School Failure: Assessment, Intervention, and Prevention in Primary Pediatric Care

Abstract

1. Robert S. Byrd, MD, MPH* 1. *Associate Professor of Clinical Pediatrics, Division of General Pediatrics, University of California at Davis, Sacramento, Calif After completing this article, readers should be able to: 1. Recognize the interaction between school failure and health. 2. Describe the causes of school-related difficulties and the assessment of school failure. 3. Describe the role of psychological testing in the assessment of academic failure. 4. Delineate the role of grade retention in addressing academic failure. 5. Understand the roles of pediatric care practitioners in helping children who are failing in school. Failure in school can have lifelong consequences. The causes of school failure are myriad and often multiple within individual students who are struggling academically. Social, behavioral, and emotional problems frequently lead to academic difficulties. Health conditions also can impair academic performance. One in five children who repeat a grade in school has some identifiable disability. Irrespective of its cause, school failure is associated with adverse health outcomes. Children who fail in school are more likely to engage in subsequent health-impairing behaviors as adolescents. Failing students also are more likely to drop out of school. Adults who have no high school education often face limited economic opportunities, but they also are more likely to engage in health-impairing behaviors, to experience poor health, and to die at younger ages. Comprehensive approaches to evaluation and intervention may improve outcomes, and health care practitioners should play a vital role in these assessments. Moreover, clinicians can make a significant difference in outcomes by helping families identify the causes of failure and advocate for the resources to alter a child’s downward academic trajectory, preventing further compromise of a child’s health. Pediatric clinicians also should assess and intervene in risk behaviors of failing students. School readiness promotion and school failure prevention should be incorporated into routine health supervision visits. About 10% to 15% of school-age children repeat or fail a grade in school. Grade failure is more likely among males, minorities, …