Identifying Very Preterm Children at Educational Risk Using a School Readiness Framework

Abstract

Article is available for free via the provided URL.OBJECTIVES: Children born very preterm (VPT) are at high risk of educational delay, yet few guidelines exist for the early identification of those at greatest risk. Using a school readiness framework, this study examined relations between preschool neurodevelopmental functioning and educational outcomes to age 9 years. METHODS: The sample consisted of a regional cohort of 110 VPT (?32 weeks? gestation) and 113 full-term children born during 1998?2000. At corrected age 4 years, children completed a multidisciplinary assessment of their health/motor development, socioemotional adjustment, core learning skills, language, and general cognition. At ages 6 and 9, children?s literacy and numeracy skills were assessed using the Woodcock-Johnson III Tests of Achievement. RESULTS: Across all readiness domains, VPT children were at high risk of delay/impairment (odds ratios 2.5?3.5). Multiple problems were also more common (47% vs 16%). At follow-up, almost two-thirds of VPT children were subject to significant educational delay in either literacy, numeracy or both compared with 29% to 31% of full-term children (odds ratios 3.4?4.4). The number of readiness domains affected at age 4 strongly predicted later educational risk, especially when multiple problems were present. Receiver operating characteristic analysis confirmed ?2 readiness problems as the optimal threshold for identifying VPT children at educational risk. CONCLUSIONS: School readiness offers a promising framework for the early identification of VPT children at high educational risk. Findings support the utility of ?2 affected readiness domains as an effective criterion for referral for educational surveillance and/or additional support during the transition to school.publishersversionPeer reviewe

Emotional and Behavioral Problems of Preterm and Full-Term Children at School Entry

“…[23][24][25] This disruption of brain development has important consequences for these children's long-term brain development, [26][27][28] including poorer school readiness skills. 29 Consequently, preterm children have fewer adaptive skills to help them learn in groups and maintain positive relationships with peers, [29][30][31] factors that will also influence the stability of EB problems at school entry. In addition, moderately preterm children may have fewer persistent and more resolving problems than their younger preterm counterparts because of their more mature brain at birth and their lower risk of postnatal complications 32 ; they may also have better school-readiness skills than preterm children with a younger GA. 29 As a result, moderately preterm children may have more adaptive abilities to correct initial problems.…”

“…However, EB problems may change particularly at the time of school entry, when children need to be able to adapt to a new social environment. [29][30][31] Another limitation is that we could not adjust for interventions between or before ages 4 and 5, which might have affected persistence. Furthermore, we had no clinical diagnosis of EB problems made by a psychiatrist or psychologist.…”

Desempenho linguístico de prematuros de 2 anos, considerando idade cronológica e idade corrigida

“…The advances in obstetrics and neonatology have resulted in better survival rates among children of premature birth (3) , despite the difficulty in the rates of development remaining high (4)(5)(6) . Some children that were born premature, in the absence of brain injuries, have negative consequences in several important aspects of development (7,8) , such as difficulties in acquiring language (9)(10)(11) , poor cognitive ability (9,12) , and linguistic and academic difficulties within the early school years (4,(13)(14)(15)(16)(17) . Premature children tend to present a lag in lexical development when compared with children born at term (18) .…”

Neuropsychological outcomes of preterm birth in children with no major neurodevelopmental impairments in early life

“…It is well-known that premature infants with major NDI are more likely to be impaired in various developmental domains compared with full-term infants [5,7]. In the literature, preterm infants are at high risk for problems in adaptive function, behavior, socio-emotional development and academic performance compared with fullterm infants [6,8,9].…”