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Impact of Hospitalizations due to Chronic Health Conditions on Early Child Development
Joanna E Fardell1,2, Nan Hu3, Claire E Wakefield1,2
1Behavioural Sciences Unit, School of Women's and Children's Health, UNSW Sydney, Australia.
Insights
Hospitalization for chronic health conditions negatively impacts early childhood development, increasing the risk of developmental vulnerability. Frequent and prolonged hospital stays pose significant risks to a child's school readiness and overall well-being.
Area of Science:
- Pediatrics
- Developmental Psychology
- Public Health
Background:
- Chronic health conditions in children necessitate hospitalization, potentially affecting developmental trajectories.
- Early childhood development is a critical period for establishing foundational skills for lifelong learning and well-being.
Purpose of the Study:
- To evaluate the association between hospitalization for chronic health conditions and early child development outcomes at school entry.
- To identify specific hospitalization factors (frequency, duration, condition type) associated with developmental vulnerability.
Main Methods:
- Longitudinal cohort study utilizing population-based record linkage.
- Inclusion of 152,851 children with Australian Early Developmental Census (AEDC) data.
- Definition of developmental vulnerability (DV) and developmentally high-risk (DHR) based on AEDC scores (<10th centile).
Main Results:
- Children hospitalized with chronic conditions were more likely to be developmentally high-risk (aOR 1.25).
- Increased risk of being developmentally high-risk observed with frequent (>7 times) or longer (>2 weeks) hospitalizations (aOR 1.40 for both).
- Highest risk of developmental vulnerability associated with mental health/behavioral/developmental conditions (aOR 2.23).
Conclusions:
- Hospitalization for chronic health conditions, particularly frequent or prolonged stays, is linked to adverse early childhood development.
- Targeted research and interventions are crucial to support the developmental and well-being needs of hospitalized children with chronic conditions.
Objective:
To assess the impact of hospitalization for chronic health conditions on early child development and wellbeing at school start.
Methods:
We conducted a longitudinal cohort study of children starting school using population-based record linkage of routinely collected admitted hospital data and standardized assessment of early childhood development (Australian Early Developmental Census: AEDC). Developmental vulnerability (DV) was defined as children scoring <10th centile in any one of five developmental domains. Children scoring <10th centile on two or more domains were considered developmentally high-risk (DHR). Children hospitalized with chronic health conditions were compared to children without hospitalizations prior to school start.
Results:
Among 152,851 children with an AEDC record, 22,271 (14·6%) were hospitalized with a chronic condition. Children hospitalized with chronic health conditions were more likely to be DHR (adjusted odds ratio 1.25, 95% CI: 1.18-1.31) compared to children without hospitalizations. Children hospitalized more frequently (>7 times) or with longer duration (>2 weeks) had a 40% increased risk of being DHR (1.40, 95% CI: 1.05-1.88 and 1.40, 95% CI: 1.13-1.74, respectively). Children hospitalized with mental health/behavioral/developmental conditions had the highest risk of DHR (2.23, 95% CI: 1.72-2.90). Developmental vulnerability was increased for physical health (1.37, 95% CI: 1.30-1.45), language (1.28, 95% CI: 1.19-1.38), social competence (1.22, 95% CI: 1.16-1.29), communication (1.17, 95% CI: 1.10-1.23), and emotional maturity (1.16, 95% CI: 1.09-1.23).
Conclusions:
Frequent and longer duration hospitalizations for chronic health conditions can impact early childhood development. Research and interventions are required to support future development and well-being of children with chronic health conditions who are hospitalized.
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