Study reveals how congenital anomalies and deprivation impact children’s educational achievement

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 work is published in the journal PLOS Medicine.

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 (U.S.) and City St George’s, University of London.

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, hospitalization 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 ages 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 anonymized 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% of children with major congenital anomalies achieved the relevant educational standard, compared with 93.8% of children without. At age 16, 46.8% of children with major congenital anomalies achieved five GCSEs at grades C–A*, including English or Welsh, mathematics and science, compared with 56.1% 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% of those with major congenital anomalies and 38.4% of those without achieved the five-GCSE standard. In the least deprived group, attainment rose to 67.6% and 75%, 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.

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 twofold to fourfold 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.

Who’s behind this story?

Gaby Clark

MA in English, copy editor since 2021 with experience in higher education and health content. Dedicated to trustworthy science news.

Full profile →

Andrew Zinin

Master’s in physics with research experience. Long-time science news enthusiast. Plays key role in Science X’s editorial success.

Full profile →