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Academic Performance of Children With Sickle Cell Disease in the United States: A Meta-Analysis
Background: Students with sickle cell disease are at risk for poor academic performance due to the combined and/or interactive effects of environmental, psychosocial, and disease-specific factors. Poor academic performance has significant social and health consequences. Objective: To study academic...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8711768/ https://www.ncbi.nlm.nih.gov/pubmed/34966350 http://dx.doi.org/10.3389/fneur.2021.786065 |
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author | Heitzer, Andrew M. Hamilton, Latacha Stafford, Claire Gossett, Jeffrey Ouellette, Lara Trpchevska, Ana King, Allison A. Kang, Guolian Hankins, Jane S. |
author_facet | Heitzer, Andrew M. Hamilton, Latacha Stafford, Claire Gossett, Jeffrey Ouellette, Lara Trpchevska, Ana King, Allison A. Kang, Guolian Hankins, Jane S. |
author_sort | Heitzer, Andrew M. |
collection | PubMed |
description | Background: Students with sickle cell disease are at risk for poor academic performance due to the combined and/or interactive effects of environmental, psychosocial, and disease-specific factors. Poor academic performance has significant social and health consequences. Objective: To study academic achievement and attainment in children with sickle cell disease in the United States. Design: Medline, Embase, SCOPUS, CINAHL, ERIC, and PsycINFO were searched for peer-reviewed articles. Studies of children (ages 5–18) diagnosed with sickle cell disease of any genotype reporting academic achievement (standardized tests of reading, math, and spelling) or attainment (grade retention or special education) outcomes were included. Outcomes were analyzed using a random effects model. Achievement scores were compared to within study controls or normative expectations. Prevalence of grade retention and special education services were compared to national (United States) estimates for Black students. Age at assessment and overall IQ were evaluated separately for association with reading and mathematics scores. Subgroup analyses of reading and math scores were analyzed by cerebral infarct status (no cerebrovascular accident, silent infarct, stroke). Results: There were 44 eligible studies. Students with sickle cell disease scored 0.70, 0.87, and 0.80 (p < 0.001) SD below normative expectations on measures of reading, mathematics, and spelling, respectively. Compared to unaffected sibling and/or healthy controls (k = 8, n = 508), reading and math scores were 0.40 (p = 0.017) and 0.36 (p = 0.033) SD below expectations. Grade retention was approximately 10 times higher in students with sickle cell disease than Black students nationally. Intellectual functioning explained 97.3 and 85.8% of the variance in reading and mathematics performance, respectively (p < 0.001). Subgroup analyses revealed significant differences in reading (p = 0.034) and mathematics (p < 0.001) based on infarct status, with lower performance associated with presence of a silent infarct or stroke. Conclusion: Students with sickle cell disease demonstrate notable academic difficulties and are at high risk for grade retainment. Development of academic interventions and increased access to school support services are needed for this vulnerable population. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020179062. |
format | Online Article Text |
id | pubmed-8711768 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-87117682021-12-28 Academic Performance of Children With Sickle Cell Disease in the United States: A Meta-Analysis Heitzer, Andrew M. Hamilton, Latacha Stafford, Claire Gossett, Jeffrey Ouellette, Lara Trpchevska, Ana King, Allison A. Kang, Guolian Hankins, Jane S. Front Neurol Neurology Background: Students with sickle cell disease are at risk for poor academic performance due to the combined and/or interactive effects of environmental, psychosocial, and disease-specific factors. Poor academic performance has significant social and health consequences. Objective: To study academic achievement and attainment in children with sickle cell disease in the United States. Design: Medline, Embase, SCOPUS, CINAHL, ERIC, and PsycINFO were searched for peer-reviewed articles. Studies of children (ages 5–18) diagnosed with sickle cell disease of any genotype reporting academic achievement (standardized tests of reading, math, and spelling) or attainment (grade retention or special education) outcomes were included. Outcomes were analyzed using a random effects model. Achievement scores were compared to within study controls or normative expectations. Prevalence of grade retention and special education services were compared to national (United States) estimates for Black students. Age at assessment and overall IQ were evaluated separately for association with reading and mathematics scores. Subgroup analyses of reading and math scores were analyzed by cerebral infarct status (no cerebrovascular accident, silent infarct, stroke). Results: There were 44 eligible studies. Students with sickle cell disease scored 0.70, 0.87, and 0.80 (p < 0.001) SD below normative expectations on measures of reading, mathematics, and spelling, respectively. Compared to unaffected sibling and/or healthy controls (k = 8, n = 508), reading and math scores were 0.40 (p = 0.017) and 0.36 (p = 0.033) SD below expectations. Grade retention was approximately 10 times higher in students with sickle cell disease than Black students nationally. Intellectual functioning explained 97.3 and 85.8% of the variance in reading and mathematics performance, respectively (p < 0.001). Subgroup analyses revealed significant differences in reading (p = 0.034) and mathematics (p < 0.001) based on infarct status, with lower performance associated with presence of a silent infarct or stroke. Conclusion: Students with sickle cell disease demonstrate notable academic difficulties and are at high risk for grade retainment. Development of academic interventions and increased access to school support services are needed for this vulnerable population. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020179062. Frontiers Media S.A. 2021-12-13 /pmc/articles/PMC8711768/ /pubmed/34966350 http://dx.doi.org/10.3389/fneur.2021.786065 Text en Copyright © 2021 Heitzer, Hamilton, Stafford, Gossett, Ouellette, Trpchevska, King, Kang and Hankins. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Neurology Heitzer, Andrew M. Hamilton, Latacha Stafford, Claire Gossett, Jeffrey Ouellette, Lara Trpchevska, Ana King, Allison A. Kang, Guolian Hankins, Jane S. Academic Performance of Children With Sickle Cell Disease in the United States: A Meta-Analysis |
title | Academic Performance of Children With Sickle Cell Disease in the United States: A Meta-Analysis |
title_full | Academic Performance of Children With Sickle Cell Disease in the United States: A Meta-Analysis |
title_fullStr | Academic Performance of Children With Sickle Cell Disease in the United States: A Meta-Analysis |
title_full_unstemmed | Academic Performance of Children With Sickle Cell Disease in the United States: A Meta-Analysis |
title_short | Academic Performance of Children With Sickle Cell Disease in the United States: A Meta-Analysis |
title_sort | academic performance of children with sickle cell disease in the united states: a meta-analysis |
topic | Neurology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8711768/ https://www.ncbi.nlm.nih.gov/pubmed/34966350 http://dx.doi.org/10.3389/fneur.2021.786065 |
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