Educational attainment among primary school children with neurodisability: a population-based cohort study using linked education and health data from England.

objectiveTo compare educational attainment between children with and without hospital-recorded neurodisability in England at ages 5, 7 and 11 using linked administrative hospital and education data in the Education and Child Health Insights from Linked Data (ECHILD) database.

designPopulation-based cohort study.

methodsWe derived a national birth cohort of 2 351 589 children born in England between 1 September 2003 and 31 August 2008 enrolled in state-funded primary schools in Reception (age 4-5) using linked health and education records. Neurodisability, defined here as chronic conditions affecting the nervous system which result in functional limitations, is identified using hospital admission records. We described differences in primary school educational attainment for children with and without neurodisability.

resultsAbout 2.2% of children had a recorded neurodisability before starting Reception. These children consistently underperformed in national assessments, with fewer than half meeting nationally expected levels in Maths and English at every time point (vs ~70% of peers). By the end of primary school (age 10/11), 31% of children with neurodisability (vs 6% of peers) did not participate in national assessments despite being enrolled in school. Among children with neurodisability, educational attainment was lowest for children with Down syndrome and highest for children with perinatal conditions. IMPLICATIONS: Substantial attainment gaps exist between children with and without neurodisability and persist across primary school. By age 11, many children with neurodisability do not undertake national assessments, highlighting the need for personalised, functional outcome measures to capture their educational development.