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Kids hospitalised with chronic illness up to three times more likely to fall behind at school

The first large-scale study to measure the academic outcomes of children hospitalised with a chronic condition finds one in every 10 kids under the age of 14 live with a chronic health condition (which can include heart disease, diabetes and asthma) that affects many areas of a child’s life.

A big data study from UNSW Sydney and University of Sydney has used data from Australia’s standardised school assessment, the NAPLAN, to find out just how much children hospitalised with chronic illness are falling behind.

The NAPLAN test – which children in grades 3, 5, 7 and 9 need to sit annually – measures students’ academic skills in reading, writing, spelling, numeracy, grammar, and punctuation.

Co-senior author of the study Professor Natasha Nassar, paediatric epidemiologist and chair of translational childhood medicine at the University of Sydney, says that while the NAPLAN isn’t the be all and end all, it does give a population level and standardised view of how well children are performing over time.

“The NAPLAN gives us a snapshot of how those children are going and lets us look at how their educational trajectories develop over time,” she says.

“Our results show that although one in 20 children may miss the NAPLAN test, this was double (10 per cent) for those hospitalised with a chronic condition,” says co-senior author of the study Raghu Lingam, a professor in paediatric population health at UNSW Medicine & Health and paediatrician at Sydney Children’s Hospitals Network.

“Nearly 40 per cent of the most severely affected children – that is, those that were hospitalised more than seven times or more than 15 days – didn’t even take the NAPLAN test.

“Those children hospitalised with a chronic condition that did sit the NAPLAN test were at a 30-60 per cent increased risk of not meeting national minimal standards.”

The researchers analysed data from a population group of all children born in NSW between 2000 and 2006, with a focus on their NAPLAN results when they were in grades 3, 5 and 7. While the available dataset only included results from public schools (over 300,000 children in total), it still accounted for about two thirds of students in NSW.

Around 16-18 per cent of students in these grades had been hospitalised with a chronic condition before their scheduled NAPLAN tests, which the team identified using a combination of routine birth records and hospital admission records.

Alarmingly, the more hospital admissions or bed-days a child had – regardless of their type of chronic condition – the poorer their academic performance.

Finding more support

Currently, children with physical or behavioural disabilities receive support from government and schools to help their access to education, via Schools for Specific Purposes, access to specialist support teachers and tailored learning and support programs and resources.

But children hospitalised due to chronic illness often fall through these support gaps.

“There is no standardised model of care or policy related directly to children with chronic illness,” says Dr Fardell.

“While there’s support in place for children identified as having a disability, there is this whole other population that just aren’t being served under the current set of policies and support structures.”

Dr Nan Hu, co-lead author of the paper and research fellow at the UNSW School of Women’s and Children’s Health, says integrated interventions will go a long way in helping these students.

“We need to offer more help to those children affected with chronic conditions – in particular, those who are hospitalised,” he says.


Information published in Archives of Disease in Childhood,

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