Multivariate impact of health and caretaking risk factors on the school adjustment of first graders

The current investigation examined seven health and caretaking risk factors that threaten children's school adjustment: low birth weight, low Apgar score, lead poisoning, birth to a single mother, birth to a teen mother, child maltreatment, and out-of-home care. The purpose of this study was to assess the relationships among these risk factors and several indicators of school adjustment in an entire population of students. Participants included 9,088 first-grade students in a large urban school district. Information on risk factors and school adjustment was obtained from computerized records that were combined using record linkage. The independent and interactive effects of the risk factors on school adjustment were assessed using logistic regression. Results showed that six of the seven risk factors significantly increased children's risk for poor school adjustment. Findings were stable across several subsamples. No significant interactive effects were found among the risk factors. Implications for research and practice were discussed.