Effects of Diabetes on Learning in Children

Abstract

ABSTRACT. Objective. Subtle neuropsychological deficits have been found in some children with type 1 diabetes. However, these data have been inconsistent, and it is not clear what the impact of these deficits might be on the learning of children with diabetes over time. The purpose of this study was to determine whether type 1 diabetes significantly interferes with the development of functional academic skills. It was hypothesized that 1) children with type 1 diabetes would demonstrate deficits in academic performance and behavior when compared with sibling or classmate control subjects and 2) that academic performance in children with type 1 diabetes would decline slightly but significantly over time whereas the performance of siblings or classmates would not.Methods. Three groups of children from 5 pediatric diabetes clinics in a primarily rural Midwestern state participated in this study: children with type 1 diabetes (n ‫؍‬ 244), a sibling control group (n ‫؍‬ 110), and an anonymous matched classmate control group (n ‫؍‬ 209). The mean age of the children with diabetes was 14.8 years (standard deviation: 3.2) and of the siblings was 14.6 years (3.2); the mean grades were 8.1 (2.9) for the children with diabetes and 7.9 (3.1) for the siblings. The Hollingshead 2-factor index revealed that the children were from primarily middle-to upper-middle-class families. The mean age of onset of diabetes for the children with diabetes was 8.3 years (3.7) with a mean disease duration of 7.1 years (3.9). Because the matched classmate data were obtained anonymously, demographic information was not available on this group. Academic achievement was measured using both standardized tests and data on classroom performance. The standardized test data included scores from the Iowa Tests of Basic Skills (ITBS) for grades 3 through 8 and the Iowa Tests of Educational Development (ITED) for grades 9 through 12. Scores in 3 broad academic areas that are obtained on children of all ages were examined: math, reading, and core total (a composite score of reading, language, and math). ITBS/ITED data were obtained on all participants. School data including the number of days absent, school years repeated, and grade point averages for math and reading were obtained on the children with diabetes and their siblings. A short, 50-item screening scale (PBS-50d), adapted from the longer 165 item Pediatric Behavior Scale (PBS), was completed by the parents to obtain information on the behavioral characteristics of the children with diabetes and their siblings. Diabetes variables measured included metabolic control (HbA1c), age at onset, and disease duration. This study looked at both the current academic performance of children with diabetes and their performance over time in relation to 2 control groups: siblings and matched classmates. A crosssectional approach was used to evaluate current performance. Statistical differences between groups were evaluated using matched t tests or McNemar's test for differences between related samples as appropr...

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