Academic Achievement Deficits and Their Neuropsychological Correlates in Children Born Extremely Preterm

Abstract

Objective The purpose of this study was to examine the risks associated with learning disabilities (LD) in a large sample of children born extremely preterm. We predicted higher than expected rates of LD, particularly in math, and children with LD in math, reading, or both would have lower IQs and specific patterns of neuropsychological deficits. Method We evaluated academic achievement, rates of LD, and their neuropsychological correlates in the Extremely Low Gestational Age Newborn (ELGAN) Study cohort of 10-year-old children born at 23 to 27 weeks gestational age. Primary analyses focused on children without intellectual disability (verbal IQ > 70 and nonverbal IQ > 70; N=668). Low achievement was defined as a standard score ≤ 85 on the reading or math measures. Results The risk of low math achievement scores (27%) was 1.5 times higher than the risk of low reading achievement scores (17%). Children were classified as having LD based on low achievement criteria in reading only (RD, 6.4% of sample), math only (MD, 16.2%), both reading and math (RD/MD, 8.3%), or no reading or math disabilities (No LD, 69.1%). Although all three LD groups had multiple neuropsychological weaknesses compared to the No LD group, the RD and MD groups had different patterns of neuropsychological impairment. Conclusion These children from the ELGAN cohort had higher than expected rates of LD, particularly in mathematics, even after taking socioeconomic status into consideration. These results point to specific cognitive weaknesses that differ between extremely preterm children with RD and MD and the utility of neuropsychological assessments in addressing low academic achievement.

Mathematics Skills and Executive Functions Following Preterm Birth: A Longitudinal Study of 5-to 7- Year Old Children

“…We predict that this deficit in the preterm group will persist over time, and possibly increase further. In line with this, mathematics deficits have been found in pre-teens (Akshoomoff et al, 2017;Rose et al, 2011), and teenagers (Litt et al, 2012) born preterm. The same applies for other aspects of formal mathematics, such as Set Construction and Number Facts.…”

“…Very preterm birth (before 33 weeks of gestation) has a negative effect on academic achievement in general (Johnson, Wolke, Hennessy, & Marlow, 2011), and mathematical ability in particular (Akshoomoff et al, 2017;Taylor, Espy, & Anderson, 2009). Every year about 15 million children are born preterm, with preterm birth rates ranging from 5-18% (Liu et al, 2016).…”

Neonatal systemic inflammation and the risk of low scores on measures of reading and mathematics achievement at age 10 years among children born extremely preterm

“…Similarly, other potential confounders such as the child's sex were also not associated with systemic inflammation. On the other hand, low birth weight Z‐score, indicative of fetal growth restriction, is associated in this sample with elevated concentrations of some proteins (Landis and Koch, 1977; Leviton et al, 2016) and with low Word Reading scores (Ackshoomoff et al, 2017). Thus, low birth weight Z‐score is a potential confounder.…”

Mathematics ability and related skills in preschoolers born very preterm

“…Children born very preterm (VPT; GA less than 33 weeks) are at increased risk for academic difficulties, and even children without low IQs are more likely than their fullterm (FT)-born peers to have specific learning disabilities or underachievement in reading, spelling, and/or mathematics (Aarnoudse-Moens, Weisglas-Kuperus, van Goudoever, & Oosterlaan, 2009;Litt, Taylor, Klein, & Hack, 2005). Previous studies with independent samples have shown mathematics to be a particular weakness (Akshoomoff et al, 2017;Taylor, Espy, & Anderson, 2009;Taylor, Klein, Drotar, Schluchter, & Hack, 2006). Preschool is an important period in a child's development and early identification of academic weaknesses and targeted intervention are essential to improving outcomes.…”