Children and young people with inflammatory bowel disease attend less school than their healthy peers

Arch Dis Child. 2020 Jul;105(7):671-676. doi: 10.1136/archdischild-2019-317765. Epub 2020 Jan 14.

Abstract

Objective: Chronic diseases, such as inflammatory bowel disease (IBD), can impact negatively on education and social development. Examining the impact of IBD on school/college attendance for children and young people (CYP) is vital to provide targeted support to patients, families and schools.

Methods: We performed a cross-sectional survey to determine the school/college attendance rates, the reasons for absence related to IBD and facilitators or barriers to school/college attendance. In a subset of patients followed up locally, we performed a detailed review of hospital attendance data to assess healthcare burden.

Results: Two hundred and thirty-one questionnaires were given to CYP with IBD aged 5-17 years. Response rate was 74% (final sample 169). The median school/college attendance rate was 92.5%, significantly lower than all children in England (95.2%). 39.6% of children with IBD were persistently absent, defined nationally as missing 10% or more of school. Only five children (3%) had a 100% attendance record. Increasing age and use of monoclonal therapy were predictors of poor school attendance. Concerns about feeling unwell at school/college, access to toilets, keeping up with work and teachers' understanding of IBD are the main issues for CYP with IBD. There was a significant negative correlation between number of days in hospital and school attendance.

Conclusion: IBD has a significant impact on school/college attendance, with hospital attendance, disease burden and school difficulties being major factors. Employing strategies to minimise healthcare burden and developing a partnership between health and education to support children with IBD will serve to facilitate school/college attendance.

Keywords: chronic illness; education; inflammatory bowel disease; paediatric; school.

MeSH terms

  • Adolescent
  • Age Factors
  • Antibodies, Monoclonal / therapeutic use*
  • Child
  • Child, Preschool
  • Comprehension
  • Cross-Sectional Studies
  • Education / statistics & numerical data*
  • England / epidemiology
  • Faculty / psychology
  • Health Status
  • Humans
  • Inflammatory Bowel Diseases / drug therapy
  • Inflammatory Bowel Diseases / epidemiology*
  • Length of Stay / statistics & numerical data
  • Schools*
  • Surveys and Questionnaires
  • Toilet Facilities

Substances

  • Antibodies, Monoclonal