Changing rates of physical and psychosocial impairments over 9 years in cohorts of school beginners in Germany: long-term trends of impairments in children

Abstract

OBJECTIVE: The aim of this study was to investigate the prevalence of impairments of physical and psychosocial development in children commencing primary school and to analyse changes over 9 years in consecutive cohorts. PATIENTS AND METHOD: We utilised a retrospective cross-sectional study design to assess the prevalence of impairments over nine consecutive cohorts of German children beginning school from 1997 to 2005. A total of 9,514 children were assessed for physical and psychosocial impairment using a manualised medical assessment. RESULTS: There was a dramatic increase in the rates of motor and speech disorders detected among children tested over the 9-year period. We observed a seven-fold increase in motor impairments (OR 7.1; 95% CI 4.2–11.7) and almost a three-fold increase in speech disorders (OR 2.6; 95% CI 2.1–3.3) from 1997 to 2005. Males had higher rates of impairment in all domains of functioning as compared to females (26.0% vs 15.3%; p < 0.0005). By 2005, however, girls had comparable rates of speech and motor impairments to males. No clear pattern of change in behavioural or cognitive impairments was seen. CONCLUSIONS: The data suggest a changing pattern of deficits in young children, especially girls, which is alarming and warrants close scrutiny. Potential confounding factors may have influenced the results, which should be interpreted with caution. Further research is needed to support our results and to identify the aetiologies of the observed changes. If confirmed, our data have implications for intervention and public health initiatives.