title: Impact of chronic illness timing and persistence at school entry on child and parent outcomes: Australian longitudinal study.
abstract: OBJECTIVE
  To understand the prevalence and timing of child chronic illness at school entry; associations with child learning, behavior and health-related quality of life and parent mental health at ages 6 to 7, 8 to 9, and 10 to 11 years; and cumulative health care costs.
  
  
  METHODS
  Data were drawn from the first 4 waves of the Longitudinal Study of Australian Children. Children were aged 4 to 5 years at wave 1, with data collection every 2 years. Parent-reported timing of child chronic illness at school entry was categorized into 4 chronic illness groups based on changes between waves 1 and 2: none, resolving, incident and persistent. Child outcomes included: parent-reported quality of life, parent- and teacher-reported behavior, teacher-reported child learning, teacher-reported child-teacher relationship, directly assessed nonverbal and verbal cognition and parent self-reported mental health. Linear regression, adjusted for gender and socioeconomic position, was used to quantify longitudinal associations between chronic illness timing at school entry with outcomes at age 6 to 7 years, 8 to 9 years and 10 to 11 years.
  
  
  RESULTS
  Of the 4983 children enrolled in the study, chronic illness data was available for 4464 children (89.6%) at both waves 1 and 2. From wave 1, 6.1% had a condition that persisted until wave 2, while 14.1% had a condition that resolved. Furthermore, 4.7% had a newly emerging condition at wave 2. Compared with the no chronic illness group, children with persistent or emerging chronic illness during school entry had the poorest outcomes (except father's mental health) at all time points, while children with resolving conditions had smaller differences.
  
  
  CONCLUSIONS
  Child chronic illness at school entry is associated with poorer longitudinal child and maternal outcomes. Therefore, future research should aim to determine the risk and protective factors that contribute to the poorer child and parent outcomes experienced in this growing population.
authors.affiliation: Royal Children's Hospital Education Institute, Parkville, Victoria, Australia; Murdoch Childrens Research Institute, Parkville, Victoria, Australia; The University of Melbourne, Parkville, Victoria, Australia. Electronic address: jon.quach@mcri.edu.au.
authors.forename: Jon
authors.initials: J
authors.lastname: Quach
authors.affiliation: Royal Children's Hospital Education Institute, Parkville, Victoria, Australia; Murdoch Childrens Research Institute, Parkville, Victoria, Australia; The University of Melbourne, Parkville, Victoria, Australia.
authors.forename: Tony
authors.initials: T
authors.lastname: Barnett
mesh_terms: D000328:Adult; D001315:Australia / Q000453:epidemiology; D002648:Child; D002652:Child Behavior / Q000523:psychology*; D002908:Chronic Disease / Q000453:epidemiology / Q000523:psychology*; D003430:Cross-Sectional Studies; D005260:Female; D006304:Health Status; D006801:Humans; D007858:Learning; D016014:Linear Models; D008137:Longitudinal Studies; D008297:Male; D008603:Mental Health; D015999:Multivariate Analysis; D010290:Parents / Q000523:psychology*; D015995:Prevalence; D011788:Quality of Life / Q000523:psychology*; D012574:Schools; D013997:Time Factors
keywords: chronic illness; longitudinal; population-based study; school entry