Classroom attention in children with Type 1 diabetes mellitus: The effect of stabilizing serum glucose

Daley, Kelly B.; Wodrich, David L.; Hasan, Khalid

doi:10.1016/j.jpeds.2005.08.076

Cited by 51 publications

(15 citation statements)

References 23 publications

(22 reference statements)

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“…Overall, given these findings, it might be tempting to think that supplanting conventional with intensive therapy could enhance some areas of school performance and academic success among struggling students with T1DM. Supporting this hypothesis, findings from a recent study by Daley et al demonstrated that switching four boys with previously unstable daily serum glucose to an insulin pump produced dramatic improvements in classroom attention (e.g., averaging a 20% increase in on-task behavior and a 34% decrease in off-task behavior) (16). However, in the current study, when statistical significance is found, the effect sizes associated with intensive therapy remain relatively small (explaining approximately 5% of the variances) and the inattention dimension was not itself significantly associated with type of therapy.…”

Section: Discussionmentioning

confidence: 95%

“…Crucially, the extant literature comprises primarily clinic-based studies using standardized psychometric tests, often with little or no school-based data (e.g., teachers' ratings of academic success and classroom attention). Furthermore, although smaller scale studies imply that improving glycemic control enhances classroom performance (16), no known study has addressed the link between an array of medical variables and basic classroom performance.…”

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confidence: 99%

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Type 1 diabetes mellitus and school: a comparison of patients and healthy siblings

2009

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Children and adolescents with type 1 diabetes mellitus (T1DM) are at risk for a variety of problems at school. Well-controlled studies using data collected in schools, however, are limited. The purposes of this study are to determine whether selected school problems are associated with T1DM and to investigate an association between these problems and medical variables. Teachers rated 95 diabetic students (M = 11.8; SD = 3.0 yr old) and 95 of their siblings (M = 12.1; SD = 3.0 yr old) regarding academic skills, work completion, day-to-day variability, and classroom attention. Medical and school records also were accessed. The T1DM group had lower academic skills ratings overall (p < 0.02), especially in writing (p < 0.01), a trend toward poorer classroom attention (p < 0.08), and many more missed school days (p < 0.001). Diabetics on intensive therapy protocols had better academic ratings overall (p < 0.02), including in math (p < 0.03) and fewer missed school days (p < 0.03), but they unexpectedly were rated as having more classroom behaviors that jeopardize work completion (p < 0.05) than counterparts on conventional therapy. Among all diabetics, glycated hemoglobin (HbA(lc)) levels were moderately related to each academic skill rating (r = -0.34 to -0.37; p < 0.01) and strongly related to classroom attention (r = 0.53; p = 0.000). T1DM itself appears to be a relatively minor influence to several important aspects of school. Furthermore, although intensive therapy alone may well promote school success, meticulous glycemic control, however achieved, appears more important in mitigating prospective classroom attention and academic problems.

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Section: Discussionmentioning

confidence: 95%

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confidence: 99%

Type 1 diabetes mellitus and school: a comparison of patients and healthy siblings

2009

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“…These criteria match the nature of T1DM and its implications for classroom functioning. For example, attention, finemotor, and cognitive deficits have been observed during hypoglycemic periods (Daley et al, 2006;Dey et al, 1997;Rovet & Alvarez, 1997), but diminish once blood glucose returns to normal levels (Kail et al, 2000). Therefore, a classroom accommodation that takes into account the transient nature of deficits is defined as a disease-specific accommodation.…”

Section: Methodsmentioning

confidence: 99%

The effect of sharing health information on teachers' production of classroom accommodations

Cunningham

Wodrich

2006

Psychol. Schs.

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Ninety elementary-school teachers read information about a hypothetical student experiencing school-related problems due to Type 1 diabetes mellitus (T1DM), generated classroom accommodations to assist the student, and rated their confidence in these accommodations. Each teacher was provided one of three levels of information about T1DM: (a) no disease information, (b) basic disease information, and (c) basic disease information + classroom implications. Providing teachers with more information about T1DM increased their ability to accommodate a student's learning needs. Similarly, a lower proportion of disease-specific accommodations were generated by teachers receiving no disease information (37%) than by teachers receiving basic disease information or basic disease information ϩ classroom implications, and the later two groups were equivalent (47% for each). This study and future work concerning the effect of chronic illness on classroom performance and adjustment have implications for medical professionals, teachers, and school psychologists.

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“…Apart from its physical benefits, optimal glycemic control may also help students succeed in school. For example, Daley, Wodrich, and Hasan (2006) recently studied four boys with unstable blood glucose using a multiple baseline design. As each boy received an insulin pump, a procedure that stabilized his blood sugar, improvements co-occurred in the percentage of on-task and off-task behavior as he completed seatwork in his classroom (e.g., off-task behavior, on average, decreased by 25%; on-task behavior, on average, improved by 17%).…”

Section: Type 1 Diabetes Mellitusmentioning

confidence: 99%

School‐based tertiary and targeted interventions for students with chronic medical conditions: Examples from type 1 diabetes mellitus and epilepsy

Wodrich

Cunningham

2007

Psychology in the Schools

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Approximately 15% of children experience a significant illness prior to age 18 years. For many of them, school absenteeism, substandard academic performance, and social problems ensue. When disorders affect the central nervous system, some suffer global developmental delays or selective neuropsychological deficits. As health service providers, school psychologists understand both the educational process and the ways in which childhood illnesses can impact it. This article argues that school psychologists' breadth of knowledge enables consultation with teachers about health-related classroom accommodations and communication between medical professionals and educators. Epilepsy and type 1 diabetes mellitus are two conditions associated with a risk of school problems. Using these two disorders as examples, this article outlines roles for school psychologists and provides specific guidance about how they can promote success among all students with chronic illnesses. C 2007 Wiley Periodicals, Inc.The first decade of the 21st century may be a turning point in school psychologists' practice due to the 2004 reauthorization of the Individuals with Disabilities Education Act (PL 108-446), which now encourages consultative services when students present with learning problems. As a result, gatekeeping-associated psychoeducational testing, sometimes equated with perfunctory IQ testing, may be greatly diminished by new guidelines for specific learning disability determination. If these legislative changes extend to practice, school psychologists may have more flexibility to consider practice alternatives. Division 16 of the American Psychological Association and the National Association of School Psychologists have advocated for health promotion for all students and focused consultation for the relatively few with documented illness (American Psychological Association, Division 16, 1998;Ysseldyke et al., 2006). This article concerns the second task-how to help students with recognized health problems and, in doing so, forge new and expanded ways to practice.School psychologists' concern with health-related issues is expanding. A literature search, which reviewed studies published in leading school psychology journals over a 21-year period, found that the publication of health-related articles has significantly increased (Wodrich & Schmitt, 2003). Furthermore, diverse health disorders (e.g., asthma, cancer, diabetes, epilepsy) are now addressed in these journals. Empirical information now appears regarding routine psychological practices that encompass health issues. For example, Carlson, Demaray, and Hunter-Oehmke (2006) found that 62% of school psychologists surveyed said that they collaborate with health care professionals in psychotropic medication trials. In another practitioner survey, Wodrich and Spencer (in press) found that more than 95% of school psychologists were currently involved in identifying students for other health impairment (OHI) services, including those with epilepsy, asthma, diabetes, and cancer.Frequen...

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Classroom attention in children with Type 1 diabetes mellitus: The effect of stabilizing serum glucose

Cited by 51 publications

References 23 publications

Type 1 diabetes mellitus and school: a comparison of patients and healthy siblings

Type 1 diabetes mellitus and school: a comparison of patients and healthy siblings

The effect of sharing health information on teachers' production of classroom accommodations

School‐based tertiary and targeted interventions for students with chronic medical conditions: Examples from type 1 diabetes mellitus and epilepsy

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