Impact of Juvenile Idiopathic Arthritis on School Attendance and Performance

Abstract

Juvenile idiopathic arthritis (JIA) includes a group of disorders characterized by chronic arthritis. It is the most common chronic rheumatic illness in children and is a significant cause of morbidity, disability and dysfunction. Therefore, the potential for school attendance and academic performance become compromised and these children are often confronted with educational difficulties. Objectives: To assess the impact JIA on academic difficulty, academic performance, potential causes of absenteeism, school failure and relationship between schooling and different types of JIA. Materials and Methods: All school going JIA patients between 6-16 years of age who had at least 2 years of schooling (1 year before disease onset and 1 year during the course of disease) were included for the analysis. Two hundred JIA patients were selected by purposive sampling method. A detailed questionnaire was completed for each participant which included socio-demographic, clinical and laboratory characteristics, data related to schooling, academic difficulties and their causes, absenteeism and causes, sports and cultural activities, school failure and school re-entry if any. Fifty four controls were taken who were the healthy sibs of those JIA patients having at least 2 previous years of schooling. Results: Mean age of JIA patients were 10.8 years, 67% were male and male female ratio was 2:1. Academic difficulties were observed for reading, writing and both due to disease process and deformity. Number of absent days and poor attendance in examination was significantly higher in JIA patients (p value < 0.001). Moreover, in case group, only 18% had improved result than the academic year prior to disease onset, 3% had no change, 57% deteriorated and 22% stopped schooling. There were 44 cases of school failure among JIA patients, 30 had school re-entry. No children had school failure or re-entry among the control group. Multiple causes of absenteeism like flare, hospitalization, side effects of drugs, movement difficulties, parental non-interest and some other factors like rainfall, delayed rising from sleep etc co-existed for most of the cases. In control group, mean percentage of absenteeism was 1.6%, mostly due to some febrile illness, cold weather, rainfall, lack of transport, sickness of caregiver etc. Children who did not participate in sports activities were 9.3% in control group and 48.5% in case group (p value < 0.001). Conclusion: It is evident from this study that JIA has negative impact on schooling characterized by poor attendance and academic performance.

Efficacy and safety of tofacitinib in the treatment of refractory cases of polyarticular course juvenile idiopathic arthritis: A study from Bangladesh

“…In this prospective observational study, there was male predominance. Similar results with male predominance was found in few other studies done in our country 18‐20 . The reason for male predominance in our country could be due to male preferences in all aspects in family and society.…”

Effectiveness of eHealth and mHealth Interventions Supporting Children and Young People Living With Juvenile Idiopathic Arthritis: Systematic Review and Meta-analysis

“…In fact, no significant difference was reported [ 65 , 69 ], and absenteeism from school decreased [ 65 ]. These findings are encouraging, especially considering the related impact JIA can have on reducing academic performance, as depicted by Bouaddi et al [ 99 ] and Laila et al [ 100 ]. Although these findings are limited, they will add to the growing body of evidence reporting that exercise therapy is well-tolerated by children and young people with JIA [ 98 , 101 , 102 ], further supporting physical activity as a helpful and necessary treatment modality, improving adherence [ 24 , 103 ].…”

Supporting Primary School Children with Juvenile Idiopathic Arthritis: A Qualitative Investigation of Teaching Staff Experiences

“…Accumulating evidence highlights how children with JIA report significant school absence due to JIA [ 10 , 11 , 12 ], with school absence associated with more severe disease in subsequent years [ 9 ]. In addition to school absence, children also report experiencing challenges with managing JIA in a school setting.…”

“…While useful, such studies are not specific to the requirements of supporting a child with JIA in a school setting as JIA management includes specific characteristics which may differ from those of management of chronic pain such as joint flares and management of biological therapies. Additionally, most studies which have looked at the school-related experiences of children and young people with JIA have included age-related eligibility criteria which span both primary and secondary school ages (e.g., [ 10 , 11 ]). Such a wide age range neglects to acknowledge the many differences between primary and secondary schools.…”