Factors associated with academic achievement in children with type 1 diabetes.
OBJECTIVE
To examine academic achievement in children with diabetes and to identify predictors of achievement.


METHODS
Participants were 244 children, ages 8-18 years, with type 1 diabetes. Measures included school-administered standardized achievement tests (Iowa Tests of Basic Skills and Iowa Tests of Educational Development [ITBS/ITED]), grade point averages (GPAs), school absences, behavioral assessment, age at disease onset, hospitalizations, and HbA(1c). Statistical differences between subgroups of children were evaluated using t test and ANOVA, statistically controlling for socioeconomic status. Regression analyses were carried out to examine predictors of academic performance.


RESULTS
Reading scores and GPA were lower for children with poor metabolic control than for children with average control. Children with hospitalizations for hyperglycemia had lower overall achievement scores than children with better metabolic control and fewer hospitalizations for hyperglycemia. The small group of children with tight metabolic control and hypoglycemic hospitalizations scored particularly low on the ITBS/ITED. Other variables had less clear relationships with academic achievement. Neither early onset of diabetes nor frequent school absence was associated with lower scores on the ITBS/ITED. Sex comparisons found that boys performed better than girls only in math. Socioeconomic status and parent ratings of behavior problems were significantly correlated with academic achievement, but medical variables added only slightly to predictive precision.


CONCLUSIONS
For most children with diabetes, medical variables are not as strongly associated with academic achievement as are factors such as socioeconomic status and behavioral factors. Poor metabolic control and serious hypoglycemia, however, are a potential concern for a subset of these children.
McCarthy
Ann Marie
AM
College of Nursing, The University of Iowa, Iowa City, Iowa 52242, USA. ann-mccarthy@uiowa.edu
Lindgren
Scott
S
Mengeling
Michelle A
MA
Tsalikian
Eva
E
Engvall
Janet
J
D000124:Achievement; D000223:Adaptation, Psychological; D000293:Adolescent; D017668:Age of Onset; D001786:Blood Glucose; D002648:Child; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000453:epidemiology / Q000523:psychology*; D004521:Educational Measurement; D004522:Educational Status; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D006943:Hyperglycemia / Q000453:epidemiology / Q000523:psychology; D007858:Learning; D008297:Male; D011237:Predictive Value of Tests; D017678:Sex Distribution
D001786:Blood Glucose