Abstract
The aims of this study were to identify the aspects of school readiness that best distinguish very preterm (VPT) preschoolers from full-term (FT) controls, determine the extent to which readiness problems in the VPT group reflected global cognitive weaknesses or more specific deficits, and identify distinct profiles of readiness problems. Fifty-three VPT (gestational age ≤ 30 weeks) 4-year-olds were compared to 38 FT (gestational age ≥ 37 weeks) controls on measures of global cognitive ability, executive function, motor skills, early literacy and numeracy, and psychosocial functioning. Latent class analysis (LCA) was also conducted to identify individual readiness profiles. The VPT group had the most pronounced difficulties on tests of spatial and nonverbal cognitive abilities, executive function, motor skills, phonological processing, and numeracy. The VPT group also had sex-related difficulties in processing speed, social functioning, and emotion regulation. These differences were evident in analyses of both continuous scores and rates of deficits. The VPT group’s difficulties in motor skills, and VPT females’ difficulties in social functioning and emotion regulation, were evident even when controlling for global cognitive ability. LCA suggested four profiles of readiness, with the majority of the VPT group assigned to profiles characterized by relative weaknesses in either cognitive abilities or psychosocial functioning or by more global readiness problems. The findings support the need to evaluate multiple aspects of school readiness in VPT preschoolers and inform efforts to design more targeted early educational interventions.
Highlights
Problems in psychosocial functioning that distinguished the very preterm (VPT) group from FT controls were in areas of executive function, and, at least for females, in emotion regulation and social functioning, the effect size (ES) corresponding to these differences were not as large as those for group differences on the aforementioned performance measures
The findings from this study suggest that effects of VPT birth on school readiness are most likely to be manifest in tests of spatial, nonverbal, and motor skills, executive function, phonological processing, and early number knowledge
Variability in the types of readiness problems displayed by VPT preschoolers is supported by findings of independent effects of VPT birth on global cognition and motor skills and by variable profiles of readiness skills in the VPT group
Summary
These problems persist across the school-age years, are inversely related to the degree of prematurity at birth, and are preceded by earlier developmental delays [1–6]. According to the American Academy of Pediatrics [7] and an updated technical report [8], school readiness covers a broad range of characteristics conducive to learning, including health and physical/motor development, social–emotional adjustment, approaches to learning as exemplified by motivation and self-control, communication skills, and general knowledge (including knowledge of letters and numbers) and cognition. Researchers in New Zealand documented generalized delays in school readiness skills at age 4 years in VPT children compared to FT controls [4]. Delays in multiple areas of readiness were three times more common in the VPT group compared to the FT group and predicted later deficits in academic achievement at ages 6 and 9 years. Other studies provide additional evidence for deficits in cognitive and emotional self-regulation in VPT preschoolers and associations of these deficits with learning problems [11–19]
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