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Early Hum Dev. 2009 Apr;85(4):215-24. doi: 10.1016/j.earlhumdev.2008.10.004. Epub 2008 Nov 20.

Early school-based learning difficulties in children born very preterm.

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Canterbury Child Development Research Group, Department of Psychology, University of Canterbury, New Zealand.



Educational underachievement is a major morbidity associated with very preterm (VPT) birth. However, few studies have examined early school outcomes with most employing global, clinic based measures.


To examine the early school achievement in a cohort of children born VPT and studied to age 6 years.


A regional cohort of 102 VPT children (</=33 weeks GA) were followed prospectively alongside a comparison group of 108 full term (FT) children born during the same period (1998-2000). At 6 years corrected age, all children underwent a comprehensive neurodevelopmental evaluation that included the Woodcock-Johnson Tests of Achievement (WJ-III), teacher report and national numeracy and literacy test results. Rates of specific learning disabilities (LD) were also examined.


VPT children performed less well than FT children on WJ-III subtests (ps<.05), national tests (ps<.01), and in all curricular areas rated by teachers (ps<.01) except expressive language. Even VPT children without severe neurodevelopmental impairment scored lower on the WJ-III math, national tests (ps<.05) and were 2-3 times more likely to show delays (ps<.02) in math (43% vs. 19%), written language (36% vs. 22%), language comprehension (26% vs. 14%), handwriting (36% vs. 17%), spelling (38% vs. 30%) and physical education (33% vs. 11%). They were also twice as likely as FT children to have math LD (47% vs. 21%).


By age 6, a substantial proportion of VPT children are lagging behind their FT peers across multiple curriculum areas, with difficulties being most prominent in math. Findings highlight the need for early identification and educational supports to help maximise VPT children's learning opportunities during the transition to school.

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