Chronic pediatric diseases and risk for reading difficulties: a narrative review with recommendations

Abstract

Literacy is a major social determinant of health, rooted in skills that develop during early childhood. Children arriving at kindergarten unprepared to learn to read are more likely to have low reading proficiency thereafter. General and health literacy are highly correlated, affecting understanding of health conditions, treatment adherence, and transition to self-care and adult healthcare services. The American Academy of Pediatrics (AAP) recommends literacy and school readiness promotion during well-visits and neurodevelopmental surveillance is emphasized across primary and subspecialty care. While genetic and environmental risk factors for reading difficulties are well-established, risks related to complex and chronic medical conditions are less appreciated and under-researched. This review applies an eco-bio-developmental framework to explore literacy across five complex chronic conditions affecting millions of children worldwide: asthma, cancer, congenital heart disease, epilepsy, and sickle cell disease. In each, integration of an efficient reading brain network may be impacted by direct factors, such as ischemia, anesthesia, and/or medications, and also indirect factors, such as altered parent–child routines, hospital stays, and missed school. By integrating literacy into care management plans for affected children, pediatric primary care and specialty providers are poised to identify risks early, target guidance and interventions, and improve academic and health outcomes. Impact While genetic and environmental risk factors for reading difficulties are well-established, risks related to complex and/or chronic medical conditions such as asthma, cancer, congenital heart disease, epilepsy, and sickle cell disease are substantial, less appreciated, and under-researched. General and health literacy are highly correlated, with implications for the understanding one’s health condition, treatment adherence, and transitioning to self-care, which is especially important for children with complex and/or chronic illness. Pediatric primary care and specialty providers are poised to integrate reading and literacy into care management plans for children with complex and/or chronic illness, including early screening, guidance, support, and interventions.

SCHOOL DIFFICULTIES in Children Cancer Survivors: A Narrative Review and a Teacher Point-of-View

“…School difficulties in CCSs are plural and induce a real impact on their QOL [8]. These difficulties remain frequent in CCSs, with a higher prevalence than children with chronic diseases [13,11,17]. The prevalence of these difficulties varies between studies and countries, and such a variation can be explained by the differences in the national educational systems of each country [9].…”

Growth and development impact of sustainable nutrition education: An experimental study

“…The preschool period is a time when children begin to adapt to their environment and may be at risk of contracting diseases (da Silva et al., 2016; Perazzo et al., 2022; Weihrauch‐Blüher & Wiegand, 2018). Diseases that can occur in childhood can also have an impact later in life (Turkel et al., 2007).…”

Rapid Online Assessment of Reading (ROAR): Evaluation of an Online Tool for Screening Reading Skills in a Developmental-Behavioral Pediatrics Clinic

“…7 Reading disorders also are more prevalent among children with chronic disease, children born prematurely, and those with understimulating home reading environments. 8,9 A quick and valid screening tool that accurately identifies children at high risk for reading disorders would be useful for many pediatric clinics, including subspecialty and primary care clinics, to recognize which children should undergo a thorough, formalized reading assessment.…”