Influence of early childhood burns on school performance: An Australian population study

Authors

Nadin Azzam, University of New South Wales
Ju Lee Oei, University of New South Wales, Royal Hospital For Women
Susan Adams, University of New South Wales, Sydney Children's Hospital
Barbara Bajuk, NSW Pregnancy and Newborn Services Network
Lisa Hilder, University of New South Wales
Abdel-Latif Mohamed, Centenary Hospital for Women and Children
Ian M. R Wright, University of WollongongFollow
Andrew J A Holland, University of Sydney, Children's Hospital At Westmead

RIS ID

131869

Publication Details

Azzam, N., Oei, J., Adams, S., Bajuk, B., Hilder, L., Mohamed, A., Wright, I. M. R. & Holland, A. J. A. (2018). Influence of early childhood burns on school performance: An Australian population study. Archives of Disease in Childhood, 103 (5), 444-451.

Abstract

Objectives: To determine the influence of burn injuries on childhood performance in national standardised curriculum-based school tests.

Design: Birth and health records of 977 children who were hospitalised with a burn injury between 2000 and 2006 in the state of New South Wales, Australia, were linked to performance scores in the National Assessment Program: Literacy and Numeracy test, a compulsory nationwide curriculum-based test (CBT) and compared with children who were not hospitalised for burns and who were matched for birth year, gender, gestation and socioeconomic status.

Main outcome measures: Test scores in years 3 (ages 8–9), 5 (ages 10–11) and 7 (ages 13–14) in numeracy, writing, reading, spelling, grammar and punctuation.

Results: Mean age at first burn injury was 28 months (median: 20, range: 0–140). Children with burns were significantly more likely to have younger mothers (28.5 vs 29.6 years) (P<0.001), be indigenous (OR 2.5 (95% CI 2.1 to 3.1)) (P<0.001) and have siblings (OR 1.2 (95% CI 1.1 to 1.4)) (P<0.001). They were also less likely to meet national minimum standards in most domains of testing until year 5, even after adjustment for parental education levels, parental smoking, maternal age and indigenous status. Each 10% increase in total body surface area burnt was associated with a decrease in year 5 scores by 37.0% in numeracy and 71.9% in writing.

Conclusions: Most childhood burn injuries occur before the start of formal schooling. Children who are hospitalised for burns perform more poorly in CBT even after accounting for family and socioeconomic disadvantage. Rehabilitation of children with burn injuries must address school performance to decrease any long-term negative societal impact of burns.