Identifying very preterm children at educational risk using a school readiness framework

Journal article


Pritchard, Verena E., Bora, Samudragupta, Austin, Nicola C., Levin, Karelia J. and Woodward, Lianne J.. (2014) Identifying very preterm children at educational risk using a school readiness framework. JAMA Pediatrics. 134(3), pp. 825 - 832. https://doi.org/10.1542/peds.2013-3865
AuthorsPritchard, Verena E., Bora, Samudragupta, Austin, Nicola C., Levin, Karelia J. and Woodward, Lianne J.
Abstract

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.

Keywordsvery preterm; preschool; school readiness; neurodevelopment; outcome
Year2014
JournalJAMA Pediatrics
Journal citation134 (3), pp. 825 - 832
PublisherAmerican Medical Association
ISSN1072-4710
Digital Object Identifier (DOI)https://doi.org/10.1542/peds.2013-3865
Scopus EID2-s2.0-84907188256
Page range825 - 832
Research GroupInstitute for Learning Sciences and Teacher Education (ILSTE)
Place of publicationUnited States of America
EditorsF.P. Rivara
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