Comparing school-based needs and receipt of school support among children and adolescents with and without serious chronic illness: A multiperspective study with students, parents, and teachers

Abstract

Serious chronic illness can reduce the likelihood children and adolescents will achieve school success. This dissertation aimed to examine whether students with chronic illness receive school support enabling them to overcome illness-related barriers to achieve their full potential. After reviewing six chronic illnesses in-depth (Chapter Two), I reviewed the international literature (Chapter Three) and Australian policies and practice (Chapter Four) regarding the school needs of students with chronic illness. In Chapter Five, I compared parent-reported school needs and receipt of support of 215 Australian students with chronic illness with 212 healthy students. Compared with healthy students, students with chronic illness had higher rates of grade repetition and school absenteeism and were more likely to have parent-reported academic, social, and emotional needs; yet, were equally likely to receive school support. In Chapters Six to Eight, I used mixed-methods designs to examine parents’ and students’ perspectives on school-based psychosocial experiences and support. I examined whether school-based psychosocial wellbeing mediated the relationship between positive educational practices (i.e., school support facilitating students’ strengths) and engagement with school. Parent-reported school wellbeing was a significant mediator for students with chronic illness (n=215), but not healthy students (n=212). I found the same mediation effect in students with chronic illness reporting on their own needs (n=52). For Chapter Nine, I examined the same mediating relationship in German students with special health care needs (i.e., physical, emotional, behavioural, and developmental conditions: n=50) and healthy students (n=89). The mediating effect of wellbeing was small and common to both student groups. In Chapter Ten, 130 Australian educators (largely teachers and teacher’s aides) reported their perceived understanding of, and preparedness to accommodate for, the educational implications of chronic illness. Educators believed that they were underprepared to meet the needs of students with chronic illness, particularly in supporting students’ physical and emotional needs and helping students to maintain school attendance. The findings highlight the scope of unmet needs faced by students with chronic illness. Stronger policies and greater resources, particularly to promote school wellbeing, may enable students with chronic illness to achieve their full potential.