Learning Disabilities and School Problems in a Regional Cohort of Extremely Low Birth Weight (&lt; 1000 G) Children

Saigal, Saroj; Rosenbaum, Peter; Szatmári, Péter; Campbell, Dugal

doi:10.1097/00004703-199110000-00002

Cited by 88 publications

(54 citation statements)

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“…Thus, difficulties with mathematics seem to be even more pronounced for VLBW children with BPD than for children with VLBW only. 26 Similarly, gross and fine motor problems have been described in several studies of VLBW children. 27,28 In this study, the BPD children scored more poorly than both VLBW and term comparison children on a measure of gross motor skills.…”

Section: Discussionmentioning

confidence: 76%

Cognitive and Academic Consequences of Bronchopulmonary Dysplasia and Very Low Birth Weight: 8-Year-Old Outcomes

et al. 2003

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ABSTRACT. Objective. To examine the effects of bronchopulmonary dysplasia (BPD) and very low birth weight (VLBW) on the cognitive and academic achievement of a large sample of 8-year-old children.Methods. Infants who were VLBW and had BPD (n ‫؍‬ 98) or did not have BPD (n ‫؍‬ 75) and term infants (n ‫؍‬ 99) were followed prospectively to age 8. Groups were compared on measures assessing 4 broad areas of functioning: intelligence, achievement, gross motor, and attentional skills. Measures included the Wechsler Intelligence Scale for Children III, the Woodcock Johnson Test of Achievement-Revised, the Bruininks-Oseretsky Test of Motor Proficiency, the Tactual Performance Test (spatial memory), and the Continuous Performance Test (attention). School outcomes were assessed by parent and teacher report, as well as from school records. Groups were comparable on socioeconomic status, sex, and race. The total sample of BPD, VLBW, and term children was compared on all outcome measures. In addition, neurologic risk was assessed in the present sample and included the following: intraventricular hemorrhage, echodense lesions, porencephaly, hydrocephalus, ventriculoperitoneal shunt, meningitis, and periventricular leukomalacia. Individual difference analyses were conducted for neurologically intact children in all 3 groups. Finally, treatment effects were examined by comparing BPD children who had received steroids as part of their treatment with BPD children who had not.Results. The BPD group demonstrated deficits compared with VLBW and term children in intelligence; reading, mathematics, and gross motor skills; and special education services. VLBW children differed from term children in all of the above areas, except reading recognition, comprehension, and occupational therapy. Attentional differences were obtained between BPD and term children only. The BPD group (54%) was more likely to be enrolled in special education classes than VLBW (37%) or term children (25%). In addition, more BPD children (20%) achieved full-scale IQ scores <70, in the mental retardation range, compared with either VLBW (11%) or term (3%) children, with all VLBW children significantly more likely than term children to achieve IQs in the subaverage category. After controlling for birth weight and neurologic problems, BPD and/or duration on oxygen predicted lower performance IQ, perceptual organization, full-scale IQ, motor and attentional skills, and special education placement. The qualitative classification of BPD (present or absent) was a significant predictor for lower scores on measures of applied problems; motor skills; and incidence of speech-language, occupational, and physical therapies. Individual difference analyses were performed to ascertain whether differences between the risk groups were primarily attributable to neurologic complications. Even with the neurologically intact sample of BPD and VLBW children, differences between the term comparison group and both the BPD and VLBW groups were found for many outcome measures. When birth w...

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Section: Discussionmentioning

confidence: 76%

Cognitive and Academic Consequences of Bronchopulmonary Dysplasia and Very Low Birth Weight: 8-Year-Old Outcomes

et al. 2003

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“…In turn, children with difficulties identified at school age often display visual-spatial deficits and impaired gross and fine motor coordination and integration, and these deficits may contribute to learning and other functional disabilities (Murray et al 1990, Saigal et al 1991, McCormick et al 1992, Msall et al 1993, Soorani-Lunsing et al 1993, Hack et al 1994, Saigal et al 1994, O'Callaghan et al 1996. Although much attention has been given to characterizing early neuromotor development of preterm infants (Piper et al 1991, Majnemer et al 1993, few reports have been published on neurological and motor sequelae at school age.…”

Section: Discussionmentioning

confidence: 99%

“…Although much attention has been given to characterizing early neuromotor development of preterm infants (Piper et al 1991, Majnemer et al 1993, few reports have been published on neurological and motor sequelae at school age. Although most studies have focused on major deficits such as CP, evidence of tremor, deficits in balance, postural control, and fine motor coordination have been recently documented in cohorts of small, preterm infants followed to school age (Marlow et al 1989, Murray et al 1990, Skidmore et al 1990, Saigal et al 1991, Hack et al 1994.…”

Section: Discussionmentioning

confidence: 99%

“…Longitudinal studies to school age have demonstrated that this population is at great risk for a range of neurodevelopmental sequelae. Although emphasis has been placed on elucidation of intellectual and severe neurological sequelae, the prevalence of subtle neuromotor deficits and their impact on scholastic achievement and functional independence at home and in the community is increasingly appreciated (Northway et al 1967, Saigal et al 1991, McCormick et al 1992, Msall et al 1993, Hack et al 1994, O'Callaghan et al 1996.…”

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confidence: 99%

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Severe bronchopulmonary dysplasia increases risk for later neurological and motor sequelae in preterm survivors

Majnemer

Riley

Shevell

et al. 2000

Develop Med Child Neuro

102

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Preterm children who develop severe chronic lung disease may be developmentally compromised by exposure to hypoxic episodes. This study aims to determine if children with severe bronchopulmonary dysplasia (BPD) who required home oxygen therapy were at greater risk for neurological and motor deficits at school age than preterm peers without BPD. This study evaluated 27 subjects with BPD and 27 preterm control infants matched for gestational age, birth weight, sex, and year of birth at a mean age of 9.9 years (2.0 SD) using standardized neuromotor outcome measures. Pair‐matched comparisons and regression analyses were used to determine if subjects with BPD were at increased risk for neuromotor sequelae. Neurological abnormalities, including subtle neurological signs, cerebral palsy, microcephaly, and behavioral difficulties were highly prevalent in the BPD group (71% compared with 19% in control group, P<0.005). Over half the BPD cohort had difficulties in gross and/or fine motor skills. There were significant differences in postural stability between groups. Duration of hospitalization and home oxygen treatment, and decreased lung function at school age, markers of severity of illness, correlated with motor outcomes. The findings underline the importance of preventing the cardiorespiratory complications associated with chronic lung disease to minimize disability in preterm children. For children with severe BPD, better recognition and subsequent remediation of neuromotor impairments that manifest at school age may help maximize their functional potential.

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“…It is well established that certain perinatal factors, especially low birth weight (LBW), significantly increase the risk of educational problems, 6 -12 even when controlling for sociodemographic factors. [13][14][15][16][17][18][19][20][21][22][23] Some authors also have recognized the independent effects of sociodemographic variables, such as poverty, maternal education, race, and gender on educational outcomes 24 -32 and have indicated that these effects become more pronounced as children progress through school. 4,[33][34][35] In a few studies, it has been observed that different types of developmental problems are influenced differently by sociodemographic and perinatal risk factors.…”

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confidence: 99%

The Impact of Low Birth Weight, Perinatal Conditions, and Sociodemographic Factors on Educational Outcome in Kindergarten

Resnick¹,

Gueorguieva

Carter

et al. 1999

Pediatrics

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ABSTRACT. Objective. To assess the relative effects and the impact of perinatal and sociodemographic risk factors on long-term morbidity within a total birth population in Florida.Methods. School records for 339 171 children entering kindergarten in Florida public schools in the 1992-1993, 1993-1994, or 1994 -1995 academic years were matched with Florida birth records from 1985 to 1990. Effects on long-term morbidity were assessed through a multivariate analysis of an educational outcome variable, defined as placement into 9 mutually exclusive categories in kindergarten. Of those categories, 7 were special education (SE) classifications determined by statewide standardized eligibility criteria, 1 was academic problems, and the reference category was regular classroom. Generalized logistic regression was used to simultaneously estimate the odds of placement in SE and academic problems. The impact of all risk factors was assessed via estimated attributable excess/deficit numbers, based on the multivariate analysis.Results. Educational outcome was significantly influenced by both perinatal and sociodemographic factors. Perinatal factors had greater adverse effects on the most severe SE types, with birth weight <1000 g having the greatest effect. Sociodemographic predictors had greater effects on the mild educational disabilities. Because of their greater prevalence, the impact attributable to each of the factors (poverty, male gender, low maternal education, or non-white race) was between 5 and 10 times greater than that of low birth weight and >10 times greater than that of very low birth weight, presence of a congenital anomaly, or prenatal care.Conclusions. Results are consistent with the hypothesis that adverse perinatal conditions result in severe educational disabilities, whereas less severe outcomes are influenced by sociodemographic factors. Overall, sociodemographic factors have a greater total impact on adverse educational outcomes than perinatal factors. Pediatrics 1999;104(6). URL: http://www.pediatrics.org/ cgi/content/full/104/6/e74; birth weight, child development, special education, educational status, morbidity, infant, low birth weight, risk factors, socioeconomic factors, logistic models, Florida.

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Learning Disabilities and School Problems in a Regional Cohort of Extremely Low Birth Weight (< 1000 G) Children

Cited by 88 publications

References 0 publications

Cognitive and Academic Consequences of Bronchopulmonary Dysplasia and Very Low Birth Weight: 8-Year-Old Outcomes

Cognitive and Academic Consequences of Bronchopulmonary Dysplasia and Very Low Birth Weight: 8-Year-Old Outcomes

Severe bronchopulmonary dysplasia increases risk for later neurological and motor sequelae in preterm survivors

The Impact of Low Birth Weight, Perinatal Conditions, and Sociodemographic Factors on Educational Outcome in Kindergarten

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