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Background: Compared with typically developing children, children with special needs often struggle with academic and social aspects of school, though certain factors can improve their academic and social developmental trajectory. The objective of this investigation was to explore the association between the developmental health of children with special needs at school-entry, as measured by the Early Development Instrument (EDI), and neighborhood-level SES. To date, the EDI has only been validated for use in typically developing children. Hence, a secondary objective of this investigation was to explore the psychometric properties of the EDI for children with special needs. Methods: The data for this investigation were from the Pan-Canadian database of children’s developmental health at school entry. The psychometric properties of the EDI, including item and domain characteristics, factor structure, and construct validity, were tested for children with special needs. Hierarchical generalized linear models was used to model the association between EDI domain scores and a custom neighborhood SES index. Results: A total of 29,841 (69.8% male) and 29,520 (69.7% male) children with special needs were available for the investigation on the psychometric properties of the EDI and the relationship between EDI outcomes and SES, respectively. The psychometric performance of the EDI in children with special needs was similar to its performance in typically developing children. The EDI was subsequently used to explore the association between developmental outcomes and neighborhood socioeconomic status (SES). All EDI domains were positively correlated with SES, indicating that children in high SES neighborhoods have better developmental outcomes at school entry than those in lower SES neighborhoods. Conclusions: The results of this investigation draw attention to the potential impact of contextual factors on children’s health and have implications for policy development and service planning. These results also indicate that the EDI performs similarly in children with special needs and typically developing children, thus enabling its more extensive use for this population. / Thesis / Master of Science (MSc) / Background: Compared with typically developing children, children with special needs often struggle with academic and social aspects of school, though certain factors can improve their academic and social developmental trajectory. The objective of this investigation was to explore the association between the developmental health of children with special needs at school-entry, as measured by the Early Development Instrument (EDI), and neighborhood-level SES. To date, the EDI has only been validated for use in typically developing children. Hence, a secondary objective of this investigation was to explore the psychometric properties of the EDI for children with special needs. Methods: The data for this investigation were from the Pan-Canadian database of children’s developmental health at school entry. The psychometric properties of the EDI, including item and domain characteristics, factor structure, and construct validity, were tested for children with special needs. Hierarchical generalized linear models was used to model the association between EDI domain scores and a custom neighborhood SES index. Results: A total of 29,841 (69.8% male) and 29,520 (69.7% male) children with special needs were available for the investigation on the psychometric properties of the EDI and the relationship between EDI outcomes and SES, respectively. The psychometric performance of the EDI in children with special needs was similar to its performance in typically developing children. The EDI was subsequently used to explore the association between developmental outcomes and neighborhood socioeconomic status (SES). All EDI domains were positively correlated with SES, indicating that children in high SES neighborhoods have better developmental outcomes at school entry than those in lower SES neighborhoods. Conclusions: The results of this investigation draw attention to the potential impact of contextual factors on children’s health and have implications for policy development and service planning. These results also indicate that the EDI performs similarly in children with special needs and typically developing children, thus enabling its more extensive use for this population.

Background: One in every nine school-age children in Ontario has special needs (SN) as a result of developmental disorders, however, the distribution of SN is unequal among schools. This prompted a group level exploration of the developmental health outcomes of typically developing children in schools with SN children. Methods: This study uses data from the Early Development Instrument (EDI; kindergarten measure of child development), administered in Ontario between 2010-2012, and neighbourhood-level socioeconomic status (SES) from the 2006 Canadian Census to examine associations between school SN prevalence and typically developing children’s development. Relationships between school SN prevalence and developmental health in those schools were explored in Grade 3 using Education, Quality and Accountability Office (EQAO) tests. Findings: Kindergarten multivariable regression model showed that school SN prevalence was associated with school level kindergarten vulnerability rates after controlling for SES and demographic factors. However, school SN prevalence was not a significant predictor of school performance in Grade 3 reading, writing and math test scores. Our exploration revealed that school kindergarten vulnerability rate, which was itself associated with the school prevalence of children with SN, was a stronger predictor of school Grade 3 academic outcomes than school SN prevalence after controlling for demographic and SES factors. Conclusions: This study provides a snapshot of population level inequalities in child health outcomes by demonstrating associations between school SN prevalence and kindergarten vulnerability, and kindergarten vulnerability and Grade 3 achievement. These findings further emphasize the importance of adequate early intervention programs in schools, and appropriate resource allocation for the health outcomes of typically developing children. / Thesis / Master of Health Sciences (MSc)