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Download - Code Red: The Critical Condition of Health in Texas

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average (Field et al., 2001). There is also evidence that co-morbidity of diabetes and depression affectsapproximately 20% of youth with type 1 compared to 7% of youth without diabetes; but little is knownabout depression in youth with diabetes (Grey et al., 2002). A 1994 meta-analysis of 60 studies ofdepressive symptoms among children and adolescents with chronic medical problems (Bennett D. S.,1994) suggests that children with certain disorders (e.g., asthma, recurrent abdominal pain, sickle cellanemia) may be at greater risk of depressive symptoms than children with other disorders (e.g., cancer,cystic fibrosis, diabetes mellitus).Limitations. The validity of findings on depression and academic performance are limited by measurementissues; most of the studies cited above rely on children’s responses to questionnaires rather than clinicalassessments of depression. While these scales have been utilized in many studies in differentpopulations of children and adolescents, their reliability and validity for evaluating interventions aimed atacademic performance may be open to challenge.Implications. The relationship between depression and academic performance is complicated; it appearsthat depression is both a risk factor and a consequence of poor academic performance. However, theprevalence of depressive symptoms, the risk of suicide, and the co-morbidity of depression with chronicmedical problems such as asthma, support further research on the relationship between depression andacademics.EpilepsyPrevalence. Epilepsy and seizures impact approximately 2.5 million Americans. Roughly 181,000 newcases of epilepsy are diagnosed each year and the incidence is greatest among those between the agesof 2 and 65 (Epilepsy Foundation). Specifically, 45,000 children under the age of 15 are diagnosed withepilepsy annually and 315,000 have epilepsy. Among those most affected by epilepsy are poor, inner-city,and immigrant children (Epilepsy Foundation).Epilepsy and Academic Performance. Children with epilepsy consistently demonstrate poorer academicachievement than those without epilepsy and those who suffer from other chronic illnesses such asasthma (Austin et al., 1998, 1999; Fowler et al., 1985; Huberty et al., 2000; Mitchell et al., 1991;Schoenfeld et al., 1999; Seidenberg et al., 1986). Seidenberg and colleagues (Seidenberg et al., 1986)compared the academic achievement of a sample of 122 children with epilepsy with national norms. Theyreported that as a group, the children with epilepsy made less academic progress than expected for theirIQ levels and age levels. Arithmetic and spelling deficiencies were the most pronounced for the sample;however, reading comprehension and word recognition were also deficient. Mitchell et al. (Mitchell et al.,1991) also compared the academic achievement of a sample of 78 children with epilepsy between 5 and13 years old who visited the Children’s Hospital Los Angeles Neurology Service with national norms.When IQ was not adjusted for, the epilepsy group reported very poor academic achievement. Forexample, 55% of the epileptic children were below the 25 th percentile and 40% were below the 10 thpercentile for reading comprehension. After adjusting for IQ, 16% to 50% of the subjects wereunderachieving for each subscale of the Peabody Individual Achievement Test (Mitchell et al., 1991).Austin, et al., (Austin et al., 1998) examined 117 children with epilepsy and 108 with asthma whohad been treated with medication for at least one year. They concluded that children with epilepsy weremore at risk for poor academic achievement than those with asthma. Epileptics scored significantly worsein reading, mathematics, language, vocabulary, and composite than asthmatics (Austin et al., 1998).Austin et al. (Austin et al., 1999) also followed a sample of epileptic children and asthmatic children forfour years. Again, they report that at follow-up the epileptic children continued to score significantly worsein all five achievement areas than the children with asthma. Huberty et al (Huberty et al., 2000) followed asample of children with asthma and epilepsy for four years. At follow-up, they reported that the asthmasample improved more than the epilepsy sample for academic performance and learning. Fowler andcolleagues (Fowler et al., 1985) examined a sample of 270 children who were being treated for a largearray of chronic illnesses including arthritis, blood disorders, cardiac disease, chronic bowel disease,E-10

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