Skip to main content

Advertisement

SpringerLink
Log in

Self-concept and academic achievement in children with chronic kidney disease

  • Original Article
  • Published:
Pediatric Nephrology Aims and scope Submit manuscript

Abstract

Background

Within the pediatric population, a positive self-concept is associated with better academic achievement. Children with chronic kidney disease (CKD) are at risk for lower quality of life and academic underachievement. Little is known about self-concept among children with CKD and how self-concept influences academic achievement. The objectives of the present study were to (1) describe patient-reported self-concept among children with CKD and (2) evaluate the relationship between self-concept and academic performance.

Methods

This cross-sectional study included 23 children, aged 6–16 years, with mild to moderate CKD (cause of disease due to congenital anomalies of the kidney and urinary tract) and 26 age-matched comparators. Participants completed the Self-Description Questionnaire (SDQ) and the Wide Range Achievement Test (WRAT-4). Linear regression models were used to evaluate self-concept as a predictor of academic achievement in the CKD cohort.

Results

Self-concept ratings were comparable between children with CKD and non-CKD comparators; however, academic achievement trended lower for the CKD patients on measures of arithmetic (estimate =  − 0.278, 95% confidence interval (CI) [− 0.530: − 0.026], t(45) =  − 1.99, p = 0.053). All of the SDQ domains predicted WRAT-4 arithmetic performance, such that higher scores on the SDQ were associated with higher scores in mathematics. Kidney function did not have an effect on the relationship between self-concept and academic achievement.

Conclusions

Despite the presence of a chronic disease, children with CKD endorse a positive self-concept. Positive self-concept may predict academic success in this population.

Graphical Abstract

A higher resolution version of the Graphical abstract is available as Supplementary information

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Data availability

The datasets analyzed for the current study are not publicly available but are available from the corresponding author on reasonable request.

References

  1. Harshman LA, Johnson RJ, Matheson MB, Kogon AJ, Shinnar S, Gerson AC, Warady BA, Furth SL, Hooper SR (2019) Academic achievement in children with chronic kidney disease: a report from the CKiD cohort. Pediatr Nephrol 34:689–696

    Article  PubMed  Google Scholar 

  2. Hooper SR, Gerson AC, Butler RW, Gipson DS, Mendley SR, Lande MB, Shinnar S, Wentz A, Matheson M, Cox C, Furth SL, Warady BA (2011) Neurocognitive functioning of children and adolescents with mild-to-moderate chronic kidney disease. Clin J Am Soc Nephrol 6:1824–1830

    Article  PubMed  PubMed Central  Google Scholar 

  3. Harshman LA, Hooper SR (2020) The brain in pediatric chronic kidney disease-the intersection of cognition, neuroimaging, and clinical biomarkers. Pediatr Nephrol 35:2221–2229

    Article  PubMed  PubMed Central  Google Scholar 

  4. Richardson KL, Weiss NS, Halbach S (2018) Chronic school absenteeism of children with chronic kidney disease. J Pediatr 199:267–271

    Article  PubMed  PubMed Central  Google Scholar 

  5. Duquette PJ, Hooper SR, Wetherington CE, Icard PF, Gipson DS (2007) Brief report: intellectual and academic functioning in pediatric chronic kidney disease. J Pediatr Psychol 32:1011–1017

    Article  PubMed  Google Scholar 

  6. Hussien H, Apetrii M, Covic A (2021) Health-related quality of life in patients with chronic kidney disease. Expert Rev Pharmacoecon Outcomes Res 21:43–54

    Article  PubMed  Google Scholar 

  7. Fletcher BR, Damery S, Aiyegbusi OL, Anderson N, Calvert M, Cockwell P, Ferguson J, Horton M, Paap MCS, Sidey-Gibbons C, Slade A, Turner N, Kyte D (2022) Symptom burden and health-related quality of life in chronic kidney disease: a global systematic review and meta-analysis. PLoS Med 19:e1003954

    Article  PubMed  PubMed Central  Google Scholar 

  8. Moreira JM, BouissouMoraisSoares CM, Teixeira AL, Simões E, Silva AC, Kummer AM (2015) Anxiety, depression, resilience and quality of life in children and adolescents with pre-dialysis chronic kidney disease. Pediatr Nephrol 30:2153–2162

    Article  PubMed  Google Scholar 

  9. Gerson AC, Wentz A, Abraham AG, Mendley SR, Hooper SR, Butler RW, Gipson DS, Lande MB, Shinnar S, Moxey-Mims MM, Warady BA, Furth SL (2010) Health-related quality of life of children with mild to moderate chronic kidney disease. Pediatrics 125:e349-357

    Article  PubMed  Google Scholar 

  10. Cruz MC, Andrade C, Urrutia M, Draibe S, Nogueira-Martins LA, Sesso Rde C (2011) Quality of life in patients with chronic kidney disease. Clinics (Sao Paulo) 66:991–995

    Article  PubMed  Google Scholar 

  11. Dodson JL, Cohn SE, Cox C, Hmiel PS, Wood E, Mattoo TK, Warady BA, Furth SL (2009) Urinary incontinence in the CKiD cohort and health related quality of life. J Urol 182:2007–2014

    Article  PubMed  PubMed Central  Google Scholar 

  12. Wilund KR, Thompson S, Viana JL, Wang AY (2021) Physical activity and health in chronic kidney disease. Contrib Nephrol 199:43–55

    Article  PubMed  Google Scholar 

  13. Spilt JLVLP, Leflot G, Onghena P, Colpin H (2014) Children’s social self-concept and internalizing problems: the influence of peers and teachers. Child Dev 85:1248–1256

    Article  PubMed  Google Scholar 

  14. Sebastian C, Burnett S, Blakemore SJ (2008) Development of the self-concept during adolescence. Trends Cogn Sci 12:441–446

    Article  PubMed  Google Scholar 

  15. Campbell JD (1990) Self-esteem and clarity of the self-concept. J Pers Soc Psychol 59:538–549

    Article  CAS  PubMed  Google Scholar 

  16. Ferro MA, Boyle MH (2013) Self-concept among youth with a chronic illness: a meta-analytic review. Health Psychol 32:839–848

    Article  PubMed  Google Scholar 

  17. Austin JK, Shafer PO, Deering JB (2002) Epilepsy familiarity, knowledge, and perceptions of stigma: report from a survey of adolescents in the general population. Epilepsy Behav 3:368–375

    Article  PubMed  Google Scholar 

  18. Marsh HW, Martin AJ (2011) Academic self-concept and academic achievement: relations and causal ordering. Br J Educ Psychol 81:59–77

    Article  PubMed  Google Scholar 

  19. Solomon MA, van der Plas E, Langbehn KE, Novak M, Schultz JL, Koscik TR, Conrad AL, Brophy PD, Furth SL, Nopoulos PC, Harshman LA (2021) Early pediatric chronic kidney disease is associated with brain volumetric gray matter abnormalities. Pediatr Res 89:526–532

    Article  PubMed  Google Scholar 

  20. van der Plas E, Lullmann O, Hopkins L, Schultz JL, Nopoulos PC, Harshman LA (2022) Associations between neurofilament light-chain protein, brain structure, and chronic kidney disease. Pediatr Res 91:1735–1740. https://doi.org/10.1038/s41390-021-01649-6

    Article  CAS  PubMed  Google Scholar 

  21. van der Plas E, Solomon MA, Hopkins L, Koscik T, Schultz J, Brophy PD, Nopoulos PC, Harshman LA (2022) Global and regional white matter fractional anisotropy in children with chronic kidney disease. J Pediatr 242:166-173.e3. https://doi.org/10.1016/j.jpeds.2021.11.006

  22. Pierce CB, Munoz A, Ng DK, Warady BA, Furth SL, Schwartz GJ (2021) Age- and sex-dependent clinical equations to estimate glomerular filtration rates in children and young adults with chronic kidney disease. Kidney Int 99:948–956

    Article  CAS  PubMed  Google Scholar 

  23. Hollingshead A (1975) Four Factor Index of Social Status. Yale University Department of Psychology, New Haven, CT

    Google Scholar 

  24. Olson KB (2017) After the visit: an overview of government and community programs supporting children with medical complexity. Children 4:35. https://doi.org/10.3390/children4050035

  25. Marsh HW, Barnes J, Cairns L, Tidman M (1984) Self-description questionnaire: age and sex effects in the structure and level of self-concept for preadolescent children. J Educ Psychol 76:940–956

    Article  Google Scholar 

  26. Wilkinson GS, Robertson GJ (2006) WRAT 4: wide range achievement test; professional manual. Psychological Assessment Resources Inc, Lutz, FL

    Google Scholar 

  27. Wechsler D (2003) Wechsler Intelligence Scale for Children. The Psychological Corporation, Fourth Edition (WISC-IVCDN)

    Google Scholar 

  28. Ohan JL, Johnston C (2002) Are the performance overestimates given by boys with ADHD self-protective? J Clin Child Adolesc Psychol 31:230–241

    Article  PubMed  Google Scholar 

  29. Diener MB, Milich R (1997) Effects of positive feedback on the social interactions of boys with attention deficit hyperactivity disorder: a test of the self-protective hypothesis. J Clin Child Psychol 26:256–265

    Article  CAS  PubMed  Google Scholar 

  30. Crump C, Rivera D, London R, Landau M, Erlendson B, Rodriguez E (2013) Chronic health conditions and school performance among children and youth. Ann Epidemiol 23:179–184

    Article  PubMed  Google Scholar 

  31. Marshall RM, Hynd GW, Handwerk MJ, Hall J (1997) Academic underachievement in ADHD subtypes. J Learn Disabil 30:635–642

    Article  CAS  PubMed  Google Scholar 

  32. Thomas R, Sanders S, Doust J, Beller E, Glasziou P (2015) Prevalence of attention-deficit/hyperactivity disorder: a systematic review and meta-analysis. Pediatrics 135:e994-1001

    Article  PubMed  Google Scholar 

  33. McCauley JB, Zajic MC, Oswald TM, Swain-Lerro LE, McIntyre NC, Harris MA, Trzesniewski K, Mundy PC, Solomon M (2018) Brief report: investigating relations between self-concept and performance in reading and math for school-aged children and adolescents with autism spectrum disorder. J Autism Dev Disord 48:1825–1832

    Article  PubMed  Google Scholar 

  34. Leary MR, Haupt AL, Strausser KS, Chokel JT (1998) Calibrating the sociometer: the relationship between interpersonal appraisals and state self-esteem. J Pers Soc Psychol 74:1290–1299

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgements

We would like to acknowledge Marci Novak for her role in cognitive testing and assessment and Ellen van der Plas for her thorough review of the manuscript.

Funding

This study was supported by the National Institute of Diabetes and Digestive and Kidney Diseases (K23DK110443, R01DK128835 LAH), the National Hemophilia Foundation Bridge Award (JMS), the Clinical Research Unit at the University of Iowa UL1TR002537, and The Stead Family Department of Pediatrics. There are no other financial relationships to disclose or conflicts.

Author information

Authors and Affiliations

  1. Stead Family Department of Pediatrics, Division of Pediatric Nephrology, University of Iowa Carver College of Medicine, 4037 Boyd Tower, 200 Hawkins Drive, Iowa City, IA, 52242, USA

    Silvia L. Verhofste, Amy L. Conrad, Emily J. Steinbach, Janice M. Staber & Lyndsay A. Harshman

  2. Iowa Neuroscience Institute, University of Iowa, Iowa City, IA, USA

    Amy L. Conrad, Janice M. Staber & Lyndsay A. Harshman

  3. Division of Developmental and Behavioral Health, Children’s Mercy Kansas City, Kansas City, USA

    Rebecca J. Johnson

Authors
  1. Silvia L. Verhofste
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Amy L. Conrad
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Rebecca J. Johnson
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Emily J. Steinbach
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Janice M. Staber
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Lyndsay A. Harshman
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Research idea and study design: LH; data acquisition: LH, JS, AC, ES; data analysis/interpretation: LH, JS, AC, ES, SV; supervision or mentorship: LH, JS, AC, RJ. Primary responsibility to drafting the paper: SV, ES, AC, JS, RJ, LH. All authors contributed important intellectual content during iterative manuscript drafts or revisions, accepts personal accountability for the author’s own contributions, reviewed the document submitted for review, and agrees to ensure that questions pertaining to the accuracy or integrity of any portion of the work are appropriately investigated and resolved.

Corresponding author

Correspondence to Lyndsay A. Harshman.

Ethics declarations

Consent to participate

Informed consent and/or assent, as applicable, was obtained from participants and legal guardians at the time of participation.

Additional information

Publisher's note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Below is the link to the electronic supplementary material.

Graphical abstract (PPTX 65 KB)

Supplementary file2 (DOCX 456 KB)

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Verhofste, S.L., Conrad, A.L., Johnson, R.J. et al. Self-concept and academic achievement in children with chronic kidney disease. Pediatr Nephrol 39, 819–827 (2024). https://doi.org/10.1007/s00467-023-06106-6

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00467-023-06106-6

Keywords

Search

Navigation