Neurodevelopmental multimorbidity and educational outcomes of Scottish schoolchildren
Public Health's Dr Michael Fleming describes the findings of a study investigating prevalence of neurodevelopmental multimorbidity in Scottish schoolchildren and their educational outcomes compared to peers, published this month in PLOS Medicine
Our research team linked Scotland-wide health and education data together to identify neurodevelopmental multimorbidity among Scottish schoolchildren between 2009 and 2013.
We identified children treated for depression, attention deficit hyperactivity disorder (ADHD), autism, and intellectual disability defining multimorbidity as 2 or more of those conditions co-existing. Compared to children with no conditions, children with 1 condition, and 2 or more of these conditions, experienced increased school absenteeism and exclusion, poorer exam attainment, and increased unemployment after adjusting for sociodemographic and maternity confounders, comorbid physical conditions, and additional support needs.
Children exhibiting neurodevelopmental multimorbidity displayed significantly poorer outcomes compared to peers; therefore, merely focusing healthcare systems and training on individual neurodevelopmental conditions may disadvantage those children by failing to recognize and address their complex needs. We observed that the strongest underlying drivers of absenteeism and exclusion were depression and ADHD respectively. Early diagnoses and interventions extending beyond the health sector into schools are needed to minimise long-term adverse outcomes. We conclude that efforts should focus on interventions to improve academic attainment and reduce absence and exclusion, or their respective impact, on affected children.
First published: 28 June 2018