{
  "abstract": "Objectives Children with chronic conditions in low- and middle-income countries (LMICs) face persistent inequities in early childhood education (ECE) access. We aimed to investigate preschool education rates, associated factors, and parental perspectives on barriers to preschool participation among children with chronic health conditions in Turkey, an upper-middle-income country.Methods We retrospectively analyzed children aged 36–60 months evaluated for developmental difficulties (DDs) at Ankara University School of Medicine Department of Pediatrics Developmental Pediatrics Division during 2022. To assess preschool participation and barriers, data from the Expanded Guide for Monitoring Child Development (Expanded GMCD), incorporating WHO ICF and Nurturing Care Framework was used. Bivariate analyses examined associations between preschool attendance and child, family, and contextual characteristics.Results Of 978 children with DDs, 110 (11.2%) with chronic conditions comprised the study sample (61.8% boys; median age 45.0 months (range:36–60) Most prevalent diagnosis was autism spectrum disorder (26.4%), Of these 29 (26.4%) children attended preschool. Attendance was associated with age ≥48 months (OR=3.10; 95% CI: 1.29–7.46, p=0.010), presence of maternal employment (OR=3.74; 95% CI: 1.36–10.28, p=008), and maternal education >high school (OR=3.79; 95% CI: 1.53–9.43, p=0.003). Reported barriers included child being ‘too young’ (63.0%), financial difficulties (21.0%), health-related issues (19.8%), family reluctance (6.2%), school refusal (3.7%), and lack of local services (2.5%).Conclusions ECE participation among Turkish children with chronic conditions was very limited in our study. Parent-reported barriers underscore age-related, socioeconomic, and systemic challenges, highlighting the urgent need for inclusive, context-specific early education policies in LMICs.",
  "authors": [
    {
      "affiliations": [
        "Ankara University School of Medicine, Department of Pediatrics, Developmental Pediatrics Division, Ankara, Turkey"
      ],
      "name": "Hale Sandikci Iskenderli"
    },
    {
      "affiliations": [
        "Ankara University School of Medicine, Department of Pediatrics, Developmental Pediatrics Division, Ankara, Turkey"
      ],
      "name": "Ezgi Ozalp Akin"
    }
  ],
  "title": "135 Preschool education access and barriers for children with chronic health conditions in a middle-income country: parent perspectives from Turkey",
  "uid": "f8f9cf3d-ae6f-536c-ab1b-49dae90bb8ee"
}