The Presence of Asthma, the Use of Inhaled Steroids, and Parental Education Level Affect School Performance in Children

Abstract

Objective. Childhood asthma is a frequent cause of absenteeism that affects school performance. We aimed to investigate the impact of asthma on absenteeism and school performance level of elementary and high school students. Methods. Data about sociodemographics, absenteeism, and academic achievement were obtained from 1539 students attending 98 schools in Greece. School performance was assessed for the last two years of school attendance using parents' and teachers' reports and grade point average promotion. Results. The mean of the days of absence of students with asthma was higher compared to the healthy students (6.2 ± 11.7 versus 0.3 ± 3.1, resp., P < 0.001). Students with reduced healthcare use presented less absenteeism than those with increased healthcare use for asthma (4.3 ± 8.6 versus 12.4 ± 17.0 days, resp., P < 0.001). Asthma and healthcare use for asthma accounted for an overall estimated variability in absence days of 13.8% and 9%, respectively. Absenteeism was associated with poor school performance for the last two years of school (P = 0.002) and with lower grade point promotion in elementary school students (P = 0.001) but not in high school students (P = 0.316). Higher level of parental education was associated with better school performance (P < 0.001). Asthma was associated with a decreased possibility for excellent performance (OR = 0.64, P = 0.049, 95%CI = 0.41–1.00) in elementary students. Students with asthma using inhalers were four times more likely to perform excellently in elementary school (OR = 4.3, P = 0.028, 95%CI = 1.17–15.95) than their asthmatic peers with alternative asthma treatments. Conclusions. Asthma and increased healthcare use enhance school absenteeism. Inhaled steroid use and the higher parental education level were the most important predicting factors for good school performance in elementary school asthmatic children.

Does asthma affect school performance in adolescents? Results from the Swedish population‐based birth cohort BAMSE

“…A similar conclusion was made by the World Health Organization (WHO) in its review of the impact of health and health behaviors on educational outcomes . However, several more recent studies have shown a negative influence on school performance among students with asthma . To our knowledge, only 1 Swedish study has been published on asthma and school performance, and no significant association between asthma and a lower overall grade was seen in this study.…”

“…In this study, for example, we used symptoms and/or medication intake, while Sundberg et al also required a doctor's diagnosis. Others used only doctor's diagnosis, only symptoms, or both diagnosis and symptoms . Further, asthma phenotypes seem to be of importance for the outcome, as this study and others show different results for different phenotypes or severity of asthma.…”

“…Our results are in line with those of recent studies, which have shown a negative effect on school performance among students with asthma (10‐13). Kohen in Canada 2010 and Tsakiris et al in Greece 2013 showed poorer school performance among students with asthma. Kohen showed the poorest outcomes for the students with the most severe asthma, while Tsakiris et al showed the opposite that use of inhalers was significantly associated with excellent school performance.…”

Findings from a community-based asthma education fair for Latino caregivers

“…That said, when the reliability for the missed school item on the parental report-driven Children's Health Survey for Asthma has been evaluated, good internal consistency (Cronbach's a40.8) has been found across studies [33]. Furthermore, there is a well-established relationship between childhood asthma, school absenteeism and poor school performance [34,35]. Additional evidence suggests that asthma caregivers with lower QoL and associated poor child asthma control also experience more missed school days compared to better controlled asthmatic children [36].…”

Effect of asthma on school performance among intermediate school students in Riyadh city, 2015-2016

“…This might be explained by inaccurate absence records being provided by the schools. 4,5,[10][11][12][13][14] The results also showed that lower socioeconomic status was associated with poor school performance. The correlation between SES and school achievement is wellestablished in the literature.…”