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Objective <p>We aimed to analyse the role of past diseases history (PDH), including developmental delay (DD), autism, intellectual disability (ID), attention deficit disorder (ADD) / attention-deficit/hyperactivity disorder (ADHD) and asthma in persistent learning disability (PLD) risk in children.</p> Methods <p>1952 children were recruited from the US National Health Interview Survey (NHIS) from 2019 to 2023 according to a predefined criteria. Logistic regression analysis was performed to detect the association between PDH and PLD risk. Threshold effect analysis was used to detect the threshold age point. Interaction and Joint effects analyses between age/sex and PDH with PLD risk was conducted. Receiver operating curve (ROC) analysis was used to investigate the single and incremental predictive value of PDH on PLD risk. Population attributable fraction (PAF) of PDH in PLD risk was computed. Sensitivity analyses were performed by sub-age/sex group analyses, repeated analyses after propensity score matching (PSM), and E-values to assess the potential impact of unmeasured confounders.</p> Results <p>History of DD, autism, ID, ADD/ADHD, and asthma were all significantly associated with increased PLD risk. ID history resulted in 13.25 more times of PLD risk. Increase of PDH numbers led to an elevating trend of PLD risk. Age over 8 years showed 6% decreasing trend of PLD risk (odds ratio (OR):0.94, 95% confidence interval (CI): 0.89–0.99), while age over 12 years showed a lower PLD risk (OR &lt; 1). 3 past diseases and 2–11 years old group had 10.78 more times PLD risk (OR: 11.78, 95% CI: 3.50, 39.68) compared with that in 2–11 years old children without PDH. 2 past diseases and female group had 2.24 more times PLD risk (OR: 3.24, 95% CI: 1.61, 6.50) compared with that in female without PDH. 2–11 years old and female showed a stronger joint effect with past diseases numbers for predicting PLD. PDH numbers had a good discriminatory power for predicting PLD risk. Combined five past diseases history accounted for over 10% of PAF for PLD risk. ID and ADD/ADHD, and autism and asthma history were the top contributors to PLD risk in female and male, respectively. Sensitivity analyses yielded similar results.</p> Conclusions <p>PDH showed good prediction, discriminatory power and certain contribution to PLD risk, while lower than 12 years old, female, and increased PDH numbers may be indicators of PLD susceptibility. Early warning of PDH may be needed in specific populations with learning disability (LD).</p>

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Past diseases history: an important predictor of persistent learning disability in US children

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年3月7日

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  • Song Mao,
  • Liangxia Wu

摘要

Objective

We aimed to analyse the role of past diseases history (PDH), including developmental delay (DD), autism, intellectual disability (ID), attention deficit disorder (ADD) / attention-deficit/hyperactivity disorder (ADHD) and asthma in persistent learning disability (PLD) risk in children.

Methods

1952 children were recruited from the US National Health Interview Survey (NHIS) from 2019 to 2023 according to a predefined criteria. Logistic regression analysis was performed to detect the association between PDH and PLD risk. Threshold effect analysis was used to detect the threshold age point. Interaction and Joint effects analyses between age/sex and PDH with PLD risk was conducted. Receiver operating curve (ROC) analysis was used to investigate the single and incremental predictive value of PDH on PLD risk. Population attributable fraction (PAF) of PDH in PLD risk was computed. Sensitivity analyses were performed by sub-age/sex group analyses, repeated analyses after propensity score matching (PSM), and E-values to assess the potential impact of unmeasured confounders.

Results

History of DD, autism, ID, ADD/ADHD, and asthma were all significantly associated with increased PLD risk. ID history resulted in 13.25 more times of PLD risk. Increase of PDH numbers led to an elevating trend of PLD risk. Age over 8 years showed 6% decreasing trend of PLD risk (odds ratio (OR):0.94, 95% confidence interval (CI): 0.89–0.99), while age over 12 years showed a lower PLD risk (OR < 1). 3 past diseases and 2–11 years old group had 10.78 more times PLD risk (OR: 11.78, 95% CI: 3.50, 39.68) compared with that in 2–11 years old children without PDH. 2 past diseases and female group had 2.24 more times PLD risk (OR: 3.24, 95% CI: 1.61, 6.50) compared with that in female without PDH. 2–11 years old and female showed a stronger joint effect with past diseases numbers for predicting PLD. PDH numbers had a good discriminatory power for predicting PLD risk. Combined five past diseases history accounted for over 10% of PAF for PLD risk. ID and ADD/ADHD, and autism and asthma history were the top contributors to PLD risk in female and male, respectively. Sensitivity analyses yielded similar results.

Conclusions

PDH showed good prediction, discriminatory power and certain contribution to PLD risk, while lower than 12 years old, female, and increased PDH numbers may be indicators of PLD susceptibility. Early warning of PDH may be needed in specific populations with learning disability (LD).