Children in Denmark with cerebral palsy rarely complete elementary school
Signe V Pedersen1, Rikke Wiingreen2,3,4, Bo M Hansen3
1Department of Pediatrics and Adolescent Medicine, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark.
Insights
Children with cerebral palsy (CP) face significant challenges in the Danish school system, with a high risk of not completing elementary education. Factors like motor impairments and intellectual deficits negatively impact their academic performance.
Area of Science:
- Pediatric Neurology
- Educational Psychology
- Public Health
Background:
- Cerebral palsy (CP) significantly impacts children's development and daily functioning.
- Inclusive education systems aim to support all students, but challenges remain for children with complex needs.
- Understanding school performance in children with CP is crucial for developing effective educational strategies.
Purpose of the Study:
- To investigate the school performance of children with cerebral palsy (CP) in Denmark.
- To identify factors associated with academic success or failure in children with CP within the school system.
Main Methods:
- Population-based cohort study of 818 children with CP and 417,731 controls, born 1997-2003.
- Data extracted from national registries, evaluating completion of 10 years of elementary school and grade point averages (GPAs).
- Statistical analyses included Mann-Whitney U tests and logistic regressions to determine odds ratios (ORs).
Main Results:
- Children with CP were significantly more likely to not complete elementary school (62.6% vs 12.4%, OR=11.85).
- Children with CP achieved lower GPAs (6.6 vs 7.3) compared to peers without CP.
- Comorbidities, maternal education, motor severity, and intellectual deficits were linked to poorer school outcomes in children with CP.
Conclusions:
- Danish children with CP experience substantial educational disparities, rarely completing elementary school despite supportive initiatives.
- The complexity of individual needs in CP presents challenges for inclusive educational environments.
- Intellectual impairment is a key predictor of poor school performance in children with CP, even with apparent normal intelligence and special educational support.
Aim:
To investigate how children with cerebral palsy (CP) perform in the Danish school system and which factors are associated with school performance.
Method:
This was a population-based cohort study including 463 126 children born from 1997 to 2003. Data were extracted from seven national registries. The study encompassed 818 children with CP (483 [59.0%] males, 335 [41.0%] females) and 417 731 without CP (214 535 [51.4%] males, 203 196 [48.6%] females). We evaluated two primary outcomes: not completing 10 years of elementary school, defined as attending fewer than eight final mandatory exams; and grade point averages (GPAs). Mann-Whitney U tests were used to analyse differences in GPAs and logistic regressions were used to calculate odds ratios (ORs).
Results:
Among children with and without CP, 62.6% and 12.4% did not complete elementary school respectively (OR = 11.85 [10.28-13.66]). Additionally, children with CP who attended all final exams achieved lower overall GPAs than children without CP (6.6 vs 7.3, p = 0.001). In children with CP, comorbidities, maternal education, severity of motor impairments, and intellectual deficits were associated with increased odds of not completing elementary school. Notably, one-third of children with CP with apparent normal intelligence did not complete school, despite special educational measures.
Interpretation:
Danish children with CP rarely complete elementary school despite initiatives for a more supportive educational system. The complexity of individual needs in children with CP may be challenging for an inclusive school environment.
What This Paper Adds:
Children with cerebral palsy (CP) have a high risk of not completing elementary school. Children with CP achieve lower overall grades than children without CP. Motor impairment, comorbidities, and maternal education are associated with poor school performance. Intellectual impairment is the most important predictor of poor school performance.
