By applying a public health approach, researchers at three universities have discovered a key indicator for increased risk of mental retardation in the general population. The study assessed population-level risk factors by linking birth records of 12-14-year-old children in Florida with their respective public school records, over the course of a school year.
Using the rationale that high-prevalence risk factors can have a substantial impact at the population level, even if the risk to the individual is low, the researchers found that low maternal education resulted in the highest risk of intellectual disability to offspring compared with other factors such as maternal illness, delivery complications, gestational age at birth, and even very low birth weight.
Extremely low birth weight infants (less than 2.2 lbs) were 9.1 times more likely to have a mild intellectual disability compared to normal birth weight infants (5.5 lbs), yet were only associated with 2.1% of cases in the population. Women with an education below the high school level were 8.9 times more likely to have a child with mild intellectual disability compared with women who had more than 12 years of education, but were associated with 50.9% of cases.
Significant socioeconomic effects were found across all levels of intellectual disabilities, with higher income and education dramatically attenuating risk associated with biologic factors such as low birth weight, indicating a range of opportunities for population-based prevention and early intervention services.
The study's corresponding author, Derek Chapman, explained, "This approach to the study of disabilities is critical because an exclusive focus on prevention via medical interventions ignores the tremendous impact we can have by addressing social factors for which low education is a marker. If infants born to women with a high school education or less had the same risk as those born to college-educated women, there would be a 75% reduction in mild intellectual disabilities. Although genetic and biologic factors clearly play a role, their risk can be attenuated and there is a greater potential impact by addressing social factors such as maternal stress, birth spacing, preconception care, the child-rearing environment, and access to early and comprehensive intervention for at-risk infants and children."
As I think about all of this, I wonder what role schools might play, because there are two different considerations here. One is the preventative end---what can we do as a society to raise the educational status for all (and is NCLB already aimed to do that) before children are born? Secondly, what can we do for mothers and children who are already in this situation? It looks like intensive pre-school programs might help the kids. Should schools also offer continuing education to parents? At first, I wondered whether or not this should really be the responsibility of the schools. It isn't, and yet we are held accountable for getting every child to meet the standards. If fewer of them came to us with learning disabilities, our job would be a lot easier. Perhaps the answer lies in partnering with other community services. While the school could provide a location for parenting classes or other outreach programs, another agency could do the training. How far should schools go in order to ensure that every child has the best possible opportunity to achieve?