Chronic health conditions and school performance in first graders: A prospective cohort study

Isabell Hoffmann, Christiane Diefenbach, Christine Gräf, Jochem König, Martina F Schmidt, Kathleen Schnick-Vollmer, Maria Blettner, Michael S Urschitz and for the ikidS Study Group

PLOS ONE, 2018, vol. 13, issue 3, 1-15

Abstract: Objective: Children with chronic health conditions may perform poorer at school. Associations may be confounded by numerous social factors. We aimed to estimate the effects of a chronic health condition on overall school performance in first graders with an emphasis on rigorous adjustment for potential confounders. Methods: A population-based cohort study was performed in the area of Mainz-Bingen (Germany). In 2015 all preschoolers were approached and the presence of a chronic health condition was assessed by parental questionnaires and preschool health examination data. The identification of a chronic health condition was based on special health care needs and presence of a doctor’s diagnosis out of 24 school-relevant diseases. At the end of the first school year, overall school performance was assessed by teachers and rated on a 5-item scale ranging from -10 to +10. Results: Of 3683 children approached, 2003 were enrolled. Overall school performance was available for 1462 children (51% boys). Of these, 52% suffered from a chronic health condition. Compared to children without a chronic health condition, children with special health care needs (15%) performed worse at school (adjusted mean difference: -0.95, 95% CI: [-1.55; -0.35], P = 0.002). Children with a doctor’s diagnosis but without special health care needs (37%) did not perform worse at school. The effect was further analysed considering the extent of special health care needed. Conclusions: Chronic health conditions affect overall school performance early in primary school. To identify academically at-risk children, a chronic health condition identification based on special health care needs may be used.

Date: 2018
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Persistent link: https://EconPapers.repec.org/RePEc:plo:pone00:0194846

DOI: 10.1371/journal.pone.0194846

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