Time in hospital sets back tens of thousands of children's learning each year, but targeted support can help them catch up

NAPLAN^[1] scores can tell us about a child’s learning, but can they also help us to support learners who have had a serious injury or a long-term chronic illness like asthma or epilepsy?

Children who spend time in hospital for these reasons miss out on time in class and are at risk of performing below the national minimum standard^[2] (NMS) in numeracy and literacy as measured by NAPLAN. A serious injury or chronic illness can have a cumulative effect, resulting in lower educational performance, non-completion of high school, and potentially limiting their social, educational and later employment opportunities.

Knowing these risks in advance means parents and educators can plan to support children before the shock of poor school or NAPLAN results.

Read more: Every teacher needs to be a literacy teacher – but that's not happening in most Australian schools^[3]

Serious injury, asthma, mental health, epilepsy and diabetes impact more than a million children each year. More than 100,000 end up in hospital.

We compared their NAPLAN results with kids of the same age and gender who lived in the same area but who had not been hospitalised for those conditions. We found spending time in hospital for these conditions did set back learning, with the exception of type 1 diabetes.

What did the study find?

Injury

About 70,000 people^[4] under the age of 16 are hospitalised with an injury each year in Australia. This can disrupt their ability to attend school or concentrate and learn.

Recovery from injury can be unpredictable. Some young people may fully recover. Others experience ongoing difficulties at school.

Compared to matched peers^[5], students who had been hospitalised with an injury had a 12% higher risk of not achieving the NMS in numeracy on NAPLAN and a 9% higher risk of not achieving the NMS in reading.

Asthma

Around 460,000 young people^[6] have asthma in Australia. If asthma is not adequately controlled, it can have a wide-ranging impact on their lives, including on their performance at school.

Our analysis^[7] of 28,114 young people hospitalised with asthma showed a difference between the sexes. Young males’ risk of not achieving the NMS was 13% higher for numeracy and 15% higher for reading compared to matched peers. In contrast, females hospitalised with asthma showed no difference.

Mental illness

Around 14% of young people experience a mental illness in Australia that can affect their health, relationships and school life. In our study^[8] of 7,069 young people hospitalised with a mental illness, young males had almost twice the risk of not achieving the NMS on NAPLAN for both numeracy and reading compared to their peers. Young females had a 1.5 times higher risk of not achieving the NMS for numeracy and those with diagnosed conduct disorder^[9] had twice the risk of not achieving the NMS for reading.

Read more: The transition into adolescence can be brutal for kids' mental health – but parents can help reduce the risk^[10]

Epilepsy

Across the country, about one in 200 children^[11] are living with epilepsy. Epilepsy can affect attention, concentration and memory, all which can be a barrier to performing well at school.

Our study^[12] of 2,383 young people hospitalised with epilepsy found young males and females had a three times higher risk of not achieving the NMS on NAPLAN for both numeracy and reading compared to peers.

Type 1 diabetes

Type 1 diabetes was the exception and showed no adverse impact on school performance. In Australia, an estimated 6,500 young people have type 1 diabetes. Our analysis^[13] of 833 young people hospitalised with type 1 diabetes did not find any difference in achieving the NMS in numeracy or reading on NAPLAN compared to matched peers.

This finding is likely explained by improved glucose control and type 1 diabetes management. It is also possible that school assessments, such as NAPLAN, do not capture everyday difficulties that students with diabetes experience.

Read more: What parents can do to make a child's chronic illness easier^[14]

How can we support these students’ learning?

It is essential that we identify students who are likely to need learning support because of an injury or chronic illness. Supports can include online learning options, flexible programming or mobilising peer support to enable sharing of class notes and homework activities.

Monitoring students’ progress when they return to school will help to identify ongoing learning support needs.

There are also ways to manage symptoms and enhance performance at school. With asthma, for example, a comprehensive asthma management plan, using medication to manage symptoms, and healthcare co-ordination^[15] between GPs, hospitals and community services can all reduce the chance of ending up in hospital. For epilepsy, learning to identify seizure triggers, lifestyle and medication management are key^[16].

Improving teachers’ understanding of symptom management for chronically ill or injured students is important too. For example, a New South Wales program, Aiming for Asthma Improvement in Children^[17], encourages self-paced training for school staff on asthma management and first aid, along with resources for managing asthma in schools. For epilepsy, Strong Foundations provides advice^[18] on the skills children with epilepsy need to manage in the classroom and playground.

Early identification and recognition that an injured or chronically ill student may need learning support at school and at home are critical to ensure they are not left behind academically.

References

1. ^{^} NAPLAN (www.nap.edu.au)
2. ^{^} national minimum standard (www.nap.edu.au)
3. ^{^} Every teacher needs to be a literacy teacher – but that's not happening in most Australian schools (theconversation.com)
4. ^{^} 70,000 people (doi.org)
5. ^{^} Compared to matched peers (doi.org)
6. ^{^} 460,000 young people (www.aihw.gov.au)
7. ^{^} analysis (doi.org)
8. ^{^} study (doi.org)
9. ^{^} conduct disorder (www.betterhealth.vic.gov.au)
10. ^{^} The transition into adolescence can be brutal for kids' mental health – but parents can help reduce the risk (theconversation.com)
11. ^{^} one in 200 children (epilepsyfoundation.org.au)
12. ^{^} study (doi.org)
13. ^{^} analysis (doi.org)
14. ^{^} What parents can do to make a child's chronic illness easier (theconversation.com)
15. ^{^} healthcare co-ordination (www.schn.health.nsw.gov.au)
16. ^{^} key (www.epilepsy.org.au)
17. ^{^} Aiming for Asthma Improvement in Children (education.nsw.gov.au)
18. ^{^} advice (www.epilepsy.org.au)