Review title - Education support services for improving school engagement and academic performance of children and adolescents with a chronic health condition

Full review here

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Do services to support the education of children and teenagers with chronic health conditions help to engage them more in school activities and improve learning outcomes?

Key Messages

‐ We are still unclear of the effect of education support interventions on school engagement, learning outcomes and the likelihood of students to return to school (during periods of wellness).

‐ There is some evidence that education support interventions may improve mental health slightly, as measured in two studies as self‐esteem, but quality of life was not measured in the studies.

‐ We need more good quality evidence, including studies undertaken beyond the USA, to help us know whether these interventions work, and what best practice models would look like.

What are education support services and why might they be helpful for children and teenagers with a chronic health condition?

For some children and teenagers, having a chronic health condition can impact on their school attendance, participation and engagement. This can reduce their ability to keep up with their peers and reach their full potential. Education support services for children and adolescents with chronic health conditions aim to prevent them from becoming disengaged from school and their education and learning when they miss school due to illness. These services can take place in hospital, regular school or community, and may target the child, family, school, hospital, community or a combination of these. They can be delivered or co‐ordinated by the parents/carers, hospital, regular school or by community‐based organisations.

What did we want to find out?

We wanted to describe educational support interventions for children and adolescents with a chronic health condition and find out what effect they had on school engagement and learning outcomes, in particular. We also wanted to see if these services had an effect on mental health and quality of life.

What did we do?

We searched health, education and social science databases, as well as other registries to find published and unpublished studies. We included studies that included children aged four to 18 years with a chronic health condition who were involved in an educational support programme. The study needed to have reported on school engagement, academic achievement, school re‐entry, mental health, quality of life or adverse outcomes to be included in the summarised evidence.

What did we find?

We found four studies that met our inclusion criteria. All studies were randomised controlled studies with a combined total of 359 participants. All four studies were from the United States of America. Three studies included children with cancer, and one study focused on children with Attention Deficit Hyperactivity Disorder (ADHD). Two of the cancer studies looked at education support programmes focused on the effect of cancer treatment on the child's memory and how fast they processed information. Mental health was measured as self‐esteem in two studies. School re‐entry was measured in one study; and quality of life was not measured in any included study. No adverse effects were measured or reported in any of the included studies.

Main results

Overall, we are uncertain whether education support interventions improve either school engagement or academic achievement. We are also uncertain whether education support interventions improve transition back to school/school re‐entry. However, we suggest there is some evidence that education support may slightly improve mental health, measured as self‐esteem. Quality of life was not measured or reported in any of the included studies.

What are the limitations of the evidence?

Overall, the certainty of the evidence was judged to be low for the mental health outcome and very low for academic achievement, school engagement and return to school. The main reasons for this were that there were different types of education support programmes trialed, conflicting results, different types and sometimes indirect measures of the outcomes across studies, a large amount of missing data and there was not enough information in the reporting of outcome data. These problems, and the small number of studies included, means we cannot make clear statements about the effects of these programmes.

How up‐to‐date is the evidence?

The evidence is up‐to‐date to January 2021.