Language, math scores poorer in adolescents with childhood-onset chronic rheumatic disease

Patients with childhood-onset chronic rheumatic disease (CRD) do not perform as well as their peers on grade 12 standardized testing, independent of sociodemographic and mental health comorbidities, reports a population-based retrospective cohort study.

A team of researchers identified patients with childhood-onset CRD (juvenile arthritis and systemic autoimmune rheumatic disease) from the only paediatric rheumatology centre in Manitoba, Canada, for birth cohort January 1979 to December 1998, who were linked to the provincial administrative databases containing records of healthcare use and education outcomes.

Participants were matched by age, sex, and postal codes to peers who did not have childhood-onset CRD. Using multivariable linear regression, the researchers tested the associations of childhood-onset CRD, sociodemographic, and mental health factors with the grade 12 Language Arts Achievement Index (LAI) and the Math Achievement Index (MAI) scores, the primary outcomes of this study.

A total of 5,041 patients with childhood-onset CRD were matched to 2,713 unaffected peers. The former achieved lower LAI and MAI scores compared to their peers. More patients with childhood-onset CRD failed or did not take the language arts (51 percent vs 41 percent; p<0.001) and math (61 percent and 55 percent; p=0.02) tests.

Multivariable analysis confirmed that childhood-onset CRD correlated with worse LAI and MAI results, as did lower socioeconomic status, younger maternal age at first childbirth, family income assistance, involvement with child welfare services, and mental health morbidities (between childhood-onset diagnosis and standardized testing).