand how health and education are inexorably linked,” Redlener, who wasn’t involved in the study, said by email. “This is the case for all children, but is especially important for children who face additional chronic adversities like poverty, toxic stress or chronic illness.”

SOURCE: bit.ly/1RTWfbp Pediatrics, online April 13, 2016.

Corrects publication date in Source line to April 13

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