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Despite barriers, children with IBD can still succeed in school
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Even with all the complications presented by their disease, children with inflammatory bowel disease can still achieve results in school comparable to their peers. However, some subgroups might need extra attention to avoid a negative impact on their school performance.
In a study published in Inflammatory Bowel Diseases, Petter Malmborg, MD, PhD, of the clinical epidemiology unit at Karolinska University Hospital in Sweden, and colleagues wrote that just like IBD in older patients, childhood-onset IBD could have an impact beyond disease symptoms, including for educational and psychological development.
“To face IBD during the formative childhood years might have a deep negative impact on school achievements,” they wrote. “Low grades from the nine years of compulsory school seem to be a strong negative predictor for higher education later in life and is associated with increased risks for psychosocial problems and reduced psychiatric and somatic health in adult age.”
Researchers analyzed data from Swedish health registers to explore the link between IBD and school results. They identified 2,827 children with IBD (1,207 with Crohn’s disease; 1,370 with ulcerative colitis) and matched them with 10 reference individuals by age, sex, birth year and place of residence (n = 28,235).
Investigators used final compulsory school grades (0–320 grade points) and qualifications for high school to analyze the association of IBD with school performance.
Although they had a lower final grade point average (adjusted mean grade difference [AMGD] = –4.9; 95% CI, –7.1 to –2.6), children with IBD were not at any significantly higher risk for qualifying for high school (OR = 1.14; 95% CI, 0.99–1.31). Researchers found that patients with CD (AMGD = –4.7; 95% CI, –8.2 to –1.2) and UC (AMGD = –5.5; 95% CI, –8.7 to –2.3) had similar final grade point averages.
However, Malmborg and colleagues found that underperformance in school was more common among certain subsets of patients, particularly in children who could be grouped by markers associated with long-standing, severe intestinal inflammation, including patients in need of surgery. Patients who received more than 30 days of inpatient treatment had lower grade point averages than their peers (AMGD = –18.1; 95% CI, –25.8 to –10.4).
“Children who present with acute severe colitis or significant intestinal or perianal damage and whose early disease course is accompanied by objective markers of persistent inflammation should be identified, treated and monitored as risk patients,” they wrote. “Our study suggests that school attendance and performance of these children at risk should be evaluated systematically and continuously, and if there is any tendency to declining school results, they should be provided educational support to minimize the negative impact of chronic disease.” – by Alex Young
Disclosures: Malmborg reports support from grants from Karolinska Institutet foundations, the Swedish Medical Society (Bengt Ihres fond), Magtarmfonden, and the Bengt Ihre foundation. Please see the full study for all relevant financial disclosures.
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