ABSTRACT. Objective. To compare academic and cognitive ability, attention, attitudes, and behavior of extremely low birth weight (ELBW) adolescents who are free of major impairments at 17 years of age with termborn control subjects.Methods. Between January 31, 1981, and February 9, 1986, 250 infants of <800 g were admitted for intensive care in British Columbia, 98 (39%) of whom survived to late adolescence. Teens with major sensorimotor handicaps and/or IQ <70 were excluded (n ؍ 19). Of the 79 eligible ELBW teens, 53 (67%) were assessed at 17. Results. The ELBW group showed lower cognitive scores (vocabulary, block design, and digit symbol) and academic skills (reading and arithmetic) compared with control subjects, with no gender differences. There were no differences in attention between the 2 groups using a repetitive computer task. ELBW teens reported lower scholastic, athletic, job competence, and romantic confidence and viewed themselves as more likely to need help from others in finding a job. In the behavioral domain, parents reported their ELBW teens to display more internalizing, more externalizing, and more total problems than the control teens, with ELBW boys showing more problems. ELBW teens showed a higher percentage of clinically significant behavior problems than control subjects.Conclusions. In a provincial cohort of unimpaired survivors of birth weight <800 g, psychosocial and educational vulnerabilities persist into late adolescence and may complicate the transition to adult life compared with their peers. Pediatrics 2004;114:e725-e732. URL: www. pediatrics.org/cgi/doi/10.1542/peds.2004-0932; premature infants, very low birth weight infants, follow-up studies, developmental disabilities.ABBREVIATIONS. ELBW, extremely low birth weight; VLBW, very low birth weight; ADHD, attention-deficit/hyperactivity disorder; NICU, neonatal intensive care unit; WISC, Wechsler Intelligence Scale for Children; SD, standard deviation; SES, socioeconomic status; WAIS-III, Wechsler Intelligence Scale for Adults, Third Edition; WRAT-3, Wide Range Achievement Test, Third Edition; CPT, Continuous Performance Task; CBCL, Child Behavior Check List. I n the past 3 decades, major advances in neonatal intensive care technology and the development of functional regionalized perinatal networks have made medical services accessible to the majority of high-risk births and have led to increased survival of infants of extremely low birth weight (ELBW Յ800 g). There is now a significant body of literature describing the psychosocial and educational outcomes of infants of Ͻ1000 g birth weight born in the 1980s at school age, which include small numbers of infants of 800 g or less. Long-term neurodevelopmental, behavioral, cognitive, and motor sequelae of prematurity have been documented extensively, [1][2][3][4][5][6][7][8] including reports that predate the increase in survival of extremely small and sick infants. [9][10][11][12] In addition to children with frank neurologic and sensory impairment, a spectrum of neurodevelopm...