Research Snapshot: Factors that help or hinder children with additional needs to succeed at school

Research Snapshot: Factors that help or hinder children with additional needs to succeed at school

Research Snapshot: Factors that help or hinder children with additional needs to succeed at school


The first years of school bring children into contact with many new demands, environments and relationships. Children’s experiences in these early years carry lasting implications for their educational trajectory (Hauser-Cram et al 2007). The transition to school can be even more daunting for children with additional health and developmental needs (AHDN) and their families. They can face additional challenges like fitting in with peers, and accessing necessary additional resources (Goldfeld et al 2012; Whiteford et al 2012).

With health and education closely intertwined, there are a myriad of ways in which additional needs can impact on children’s learning and engagement with school, with these influences operating right from the earliest yearsof schooling. Yet while there has been ample research on the medical and health care experiences of children experiencing additional health and developmental needs, the impact on their school functioning has generally been under-explored. This includes those factors that put them at less or more risk of school failure.

Defining additional health care needs 

Children with additional health and developmental needs (also known as special health care needs) are those who have or are at an increased risk for a chronic physical, developmental, behavioural, or emotional condition, and who also require health and related services of a type or amount beyond that required by children generally (Newacheck et al., 1998). Additional needs include a wide variety of conditions, ranging from obesity and asthma to profound intellectual impairment, with a parallel broad range of possible presentations, levels of severity, and associated needs.

Further information about the prevalence and types of conditions experienced by children with additional needs is contained in another Australian Early Development Census (AEDC) research snapshot: Children starting schools with additional health and developmental needs: results from the 2009 Australian Early Development Census.


The research described in this snapshot aimed to understand what can help or hinder the transition to school for children with AHDN, through a narrative review of relevant literature.

Key Findings

Consistent with an ecological approach to child development, there was a mixture of influences identified ranging from the child’s characteristics to the environments in which they are operating, including numerous factors at the service-system level. The many protective factors identified suggest it is important to not only describe and respond to children’s limitations, but also to acknowledge the child’s capabilities and strengths as well as other protective factors operating at the family and service-system level so that these can be drawn on and developed to help them succeed.

Given the range of risk and protective factors that can be at play for any given child, provision of care based only on the child’s condition may be too restrictive. In contrast, a multidisciplinary approach tailored to the child’s individual circumstances may be more beneficial in supporting children with additional needs to thrive at school (Lollar et al., 2012; Janus, 2011).

The current state of the literature clearly suggests that many of the risk and protective factors are operating from the earliest experiences at school. Given that the transition period to formal schooling is a critical time that helps to shape long-term educational trajectories, it is important to address risk factors and promote protective factors early in children’s educational careers.


For Policy and Practice:

The review revealed a broad range of risk and protective factors, suggesting that there are many opportunities to intervene to promote better outcomes for these children.

For Research:

Most research to date has focused on specific conditions rather than taking a broad non-categorical approach, that is, looking at children with additional needs collectively. However, the current findings suggest that there are generic risk and protective factors likely to be relevant across many condition types, and it may therefore be helpful for more research to examine interventions, outcomes and influences for children at this broader level of analysis.

Tools such as the AEDC provide a means to further explore the factors that contribute to optimal educational outcomes for children with additional needs.

The review highlights that the ways in which additional needs impact on a child’s functioning are very complex, suggesting the need for a clear conceptual framework to guide research in this area. A proposed conceptual model of the processes that can impact on school functioning for children with additional needs will be explored in further detail in the companion research snapshot titled: ‘Pathways through school for children with additional needs: A conceptual model’.

Study Details

This research snapshot is derived from a literature review conducted within the AEDC research programme at the CCCH. 

For further details

Details of the research paper

Published article details: Howell-Meurs, S., O’Connor, M., Kvalsvig, A., & Goldfeld, S. (2014). The school functioning of children with additional health and developmental care needs in the primary years: A literature review. Melbourne, Australia: Centre for Community Child Health.

For access to AEDC data please visit for details. 


  1. Goldfeld, S., O’Connor, M., Sayers, M., Moore, T., & Oberklaid, F. (2012). Prevalence and Correlates of Special Health Care Needs in a Population Cohort of Australian Children at School Entry. Journal of Developmental & Behavioral Pediatrics, 33(4), 319-327. doi: 10.1097/DBP.0b013e31824a7b8e
  2. Hauser-Cram, P., Durand, T. & Warfield, M. (2007) Early feelings about school and later academic outcomes of children with special needs living in poverty. Early Childhood Research Quarterly, 22, 161-172.
  3. Janus, M. (2011). Impact of Impairment on Children with Special Needs at School Entry: Comparison of School Readiness Outcomes in Canada, Australia, and Mexico. Exceptionality Education International, 21(2), 29-44.
  4. Lollar, D. J., Hartzell, M. S., & Evans, M. A. (2012). Functional Difficulties and Health Conditions Among Children With Special Health Needs. Pediatrics, 129(3), e714-e722. doi: 10.1542/peds.2011-0780
  5. Newacheck, P., Strickland, B., Shonkoff, J., Perrin, J., McPherson, M., McManus, M., Arango, P. (1998). An epidemiologic profile of children with special health. Pediatrics, 102(1), 117.
  6. Whiteford, C., Walker, S. & Berthelsen, D. (2012) Australian Children with Special Health Care Needs: Social-emotional and learning competencies in the early years. International Journal of Early Childhood.

Additional sources

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  6. Brinkman, S., Sayers, M., Goldfeld, S., & Kline, J. (2009). Population monitoring of language and cognitive development in Australia: The Australian Early Development Index. International Journal of Speech3 Language Pathology, 11(5), 419-430. doi: doi:10.1080/17549500903147552
  7. Goldfeld, S., O’Connor, M., Mithen, J., Sayers, M., & Brinkman, S. (2013). Early developmental outcomes of bilingual children at school entry in an Australian population cohort. Manuscript submitted for publication.
  8. Guhn, M., Gadermann, A., Hertzman, C., & Zumbo, B. (2010). Children’s Development in Kindergarten: A Multilevel, Population-Based Analysis of ESL and Gender Effects on Socioeconomic Gradients. Child Indicators Research, 3(2), 183-203. doi: 10.1007/s12187-009-9053-7
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  10. Halle, T., Hair, E., Wandner, L., McNamara, M., & Chien, N. (2012). Predictors and outcomes of early versus later English language proficiency among English language learners. Early Childhood Research Quarterly, 27(1), 1-20. doi:10.1016/j.ecresq.2011.07.004
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  16. Puchala, C., Vu, L., & Muhajarine, N. (2010). Neighbourhood ethnic diversity buffers school readiness impact in ESL children. Canadian Journal of Public Health, 101(3), 513-518.Research

About research snapshots

AEDC snapshots provide a brief and accessible overview of research being undertaken in relation to the AEDC. The Australian Government under the AEDC programme funded this project. For further up-to-date information and resources consult the AEDC website:

About the organisation

The Royal Children’s Hospital Centre for Community Child Health (CCCH) has been at the forefront of Australian research into early childhood and behaviour for over two decades. The CCCH conducts research into many conditions and common problems faced by children that are either preventable or can be improved if recognised and managed early. By working collaboratively with leaders in policy, research, education and service delivery, the Centre aims to influence early childhood policy and improve the capacity of communities to meet the needs of children and their families.​

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