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Identifying very preterm children at educational risk using a school readiness framework
Pritchard, Verena E. Bora, Samudragupta Austin, Nicola C. Levin, Karelia J. Woodward, Lianne J.
Pritchard, Verena E.
Bora, Samudragupta
Austin, Nicola C.
Levin, Karelia J.
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.
Keywords
very preterm, preschool, school readiness, neurodevelopment, outcome
Date
2014
Type
Journal article
Journal
JAMA Pediatrics
Book
Volume
134
Issue
3
Page Range
825-832
Article Number
ACU Department
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Relation URI
Source URL
Event URL
Open Access Status
License
File Access
Controlled