Peer-reviewed article
Assessment of child-parent dyads' health-related quality of life in learning disorder care: a cross-sectional study in eastern China.
Sun L, Guan L, Gao M, Fan X, Li F et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study compared health-related quality of life (HRQoL) in 492 children with learning difficulties including ADHD, learning disabilities, and intellectual disabilities, plus their parents, in eastern China. Children across all four clinical groups showed significantly lower quality of life scores in physical, emotional, social, and school functioning compared to healthy controls. The patterns of impairment varied by diagnosis type. Parents of children with learning difficulties also experienced reduced quality of life compared to parents of healthy children.
Key points
- Children with ADHD-only, LD-only, ID-only, and ADHD+LD all had significantly lower HRQoL scores than healthy controls across multiple dimensions
- The majority of children in the study were boys (71.5%) with a median age of 8.8 years
- Different learning difficulty diagnoses showed different patterns of HRQoL impairment
- Caregivers of children with learning difficulties also experienced significantly reduced quality of life compared to parents of healthy children
- The study advocates for inclusion of children with learning difficulties in public health agendas and clinical practice
Limitations
This is a cross-sectional study without longitudinal follow-up, so it cannot establish causal relationships or track changes over time. The study is limited to eastern China and may not represent other regions or countries with different healthcare systems and social contexts.
Abstract
Background Learning difficulties, often stemming from neurodevelopmental disorders such as attention deficit hyperactivity disorder (ADHD), learning disabilities (LD), and intellectual disabilities (ID), profoundly impact children's academic performance and family well-being, particularly in highly competitive societies like China. Therefore, we aimed to compare multidimensional health-related quality of life (HRQoL; physical, emotional, social, school functioning) of children across four learning difficulty diagnostic subgroups (ADHD-only, LD-only, ID-only, ADHD + LD); as well as the HRQoL of their caregivers. Methods Four hundred and ninety-two child-parent dyads were included in this questionnaire-based study. HRQoL of children was measured by proxy-reported Pediatric Quality of Life Inventory (PedsQL) Generic Core Module (GCM), and parents' HRQoL was measured by PedsQL Family Impact Module (FIM). Independent t-tests compared the mean PedsQL GCM and FIM scores (total and scales) between each clinical group and healthy controls. The clinical relevance of group differences was evaluated using Cohen's d effect size. Furthermore, we applied general linear models (GLMs) to examine differences in scale and total scores between each clinical group (ADHD, LD, ID, and ADHD + LD) and healthy controls, adjusting for covariates. Results The median age of children was 8.8 years, and the majority were boys (71.5%). Children in the clinical groups-ADHD, LD, ID, and ADHD + LD-exhibit significantly lower HRQoL scale scores and total scores in both children and their caregivers compared to healthy controls. The pattern of HRQoL impairments differs across these clinical groups. Conclusions This study demonstrates the profiles of HRQoL in children with ADHD, LD, ID, ADHD + LD, as well as HRQoL patterns of their parents in a clinical sample in China. Our findings advocate for attention on children with learning difficulties in both public health agendas and clinical practice to address both child development and caregiver well-being.