Background: Children with chronic illness perform poorer at school, and school well-being (SWB) may mediate this association. We investigated the association between chronic illness and three domains of SWB in children in first grade. Methods: Data from a German population-based prospective cohort study were used. Children with chronic illness were identified via their preschool health examination and follow-up parent surveys during first grade. Children were grouped as either (i) having current special health care needs (SHCN), (ii) having at least one physician diagnosis of a chronic illness but no current SHCN, or (iii) being healthy. SWB was assessed at the end of first grade and measured by the Questionnaire for the Assessment of Emotional and Social School Experiences of First and Second Grade Primary School Children. Based on SWB theory and previous frameworks, the following subscales were used: School-Related Self-Concept, Social Integration, and Joy of Learning. The sum score for each subscale was converted into area-transformed T-values (mean 50 and standard deviation 10). Associations between chronic illness groups and SWB subscales were investigated by multivariable linear regression models. Effect estimates were adjusted for potential confounding variables and standardized mean differences (SMD) were calculated. Results: Of the 1,490 children included, 15% had current SHCN and 37% had a physician diagnosis of a chronic illness but no current SHCN. Compared to healthy children, children with SHCN had lower scores for the School-Related Self-Concept and the Joy of Learning subscale (SMD -0.18 for both) but not for the Social Integration subscale. In contrast, children with a chronic condition but no SHCN had lower scores only for the Social Integration subscale (SMD -0.12). Conclusions: Primary school students with a chronic illness with or without SHCN have lower SWB in some domains compared to their healthy peers. SWB may be a mediator in the association between chronic illness and poor school performance.

AimChildren with special health care needs (SHCN) perform more poorly at school compared to their classmates. Specific causal pathways have not yet been extensively studied. Therefore, we investigated teacher-rated global attention, an important prerequisite for educational attainment, in children with SHCN.MethodsData of a population-based prospective cohort study, which recruited preschool children from the Mainz-Bingen area, Germany, were analysed. Children with SHCN were identified by the Children with Special Health Care Needs screening tool. In 2016, global attention was reported by teachers at the end of first grade (mean age: 7.3 years) on a 5-point rating scale ranging from -2 through +2. Associations between SHCN consequences and teacher-rated attention were estimated by linear mixed models, adjusted for confounding variables.ResultsWe included 1921 children (51% males); of these, 14% had SHCN. Compared to their classmates, children with SHCN had poorer teacher-rated attention scores (adjusted mean difference: -0.35, 95% CI: -0.52 to -0.17). The effect was strongest among children with treatment or counselling for mental health problems or functional limitations. The effect remained after excluding children with attention deficit hyperactivity disorder from the analysis.ConclusionChildren with SHCN showed more teacher-rated attention problems, which could explain their lower educational attainment.

Objective Children with special healthcare needs (SHCN) due to a chronic health condition perform more poorly at school compared with their classmates. We aimed to estimate the effects of past, current, transient, emerging and persistent SHCN on school performance in primary school children.Methods Data from the German population-based prospective cohort study ikidS were used. The children withSHCN screener was administered before school entry (T1) and at the end of first (T2) and third grade (T3). Grades for German, maths and science (range: 1 (Very Good) to 6 (Failure)) were obtained at the end of third grade (age 8-9 years), and an average grade was calculated. Associations between the timing of SHCN and average grade were estimated by mixed linear regression models adjusted for potential confounding variables.Results 751 children were included, and 21% had ever SHCN. Children with ever SHCN had poorer school performance than children with never SHCN (adjusted mean difference in average grade [95% CI]: 0.17 [0.06; 0.28]). SHCN in the third year were associated with a poorer average grade (0.29 [0.16; 0.41]) compared with healthy children. Only emerging (0.31 [0.15; 0.48]) and persistent (0.25 [0.07; 0.43]) SHCN were associated with average grade.Conclusions This study demonstrates the negative effect of current, emerging and persistent SHCN on academic performance in primary school children. Consequently, students should be regularly assessed for SHCN during school age. Timely interventions may help reduce the adverse effects of chronic health conditions on academic achievements in childhood.

BACKGROUND:The association between health status in childhood and later educational achievement is unknown. We describe the association between a chronic health condition (CHC) and school performance at the end of first grade.PATIENTS:As part of the child health survey ikidS, 2,003 preschoolers from the Mainz-Bingen area (Rhineland-Palatinate; Germany) were recruited.METHOD:In a prospective cohort study, children with CHC were identified by the children with special health care needs screener. At the end of first grade, classroom teachers evaluated the child's school performance on a rating scale ranging from - 2 through+2 in 5 domains: numeracy, science, reading, writing, and social competencies. Associations between special health care needs (SHCN) and each domain were assessed by linear mixed regression models adjusted for potential confounders.RESULTS:1,463 children (51% males) were analyzed. Of these, 15% had SHCN. Compared to their classmates, children with SHCN performed poorer in numeracy (adjusted mean difference: - 0.40; 95% CI[- 0.57; - 0.23]) and writing (- 0.22; 95% CI[- 0.39; - 0.05]).DISCUSSION:For the first time in a German sample, we found an indication which educational competencies might be negatively impacted by SHCN early in school. This could have long-lasting effects on educational attainment and later socio-economic status.CONCLUSION:Our results question the uptake and/or effectiveness of existing medical care as well as educational support concepts for children with a CHC.

Hintergrund Die SEU gehört zu den Schlüsselaufgaben des ÖGD. Im Rahmen der SEU wird SOPESS als validiertes Instrument zur Erfassung des Entwicklungsstandes bundesweit genutzt. Datenanalysen weisen auf eine räumliche Heterogenität von Screeningergebnissen hin, deren Ursachen auf unterschiedliche Faktoren zurückgeführt werden können. Modelle zur Aufklärung der Heterogenität ziehen unterschiedliche Maßnahmen verschiedener Akteure nach sich. Teilweise sind Datenerfassung, -qualität, und -bereitstellung eingeschränkt, sodass die Kinder- und Jugendgesundheitsdienste das Potential dieser Daten nicht voll nutzen können. Möglichkeiten für die regionale Prävention sowie für die regionale und überregionale Gesundheitsberichterstattung (GBE) bleiben so ungenutzt.

Zusammenfassung Hintergrund Die Zusammenhänge zwischen kindlichem Gesundheitsstatus und weiterem Bildungsweg sind unklar. Wir beschreiben die Assoziation zwischen einer chronischen Erkrankung (CE) und schulischen Fähigkeiten am Ende der ersten Klasse. PatientenIm Rahmen der Kindergesundheitsstudie ikidS wurden insgesamt 2003 Schulanfänger der Region Mainz-Bingen rekrutiert. Methode In einer prospektiven Kohortenstudie wurden Kinder mit CE mittels Elternfragebögen über ihren speziellen medizinischen Versorgungsbedarf aufgrund einer CE identifiziert. Am Ende der ersten Klasse schätzten Lehrkräfte die schulischen Fähigkeiten auf einer 5-stufigen Skala von − 2 bis+2 in 5 Bereichen ein: Mathematik, Naturwissenschaften, Sprache, Schriftsprache und soziale Fähigkeiten. Der Zusammenhang zwischen dem speziellen Versorgungsbedarf und den schulischen Fähigkeiten erfolgte jeweils mit linearen gemischten Regressionsmodellen unter Berücksichtigung potentieller Confounder. Ergebnisse In die Analysen wurden 1463 Kinder (51% männlich) eingeschlossen. 15% der Kinder hatten einen speziellen Versorgungsbedarf. Diese Kinder zeigten in den Bereichen Mathematik (adjustierte Mittelwertsdifferenz: − 0,40; 95% KI[− 0,57; − 0,23]) und Schriftsprache (− 0,22; 95% KI[− 0,39; − 0,05]) niedrigere schulische Fähigkeiten als Kinder ohne Versorgungsbedarf. DiskussionWir haben erstmals für Deutschland Hinweise darauf gefunden, in welchen schulischen Fähigkeiten Kinder mit speziellem Versorgungsbedarf bereits früh in der Bildungslaufbahn Defizite aufweisen könnten. Dies könnte sich langfristig auf Bildungsabschlüsse und den späteren sozioökonomischen Status auswirken. Schlussfolgerung Die vorliegenden Ergebnisse hinterfragen die Inanspruchnahme und/oder Wirksamkeit bestehender Versorgungs- und Fördermaßnahmen für Kinder mit CE.

PURPOSE Hypersensitivity is a frequent complaint in children with molar incisor hypomineralisation (MIH). This double-blind randomised controlled trial aimed to evaluate non-inferiority in hypersensitivity relief of a toothpaste containing microcrystalline hydroxyapatite compared to amine fluoride in children with MIH. MATERIALS AND METHODS Children were randomised into 2 groups: either hydroxyapatite (intervention) or amine fluoride toothpaste (control). The primary endpoint was pain sensation in response to tactile stimulus (Wong-Baker FACES Pain Rating Scale) 56 days after randomisation and analysed by mixed effects linear regression analysis. Non-inferiority was inferred if the upper limit of the one-sided 95% confidence interval (CI) of the difference between intervention and control group was below the non-inferiority margin of 1 in the ITT (intention-to-treat) and PP (per protocol) population. RESULTS Twenty-one children were randomised and 14 children finished the study per protocol. In the ITT population, hydroxyapatite was non-inferior to amine fluoride (mean difference: -0.75 95%CI [-∞;0.49]). In the PP population, non-inferiority could not be shown (-0.62 [-∞;1.08]). CONCLUSIONS Overall non-inferiority in hypersensitivity relief of a toothpaste containing hydroxyapatite compared to amine fluoride could not be shown. However, the hydroxyapatite group tended to be less hypersensitive in both populations. Attrition of the PP population due to the COVID-19 pandemic led to loss of statistical power.

Long‐term survivors of childhood cancer are at increased risk for sequelae such as poor mental health (MH) or impaired health‐related quality of life (HrQoL). We aimed to evaluate early adverse effects on MH and HrQoL in young childhood cancer survivors (YCCS) before school entry.

Purpose of the Study Developmental delays at school enrollment can affect early educational achievement. Thus, diagnosis and treatment prior to school entry are important. In Germany, SOPESS - a pediatric developmental screening instrument for preschool health examinations (PHE) - was introduced in several federal states. We investigated the relationships between the results of the language-related domain of the SOPESS and later academic language competencies at the end of first grade.Procedures Data of the population-based cohort study ikidS (Rhineland Palatinate; Germany) and the PHE provided by public health authorities were linked at individual level. The relationship between the SOPESS-language risk score (range: 0 to 6, higher values indicate more developmental delay) and class teacher-based ratings of academic language competencies (range: -4 to+4, higher values indicate better competencies) was investigated with linear regression models and adjusted for several socio-economic and medical language predictors (e. g. age at school entry, gender, parental education, migration background, hearing disorder). The additional benefits of the SOPESS-language risk score was analyzed using analysis of variance.Results In total, 1357 children (48% girls, age at PHE 4.9-7.2 years) were included. A clear negative relationship between the SOPESS-language risk score and competencies in spoken and written language was found. Mean academic language competencies decreased with increasing SOPESS-language risk level from 0.8 (SD=1.7) at a risk score of 0 to-3.2 (SD=0.9) at a risk score of 6. The relationship persisted after adjusting for other language predictors. Analysis of variance showed significant benefits of the SOPESS-language risk score, even when further language predictors were considered.Conclusions There was a clear relationship between results of the SOPESS-language screening and later academic language competencies. Hence, the language-related domain of the SOPESS may be useful for further recommendations of tailored special educational and medical support services, especially if additional socio-economic and medical factors are considered.

Zusammenfassung Hintergrund Eine frühe Diagnostik und Behandlung von Entwicklungsstörungen vor der Einschulung ist für den weiteren Bildungserfolg maßgeblich. Deshalb wurde das Sozialpädiatrische Entwicklungsscreening für Schuleingangsuntersuchungen (SOPESS) konzipiert und in mehreren Bundesländern flächendeckend eingeführt. Fragestellung Wir untersuchten die Zusammenhänge zwischen den Screening-Ergebnissen der SOPESS-Sprachaufgaben vor der Einschulung und den schulischen Sprachkompetenzen am Ende der ersten Klasse als Teil einer umfassenden Evaluation des SOPESS. Methoden Daten der rheinland-pfälzischen Schuleingangsuntersuchung und der prospektiven Kindergesundheitsstudie ikidS wurden zusammengeführt und ausgewertet. Zusammenhänge zwischen dem Gesamtrisikowert Sprache des SOPESS vor Einschulung (ordinal-skaliertes Merkmal, 6 Risikostufen) und dem Gesamtfähigkeitswert Sprache am Ende der ersten Klasse (subjektive Lehrkrafteinschätzung, intervall-skaliertes Merkmal, Range −4 bis+4) wurden mittels linearer Regressionsmodelle ohne und mit Berücksichtigung von weiteren sozio-demografischen und medizinischen Sprachprädiktoren untersucht (z. B. Alter bei Einschulung, Geschlecht, Schulbildung der Eltern, Migrationshintergrund, Hörstörung). Der zusätzliche Nutzen des Gesamtrisikowertes Sprache des SOPESS wurde durch Varianzanalysen geprüft. Ergebnisse In die Auswertung konnten 1357 Kinder einbezogen werden (48% Mädchen, Alter bei Schuleingangsuntersuchung 4,9–7,2 Jahre). Es zeigte sich ein klarer negativer Zusammenhang zwischen den Stufen des Gesamtrisikowertes Sprache des SOPESS und den schulischen Sprachkompetenzen. In der Risikostufe 0 (kein Risiko) lag der Mittelwert der Sprachkompetenzen bei 0,8 (SD=1,7); in der Stufe 6 (hohes Risiko für Entwicklungsstörung) sank der Wert auf −3,2 Punkte ab (SD=0,9). Varianzanalysen zeigten zudem, dass der Gesamtrisikowert Sprache des SOPESS einen signifikanten Zusatznutzen gegenüber weiteren Sprachprädiktoren hat. Schlussfolgerungen Es zeigte sich ein klarer Zusammenhang zwischen den vorschulischen SOPESS-Sprachaufgaben und den schulischen Sprachkompetenzen am Ende der ersten Klasse. Dieses Sprachscreening könnte daher – unter Einbezug von weiteren soziodemografischen und medizinischen Prädiktoren – die Basis für eine passgenaue Auswahl von weiteren Versorgungs- und/oder Fördermaßnahmen sein.

School-related well-being (SRWB) is an important prerequisite for school performance. Nevertheless, only a few studies in the German-speaking countries exist - especially regarding the examination of the SRWB among first graders. This may be due to a lack of adequate instruments what is especially true if the health status of the children is considered.The aim of the paper is the validation of the adapted questionnaire for grapping emotional and social school experiences (FEESS 1-2; Rauer & Schuck, 2004). Thus, the focus is on its suitability for children with and without chronic diseases. Therefore, the construct of well-being (WB) respectively SRWB will be defined and embedded in relevant theories - Self-Determination Theory according to Deci and Ryan (1985) and the Expectancy-Value-Model according to Wigfield and Eccles (2000). Furthermore, the meaning of the used FEESS scales and their relationship to school performance are pointed out. 1491 children were interviewed about their learning enjoyment (LE), their social integration (SI), and their school-related self-concept of abilities (SC). Their health status was measured through a parental questionnaire and the preschool health examination. In addition, parents were asked about the health-related quality of life (QoL) of their children using a questionnaire for grapping the quality of life of children (KINDL; Bullinger, Mackensen, & Kirchberger, 1994). Psychometric properties of the adapted FEESS scales were examined for both the group of healthy and diseased children at scale and item level. Here, both classical methods and methods of item response theory were used.The results support the construct validity and the assumption of three-dimensionality (LE, SI, and SC). All three scales show a satisfactory to very good reliability. The items show very good MNSQ (weighted mean-square) values and good to very good discriminatory power. The external validity, for which the relationship between the answers of the children and the information of the parents on the health-related QoL was examined, could not yet be sufficiently supported. Except for this limitation, the SRINB of healthy and chronically ill children can be compared by using the adapted instrument in order to compensate possible inequality of opportunity.

Zusammenfassung. Das schulbezogene Wohlbefinden (SBWB) ist eine wichtige Voraussetzung für schulischen Erfolg. Trotzdem existieren – insbesondere mit Blick auf die Erfassung des SBWB von Erstklässlern – im deutschsprachigen Raum nur vereinzelt Studien. Dies lässt sich möglicherweise durch das Fehlen geeigneter Instrumente begründen. Dies gilt auch und insbesondere dann, wenn der Gesundheitszustand der Kinder berücksichtigt werden soll. Das Ziel der vorliegenden Arbeit besteht in der Validierung des adaptierten Fragebogens zur Erfassung von emotionalen und sozialen Schulerfahrungen (FEESS 1 – 2; Rauer & Schuck, 2004 ) mit Fokus auf die Eignung des Instruments für chronisch kranke und gesunde Kinder. Dafür wird zunächst das Konstrukt Wohlbefinden (WB) resp. SBWB definiert und in einschlägige Theorien – die Selbstbestimmungstheorie nach Deci und Ryan (1985) und das Erwartung-mal-Wert-Modell nach Wigfield und Eccles (2000) – eingebettet. Die Bedeutung der verwendeten FEESS-Skalen und ihr Zusammenhang zum schulischen Erfolg werden aufgezeigt. 1491 Kinder wurden zu ihrer Lernfreude (LF), sozialen Integration (SI) und zu ihrem schulbezogenen Fähigkeitsselbstkonzept (SK) befragt. Die Erfassung des Gesundheitszustands wurde über Elternfragebögen und Schuleingangsuntersuchungen eruiert. Zudem wurden die Eltern zur gesundheitsbezogenen Lebensqualität (LQ) ihrer Kinder mit Hilfe eines Fragebogens zur Erfassung der Lebensqualität von Kindern (KINDL; Bullinger, Mackensen & Kirchberger, 1994 ) befragt. Die psychometrische Qualität der adaptierten FEESS-Skalen wurde für beide Gruppen (erkrankt / gesund) auf Skalen- und Itemebene untersucht. Hierzu kamen sowohl klassische Verfahren als auch Verfahren der Item-Response-Theorie zum Einsatz. Die Ergebnisse untermauern die Validität des Konstruktes SBWB und stützen die Annahme der Dreidimensionalität (LF, SI, SK). Alle drei Skalen zeigen eine zufriedenstellende bis sehr gute Reliabilität. Die Items zeigen sehr gute MNSQ-Werte (weighted mean-square; gewichtete Abweichungsquadrate) und geeignete Trennschärfen. Die externe Validität, für deren Berechnung der Zusammenhang zwischen den Angaben der Kinder und den Angaben der Eltern zur gesundheitsbezogenen LQ untersucht wurde, konnte noch nicht ausreichend nachgewiesen werden. Bis auf diese Einschränkung kann mit Hilfe der adaptierten FEESS-Skalen im nächsten Schritt das SBWB von gesunden und erkrankten Kindern verglichen werden, um mögliche Chancenungleichheiten auszugleichen.

Pharmacological neuroenhancement (PNE) refers to the use of psychoactive substances without doctor’s prescription to enhance cognitive performance or to improve mood. Although some studies have reported that drugs for PNE are also being used to cope with stressful life situations, nothing is known about the relationship of PNE and resilience, i.e. the ability to recover from stress. This study aimed at investigating the relationship of PNE and resilience in the first representative population sample.