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Published on: September 27, 2020
Incidence of developmental disorders and special educational needs and disabilities in children in the UK
Katherine Pettinger1, Sarah Blower1, Elaine Boyle2
1Department of Health Sciences, University of York, York, UK.
Insights
Children born prematurely face higher risks of developmental disorders and special educational needs, regardless of their ethnicity. This highlights the importance of early intervention for all premature infants.
Area of Science:
- Pediatric Health
- Developmental Pediatrics
- Public Health
Background:
- Premature birth is a significant risk factor for adverse neurodevelopmental outcomes.
- Developmental disorders and special educational needs (SEN) can impact a child's long-term development and well-being.
- Understanding the influence of gestational age and ethnicity is crucial for targeted interventions.
Purpose of the Study:
- To determine the incidence of developmental disorders and SEN in a UK cohort.
- To examine the association between gestational age and the risk of developmental disorders/SEN.
- To explore the role of ethnicity in these associations.
Main Methods:
- Utilized multivariable logistic regression analysis on the Born in Bradford cohort data.
- Calculated cumulative incidence of developmental disorders and SEN up to age 12 years.
- Analyzed incidence rates of specific developmental disorders by ethnicity.
Main Results:
- Children born before full term exhibited increased odds of developmental disorders.
- Effect sizes for prematurity-associated risks were notably larger in children of Pakistani heritage.
- Significant ethnic variations in incidence rates for attention-deficit/hyperactivity disorder and learning disabilities were observed.
Conclusions:
- Preterm birth is a consistent risk factor for developmental disorders and SEN across all ethnic groups.
- Gestational age and ethnicity are important factors influencing developmental disorder risk and presentation.
- Findings underscore the need for ethnicity-sensitive developmental monitoring and support for preterm infants.
Aim:
To investigate the incidence of developmental disorders (including cerebral palsy, attention-deficit/hyperactivity disorder, and autism spectrum disorder) and special educational needs provision and to explore associations with gestational age and ethnicity.
Method:
Cumulative incidence of developmental disorders and special educational needs provision up to age 12 years/end of school year 7 respectively was explored using multivariable logistic regression in the Born in Bradford cohort, UK. Incidence rates of individual developmental disorders were calculated.
Results:
There were 13 172 children included in the analysis cohort. Birth before full term was associated with increased odds of developmental disorder compared with birth at full term: adjusted odds ratio (aOR) for those born before 34 weeks 2.22 (95% confidence interval [CI] 1.58-3.12); 34 to 36 weeks aOR 1.43 (95% CI 1.12-1.81); 37 to 38 weeks aOR 1.18 (95% CI 1.03-1.34). Effect sizes were larger among Pakistani heritage children: aOR for those born before 34 weeks 2.59 (95% CI 1.55-4.33); 34 to 36 weeks aOR 1.57 (95% CI 1.08-2.27); 37 to 38 weeks aOR 1.29 (95% CI 1.06-1.56). Unadjusted incidence rates of developmental disorders varied with ethnicity; compared with Pakistani heritage children, White British children had higher rates (per 1000 person-years) of attention-deficit/hyperactivity disorder (1.8, 95% CI 1.5-2.1 vs. 0.3, 95% CI 0.2-0.4), and lower incidences of learning disabilities (0.7, 95% CI 0.5-1.0 vs. 1.6, 95% CI 1.4-1.9).
Interpretation:
Irrespective of ethnicity, children born before full term are at increased risk of developmental disorders and/or special educational needs.
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