Abstract
At school age extremely low birth weight (ELBW) and extremely low gestational age (ELGAN) children are more likely to show Learning Disabilities (LDs) and difficulties in emotional regulation. The aim of this study was to investigate the incidence of LDs at school age and to detect neurodevelopmental indicators of risk for LDs at preschool ages in a cohort of ELBW/ELGAN children with broadly average intelligence. All consecutively newborns 2001–2006 admitted to the same Institution entered the study. Inclusion criteria were BW < 1000 g and/or GA < 28 weeks. Exclusion criteria were severe cerebral injuries, neurosensory disabilities, genetic abnormalities, and/or a Developmental Quotient below normal limits (< 1 SD) at 6 years. The presence of learning disabilities at school age was investigated through a parent-report questionnaire at children's age range 9–10 years. Neurodevelopmental profiles were assessed through the Griffiths Mental Development Scales at 1 and 2 years of corrected age and at 3, 4, 5, and 6 years of chronological age and were analyzed comparing two groups of children: those with LDs and those without. At school age 24 on 102 (23.5%) of our ELBW/ELGAN children met criteria for LDs in one or more areas, with 70.8% comorbidity with emotional/attention difficulties. Children with LDs scored significantly lower in the Griffiths Locomotor and Language subscales at 2 years of corrected age and in the Personal-social, Performance and Practical Reasoning subscales at 5 years of chronological age. Our findings suggest that, among the early developmental indicators of adverse school outcome, there is a poor motor experimentation, language delay, and personal-social immaturity. Cognitive rigidity and poor ability to manage practical situations also affect academic attainment. Timely detection of these early indicators of risk is crucial to assist the transition to school.
Highlights
Survival rates of preterm infants, especially with extremely low birth weight (ELBW) and/or extremely low gestational age at birth (ELBW and/or ELGAN, respectively), have steadily increased in the last decades due to the improvement of medical knowledge and techniques used in intensive care (Doyle et al, 2011; Latini et al, 2013)
The aim of this study was to investigate the incidence of Learning disability (LD) at school age in a cohort of children born with ELBW and/or ELGAN with broadly average intelligence and to analyse their neurodevelopmental profiles at preschool age, in order to identify early indicators of risk for adverse school outcomes
As shown by confidence intervals, there were no significant differences between LD-Group and No-LD-Group for each of the variables considered
Summary
Survival rates of preterm infants, especially with extremely low birth weight (ELBW) and/or extremely low gestational age at birth (ELBW and/or ELGAN, respectively), have steadily increased in the last decades due to the improvement of medical knowledge and techniques used in intensive care (Doyle et al, 2011; Latini et al, 2013). Studies on the neuropsychological outcome in ELBW/ELGAN children have disclosed impairments across a wide range of areas, including planning and organization, self-regulation, mental flexibility, and deployment of attention (Farooqi et al, 2013). Difficulties in these areas have been demonstrated to be strongly associated with academic struggles and higher rates of special education support (Msall, 2012). At school age ELBW and/or ELGAN children are more likely to show poorer academic performance than their peers (Litt et al, 2012; Simms et al, 2013). Even ELBW children with IQ scores within broadly normal limits frequently experience difficulties in academic achievement and attention (Grunau et al, 2002)
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