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Academic and School Health Issues Among Children Exposed to Maternal Intimate Partner Abuse
Mary A. Kernic, PhD, MPH;
Victoria L. Holt, PhD, MPH;
Marsha E. Wolf, PhD;
Barbara McKnight, PhD;
Colleen E. Huebner, PhD, MPH;
Frederick P. Rivara, MD, MPH
Arch Pediatr Adolesc Med. 2002;156:549-555.
Objective To determine the association between children's exposure to maternal
intimate partner violence (IPV) and academic problems and school health concerns.
Design The study population consisted of 153 children aged 5 to 16 years who
attended public school and whose mothers experienced police- or court-reported
IPV. The comparison group consisted of public school peers of the exposed
children. Generalized linear modeling using a binomial distribution and log-link
function served as the primary method of analysis.
Setting Urban public school district.
Main Outcome Measures The occurrence of academic problems and type-specific school nurse visits
during the 1-year study period.
Results Children whose mothers experienced IPV were more likely to be suspended
from school (relative risk [RR], 1.8; 95% confidence interval [CI], 1.2-1.7)
and to have had frequent non–suspension-related absences (RR, 1.6; 95%
CI, 1.0-2.3) than comparison children after adjusting for relevant confounders.
Intimate partner violence–exposed children were more likely to have
a school nurse visit for social or emotional complaints (RR, 2.2; 95% CI,
1.3-3.9), a visit that resulted in being sent home from school (RR, 1.6; 95%
CI, 1.1-2.3), or a visit that led to referral to the school speech pathologist
(RR, 7.5; 95% CI, 1.9-29.6) relative to comparison schoolchildren after adjusting
for relevant confounders.
Conclusions Children's exposure to maternal IPV is significantly associated with
the occurrence of academic problems and school health concerns. Describing
the increased risk of the academic and health problems exhibited by IPV-exposed
children relative to nonexposed children offers the possibility of improving
the likelihood that clinicians will identify the woman who experienced abuse
and her children, and promote referral to appropriate resources.
From the Harborview Injury Prevention and Research Center (Drs Kernic,
Holt, Wolf, and Rivara), the Departments of Epidemiology (Drs Kernic, Holt,
Wolf, and Rivara), Biostatistics (Dr McKnight), and Health Services (Dr Huebner),
School of Public Health and Community Medicine, University of Washington;
the Department of Family and Child Nursing, School of Nursing, University
of Washington (Dr Huebner), and the Department of Pediatrics, School of Medicine,
University of Washington (Dr Rivara), Seattle, Wash.
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