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Original Research: ASTHMA |

Beginning School With Asthma Independently Predicts Low Achievement in a Prospective Cohort of Children

Kathleen A. Liberty, PhD; Philip Pattemore, MD; James Reid, MBChB, FCCP; Michael Tarren-Sweeney, PhD
Author and Funding Information

From the Health Sciences Center (Drs Liberty and Tarren-Sweeney) and the School of Educational Studies and Human Development (Dr Liberty), University of Canterbury, Christchurch, New Zealand; the Department of Paediatrics (Dr Pattemore), Christchurch School of Medicine, University of Otago, Christchurch, New Zealand; the Department of General Practice and Rural Health (Dr Reid), Dunedin School of Medicine, University of Otago, Dunedin, New Zealand; and the Centre for Brain and Mental Health Research (Dr Tarren-Sweeney), University of Newcastle, Newcastle, NSW, Australia.

Correspondence to: Kathleen A. Liberty, PhD, Health Sciences Centre, University of Canterbury, PB 4800, Christchurch, New Zealand; e-mail: kathleen.liberty@canterbury.ac.nz


Funding/Support: This work was supported by the Asthma and Respiratory Foundation of New Zealand and (in part) by the internal grants program of the University of Canterbury.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (http://www.chestpubs.org/site/misc/reprints.xhtml).


© 2010 American College of Chest Physicians


Chest. 2010;138(6):1349-1355. doi:10.1378/chest.10-0543
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Background:  Concerns about the achievement of children with asthma and respiratory conditions are especially important in New Zealand, which has one of the world’s highest rates of childhood asthma. The present study evaluated whether entering school with asthma was associated with low achievement after the first year.

Methods:  A child cohort was recruited to a prospective study at time of first enrollment into randomly selected schools in Christchurch. Parent interviews covered demographics and respiratory status. Physician reports were sought for children with asthma, and all respiratory information was clinically reviewed. The children’s achievement in reading and math was individually assessed at school entry and reassessed after 12 months. Schools reported absences. Intelligence subtests were administered.

Results:  Two hundred ninety-eight children were recruited, including 55 (18.5%) with current asthma. At 1-year follow-up, retention was 93.7%. Children who entered school with asthma were more likely to be ≥ 6 months behind other participants in reading words (P = .023) and books (P = .026), but not in math (P = .167) at the end of the first year of school. Achievement was not related to asthma severity. Entering school with asthma reliably predicted low reading achievement independent of other known covariates of low achievement (high absenteeism, minority status, male gender, single-parent family, poor academic skills at school entry, and low socioeconomic status).

Conclusions:  Entering school with asthma was a significant predictor of low achievement in reading at 12-month follow-up, independent of asthma severity, high absenteeism, or other covariates of low achievement.

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