Picture: Pexels
Major new Welsh research has revealed how the combination of congenital anomalies, socioeconomic deprivation and other aspects of children’s health and educational circumstances influences their attainment.
The study suggests that while children with major congenital anomalies were less likely to achieve national academic standards, the influence of socioeconomic deprivation was even more pronounced.
The researchers say this raises important questions about how health, education and social disadvantage interact throughout childhood. Children living with both disability and deprivation may need greater health, education and social support, and the team would like to see more integrated provision across health, education and social services being explored.
The study was led by Professor Sue Jordan alongside data scientists Ieuan Scanlon and Dr Anna Rawlings, from Swansea University’s Faculty of Medicine, Health and Life Science, with collaborators from Public Health Wales, Ulster University, Mathematica Policy Research (USA), and City St George’s, University of London. It forms part of the EUROlinkCAT project funded by the European Union’s Horizon 2020.
Educational attainment is closely associated with life chances, quality of life and health. For children living with major congenital anomalies, the challenges of ill-health, disability, hospitalisation and additional learning needs may all affect their experience of school.
The researchers examined children born in Wales between 1998 and 2007 and followed their records through to 2019. Educational attainment was assessed at age 11 and 16 including performance at Key Stage 2 and achievement of five GCSEs at grades C–A*, including English or Welsh, mathematics and science. The study included more than 256,000 children at age 11 and more than 128,000 at age 16.
At the heart of the research was the Secure Anonymised Information Linkage (SAIL) Databank, a Trusted Research Environment (TRE) which made it possible to bring together information from different parts of children’s lives in an anonymised secure data environment.
The researchers linked routinely collected records, including the National Child Community Health Database, birth and death records, hospital admission records, the Welsh Congenital Anomaly Register and Information Service (CARIS) and information on free school meal eligibility, SEN provision and educational results.
At age 11, 81.9 per cent of children with major congenital anomalies achieved the relevant educational standard, compared with 93.8 per cent of children without. At age 16, 46.8 per cent of children with major congenital anomalies achieved five GCSEs at grades C–A*, including English or Welsh, mathematics and science, compared with 56.1 per cent of children without.
However, the researchers found that socioeconomic deprivation was particularly strongly associated with attainment. Among children in the most deprived group (fifth of the population), just 29.7 per cent of those with major congenital anomalies and 38.4 per cent of those without achieved the five-GCSE standard. In the least deprived group, attainment rose to 67.6 per cent and 75 per cent, respectively.
SEN provision narrowed differences between children with and without major congenital anomalies, but did not completely close the attainment gap. Children experiencing the combination of major congenital anomalies, deprivation, poor access to services, and additional health needs were among those least likely to achieve the national standards.
Professor Jordan said: “Children with major congenital anomalies from the least deprived group were more likely to achieve the five GCSEs than children without major congenital anomalies from more deprived groups. Differences between rich and poor are unsurprising – it is the two- to four-fold discrepancy that warrants the attention of a wider audience.”
The findings point to the importance of joined-up support for children whose health needs and socioeconomic circumstances place them at greater risk of educational disadvantage.