Department of Pediatrics and Adolescent Medicine, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark.
Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
Dev Med Child Neurol. 2023 Oct;65(10):1387-1394. doi: 10.1111/dmcn.15589. Epub 2023 Mar 27.
To investigate how children with cerebral palsy (CP) perform in the Danish school system and which factors are associated with school performance.
This was a population-based cohort study including 463 126 children born from 1997 to 2003. Data were extracted from seven national registries. The study encompassed 818 children with CP (483 [59.0%] males, 335 [41.0%] females) and 417 731 without CP (214 535 [51.4%] males, 203 196 [48.6%] females). We evaluated two primary outcomes: not completing 10 years of elementary school, defined as attending fewer than eight final mandatory exams; and grade point averages (GPAs). Mann-Whitney U tests were used to analyse differences in GPAs and logistic regressions were used to calculate odds ratios (ORs).
Among children with and without CP, 62.6% and 12.4% did not complete elementary school respectively (OR = 11.85 [10.28-13.66]). Additionally, children with CP who attended all final exams achieved lower overall GPAs than children without CP (6.6 vs 7.3, p = 0.001). In children with CP, comorbidities, maternal education, severity of motor impairments, and intellectual deficits were associated with increased odds of not completing elementary school. Notably, one-third of children with CP with apparent normal intelligence did not complete school, despite special educational measures.
Danish children with CP rarely complete elementary school despite initiatives for a more supportive educational system. The complexity of individual needs in children with CP may be challenging for an inclusive school environment.
Children with cerebral palsy (CP) have a high risk of not completing elementary school. Children with CP achieve lower overall grades than children without CP. Motor impairment, comorbidities, and maternal education are associated with poor school performance. Intellectual impairment is the most important predictor of poor school performance.
调查脑瘫（CP）患儿在丹麦学校系统中的表现，以及哪些因素与学业成绩相关。
这是一项基于人群的队列研究，纳入了 1997 年至 2003 年期间出生的 463126 名儿童。数据从七个国家登记处提取。该研究纳入了 818 名 CP 患儿（483 名男性，占 59.0%；335 名女性，占 41.0%）和 417731 名无 CP 患儿（214535 名男性，占 51.4%；203196 名女性，占 48.6%）。我们评估了两个主要结局：未完成 10 年小学教育，定义为参加的期末考试少于 8 门；以及平均绩点（GPA）。采用 Mann-Whitney U 检验分析 GPA 的差异，采用 logistic 回归计算比值比（OR）。
CP 患儿和无 CP 患儿中，分别有 62.6%和 12.4%未完成小学教育（OR=11.85[10.28-13.66]）。此外，参加所有期末考试的 CP 患儿的总体 GPA 低于无 CP 患儿（6.6 与 7.3，p=0.001）。在 CP 患儿中，合并症、母亲教育程度、运动障碍严重程度和智力缺陷与未完成小学教育的几率增加相关。值得注意的是，尽管采取了特殊教育措施，三分之一智力正常的 CP 患儿仍未能完成学业。
尽管丹麦推出了更具支持性的教育体系，但脑瘫患儿很少能完成小学教育。CP 患儿的个体需求复杂，可能对包容性学校环境构成挑战。
脑瘫患儿（CP）完成小学教育的风险较高。CP 患儿的总体成绩低于无 CP 患儿。运动障碍、合并症和母亲教育程度与学业成绩差相关。智力障碍是学业成绩差的最重要预测因素。
