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Presentation 3: Myths and reality B. Gindis Ph.D.

Premature birth and low birth weight

The research shows that children who are born pre-mature and/or with low birth weights were nearly three times as likely to be low achievers or special needs children once they reached school age compared with children born at full-term. However, there is no a definite link between a pre-maturity and school problems: about one third of premature children has no substantial school difficulties. Unfortunately, nothing stands out as a predictor to distinguish pre-term children with positive outcomes from those with negative outcomes. In general, the probability of having school problems with pre-mature children is relatively high. For more information please read:

The research data from Sweeden: "Very Low Birthweight Infants Fare Worse Academically Later in Life"

UPPSALA, Sweden (Reuters Health) Aug 23, 2002 - Very low birth weight (VLBW) infants fare worse than their full-term counterparts in reading and writing development, according to a study presented at the 10th European Conference on Developmental Psychology.

An initial assessment of 7,505 children showed that children with birth weights of 1500 g or less had a significantly lower IQ on average than heavier pre-term infants at 5 years of age. A cohort of 339 VLBW children, weighing less than 1500 g or with gestation periods of less than 32 weeks, was chosen for further study and investigation.

Professor Dieter Wolke and colleagues at the University of Hertfordshire, UK, assessed the reading and writing development of these children and compared the results with those obtained from a control group of 294 full-term children.

Marked differences were noted between the two groups. At 8.5 years of age, only 51.5% of the VLBW children were in the appropriate age group for their class compared with 91.2% of the control group. Dr. Wolke' group also found that 22.8% of VLBW infants were in special schools compared with 1.5% of controls. A follow-up study showed that four years later, as children progressed into secondary school, nearly 20% of the VLBW children remained in special schools.
Nearly 30% of the preterm children had reading problems at 8.5 years, compared with 9% of the control group. Writing problems were even more pronounced in the VLBW group, with almost 40% having difficulties in this area.

A closer analysis of these results showed that reading skills could be predicted in the control group by preschool phonetic awareness, IQ and preschool knowledge of the alphabet. In the VLBW group, reading ability was mainly determined by general IQ alone. In contrast, writing difficulties could be predicted by the same factors in both groups.

According to Professor Wolke, there is a critical point where the development of the prenatal infant is at a crucial stage. "It's pretty clear that the density of risk is relatively low until you get down to 1500 g or 32 weeks of gestation. From then on, there's a turning point and the density of risk becomes higher."

Professor Wolke pointed out that in spite of the risk, many preterm babies go on to develop very well. "We suggest that for a subgroup only of these children, there's clearly some early brain mechanisms which have led to lower IQ functioning in simultaneous information processing which is then related to a range of problems, like behavioural problems or reading and academic problems."

The article by Chris Gearon "Children Born Preterm Likely to Be Low Achievers in School"

WASHINGTON, DC, Aug 08, 2002 (Reuters Health) - Children who are born preterm or at low birth weights were nearly three times as likely to be low achievers or special needs children once they reached school age compared with children born at full-term, according to findings reported at the 108th annual convention of the American Psychological Association.

Presented by researchers Jeremie R. Barlow and Dr. Lawrence Lewandowski of Syracuse University, the data showed that 61% of preterm children without physically debilitating conditions experienced either low achievement or special needs in school, while 23% of full-term children experienced these problems.

"Although the majority of preterm infants in the general population will not experience severe, global dysfunction, the results of the current study suggest that impaired functioning is prevalent among children born preterm," the researchers' paper concluded. "As hypothesized, academic achievement had been significantly impacted [and] in many cases had led to grade retention and designation as students with a disability," the researchers continued.

As part of this 10-year longitudinal study, the researchers evaluated 118 infants born at 24 to 31 weeks and 119 full-term infants, born at 38 to 42 weeks. The children, who were measured at birth, 15 months, and at 2, 4, 7 and 10 years of age, were compared using school-related cognitive functioning measures that assess learning disabilities, academic achievement, placement and grade retention.

Preterm children not only scored lower on intelligence and achievement tests compared with full-term children, but parents and teachers rated preterm youngsters lower on social and behavioral functioning measures. Furthermore, the preterm children needed more educational support, were held back a grade level and were diagnosed with learning disabilities more often than the other children, the researchers found. "However, there was a group of resilient children [among preterm births], some of which were real small babies," the researchers said. Twenty-nine of the 118 children born at preterm had positive outcomes. "Nothing stood out as a predictor" to distinguish preterm children with positive outcomes from those with negative outcomes, the researchers said.

The preterm children were also diagnosed with attention deficit hyperactivity disorder at rates four- to six-times higher than the national estimates of 3% to 5% in the general population, the authors add. "The prevalence of school problems with preterm children is staggering," the researchers conclude, "and warrants greater attention from school professionals."

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