School achievement and absence in children with chronic health conditions

Families of 270 children with chronic health conditions observed in 11 subspecialty clinics at a tertiary care center were surveyed to assess the relation of demographic and health variables to school achievement and absenteeism. National achievement test scores and school days absent were compared with North Carolina state results. The mean days absent for children with chronic health conditions was 16 days, compared with the state average of less than 7 days, during the 1981-1982 academic year. The mean national achievement score for the chronically ill children was at the 51st percentile, compared with the 63rd percentile for the state's sixth graders. Log of school days absent was correlated with the number of clinic visits, physician rating of activity limitations, sex, and specific health conditions (R2 = 0.17, P = 0.001). National achievement scores were mainly related to socioeconomic factors and specific health conditions (R2 = 0.44, P = 0.001), but were unrelated to school absence. Children with spina bifida, sickle cell disease, or epilepsy, and children with the added burden of low socioeconomic status, were at particular risk for poor school achievement.