SUMMARY This paper examines the prevalence of learning difficulty in reading, spelling, mathematics and writing and the prevalence of attention deficit disorder (ADD) in extremely low‐birthweight (ELBW) children at school compared to their peers. Parents of 87 eligible ELBW children completed an educational questionnaire and questionnaire for ADD. Teachers of the ELBW children completed a detailed educational and ADD questionnaire for the study child and two control children in the same class, matched for âge and nearest in birth date to the study child. Parents reported that 4% of the ELBW children bom between 1977 and 1986 were in a special education unit, 46% received remedial help and 21% repeated a grade. Teacher assessment of six aspects of reading and spelling and five aspects of mathematics and writing skills indicated that the ELBW children experienced marked problems in all areas compared to control children and were approximately 3 times more likely to be delayed by more than a year in all areas. Prevalence of ADD was not increased in the ELBW children compared to the control group, though males in both groups had a higher prevalence of symptoms. Early intervention and special education resources must be available for ELBW children attending school. RÉSUMÉ Performances scolaires des enfants ELBW: une étude controlée L'article examine la prévalénce des difficultes d'apprentissâge en lecture, orthographe, arithmétique et ecriture, et la prévalence du trouble de deficit d'attention (ADD) chez les enfants d'extramement faible poids de naissance (ELBW) a ľécole, en comparaison avec leurs pairs. Les parents de 87 enfants ELBW choisis remplirent un questionnaire pour le niveau educatif et un autre pour le syndrome ADD. Les enseignants des enfants ELBW remplirent un questionnaire detaille sur le niveau cducatif et le syndrome ADD pour les enfants de l'étude et deux controles par classe. Les parents indiquerent que 4% des enfants ELBW nes entre 1977 et 1986 etaient dans une unite d'education speciale, 46% beneficiaient d'une assistance educative et 21% avaient redouble une classe. L'Evaluation des enseignants sur six aspects de lecture et orthographe, et cinq aspects de mathematiques et ecriture indiquait que les enfants ELBW avaient des difficultes en tous domaines par comparaison avec les controles et avaient environ trois fois plus de chances de presenter un retard de plus d'un an dans toutes les matieres. La prevalence de 1'ADD n'etaii pas plus elevee chcz les enfants ELBW que chez les.controles, bien que les garcons des deux groupes aient presenté une prevalence plus elevee des symptomes. Une intervention precoce et des ressources d'education speciale doivent etre offcrtes aux enfants ELBW frequentant I'école. ZUSAMMENFASSUNG Scludleistungen bei ELBW Kindenv erne kontrollierte Sttidie Diese Arbeit untersucht die Haufigkeit von Schwierigkeiten beim Lesen, Buchstabicren, Rechnen und Schreiben und die Häufigkeit von Aufmcrksamkeitsstörungcn (ADD) bei Schulkindem mit extrem niedrigem Geburtsgewicht (ELBW) verg...
This study examines the executive function (EF) skills of extremely-low-birthweight (ELBW) children at school compared with their peers. Thirty children with ELBW and 50 control children (both with a mean age of 62+/-4 months) were administered tests of EF including the Tower of Hanoi task, Finger Sequencing task, and Tapping Test. Children with ELBW, including those who scored more than 1 SD below the mean on the Peabody Picture Vocabulary Test-Revised, scored significantly lower than their peers on all executive tasks. There was limited correlation between EF and previous general quotient index scores obtained at routine assessment using the McCarthy Scales of General Ability at 4 years of age for the children with ELBW. Results suggest that children with ELBW are at risk for deficits in 'executive' behaviours including planning, sequencing, and inhibition which may have implications for later learning.
This study examines whether a small head circumference (HC) and low head-circumference growth velocity (HGV) during the first year of life predict consequences at school age in learning, cognition, and concentration. A total of 124 extremely-low-birthweight (ELBW) infants (birthweight 500 to 999 g) born between 1977 and 1986 were eligible for follow-up at the corrected ages of 4, 8, and 12 months and 2, 4, and 6 years. Infants were categorized as having a small HC (< 3% or 3 to 10%) on the basis of the 1990 British growth data which allowed standardized z-scores to be calculated for HC, independent of gestation and corrected age. HGV measurements were calculated using differences in the HC z-scores. In 1995, parents of 87 children agreed to participate in a study of learning and attention at school age. Attention-deficit-hyperactivity disorder (ADHD) was assessed using the Du Paul Rating Scale. Academic performances were based on a teacher questionnaire dealing with aspects of reading, writing, mathematics, and spelling. A child was considered to have a learning difficulty if academic problems were present in at least one of these four areas. Intellectual ability was assessed using the McCarthy Scale at 6 years. HC < 3% and 3 to 10% at 8 months' corrected age was strongly associated with school-aged learning problems (P=0.004), with a moderate specificity (70%), positive predictive value (PPV) (67%), and sensitivity (67%). HGV < or = 10% from birth to 4 months was also associated with learning problems at school age (P=0.01) with a higher specificity (98%) and PPV (88%) but lower sensitivity (20%). A logistic regression analysis was performed with the risk for learning difficulties at 8 months as the dependent variable. Sex, gestation, birthweight, multiple births, and a history of intraventricular hemorrhage did not substantially alter the unadjusted odds ratio (4.7; 95% CI 1.9 to 13.6). Maternal age and education did not confound the relation. No association was found between HC or HGV and ADHD. HC < 3% at 4 months (P<0.02), 8 months (P=0.02), and 12 months (P=0.04), and HGV between birth and 4 months (P<0.01) were significantly associated with low cognitive ability at 6 years.
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