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Education and employment outcomes in pediatric chronic kidney disease
Kelsey Richardson1, Ryan C Ward2, Lyndsay A Harshman2
1Department of Pediatrics, Oregon Health & Science University, 707 SW Gaines Street, Portland, OR, 97239, USA. richarke@ohsu.edu.
Insights
Children with chronic kidney disease (CKD) face educational challenges like school absenteeism and academic underachievement, impacting future employment. Interventions are needed to improve outcomes for pediatric CKD survivors.
Area of Science:
- Pediatric Nephrology
- Developmental Psychology
- Public Health
Background:
- Improved survival in pediatric chronic kidney disease (CKD) necessitates understanding long-term educational and employment outcomes.
- Existing literature indicates children with CKD, across all severities, are at risk for educational difficulties, including chronic school absenteeism.
- Neurocognitive deficits, especially in executive functioning, exacerbate academic underachievement in pediatric CKD patients.
Purpose of the Study:
- To review current knowledge on educational and employment outcomes for individuals with a history of childhood CKD.
- To identify potential interventions to enhance educational attainment in this vulnerable population.
Main Methods:
- Literature review of existing research on educational and employment outcomes in pediatric CKD.
- Analysis of factors contributing to academic underachievement, including neurocognitive deficits.
- Synthesis of findings to inform potential intervention strategies.
Main Results:
- Children with CKD experience significant educational challenges, including absenteeism and underachievement.
- Neurocognitive deficits, particularly executive dysfunction, are linked to poorer academic performance.
- Childhood academic underachievement is associated with increased risk of adult unemployment or underemployment.
Conclusions:
- Pediatric CKD survivors require targeted support to address educational disparities.
- Interventions focusing on neurocognitive deficits and academic support are crucial for improving long-term outcomes.
- Further research is needed to develop and evaluate effective interventions for this population.
Abstract:
As outcomes and survival for children with chronic kidney disease (CKD) have improved over the last 30 years, there is an emerging need to characterize and understand later educational and employment outcomes across the spectrum of pediatric CKD severity-ranging from mild CKD to requirement for dialysis and kidney transplantation. Although large-scale research on the topic of long-term educational and employment outcomes in the pediatric CKD population is relatively scarce, the existing literature does support that children across the spectrum of CKD severity are at risk for education-related difficulties including chronic school absenteeism. These education-related difficulties are compounded by well-described neurocognitive deficits-particularly in the domain of executive functioning-that may potentially perpetuate the risk for academic underachievement. This is particularly concerning given that data from the general pediatric population suggest that childhood academic underachievement is associated with higher likelihood of un-/underemployment in adulthood. This review highlights what is known about educational and employment outcomes among persons with a history of childhood CKD, as well as suggestions for interventions to improve educational outcomes for this population.
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