Cognitive abilities and school performance of extremely low birth weight children and matched term control children at age 8 years: a regional study.

The intellectual, psychoeducational, and functional status of a regional cohort of extremely low birth weight (ELBW) survivors who weighed 501 to 1000 gm at birth (n = 143) and who were born between 1977 and 1981 was compared with that of control children born at term (n = 145) who were matched for gender, age, and social class. One hundred twenty-nine ELBW survivors (90%) were available; their mean birth weight was 839 +/- 124 gm and mean gestational age 27 +/- 2.1 weeks, and 48 of them weighed less than or equal to 800 gm at birth. Both ELBW and control groups were tested at a mean unadjusted age of 8 years; 113 of 129 ELBW children completed the full test battery, eight blind children had other tests, and eight were not testable. The mean Full Scale IQ (Wechsler Intelligence Scale for Children--Revised) was 91 +/- 16 for ELBW children and 104 +/- 12 for control children (p less than 0.0001). Between 8% and 12% of the ELBW group scored in the "abnormal" range (less than or equal to -2 SD) on the Wechsler IQ and subtests, compared with 1% to 2% of the control group. The ELBW group did less well on the reading, spelling, and mathematics tests (Wide Range Achievement Test--Revised less than or equal to -2 SD: ELBW = 20% to 28%; control = 3% to 10%). The motor performance of the ELBW group (Bruininks-Oseretsky Test of Motor Proficiency less than or equal to -2 SD: ELBW = 20%; control = 1%) and their visual-motor integration (Beery Developmental Test of Visual-Motor Integration less than or equal to -2 SD: ELBW = 21%; control = 6%) were also poorer. Exclusion of 19 ELBW children with neurologic impairments or an IQ less than or equal to 70 or both did not result in significant improvement in Wechsler or achievement measures. Approximately 15% of the ELBW cohort performed in the abnormal range on the Vineland Adaptive Behavior Scales, compared with none of the control group. Although approximately two thirds of the ELBW group were performing in the normal range on intellectual measures, comparison with the control group suggests that, as a group, ELBW children were significantly disadvantaged on every measure tested.

[1]  P. Auld,et al.  Consistency and change in the development of premature infants weighing less than 1,501 grams at birth. , 1985, Pediatrics.

[2]  D. Wolke,et al.  FIVE‐YEAR FOLLOW‐UP STUDY OF EXTREMELY LOW‐BIRTHWEIGHT INFANTS , 1988, Developmental medicine and child neurology.

[3]  N. Marlow,et al.  Motor skills in extremely low birthweight children at the age of 6 years. , 1989, Archives of disease in childhood.

[4]  P. Rosenbaum,et al.  Decreased disability rate among 3-year-old survivors weighing 501 to 1000 grams at birth and born to residents of a geographically defined region from 1981 to 1984 compared with 1977 to 1980. , 1989, The Journal of pediatrics.

[5]  A. Orgill,et al.  Outcome in infants of birth weight 500 to 999 g: a continuing regional study of 5-year-old survivors. , 1987, The Journal of pediatrics.

[6]  J. Arena,et al.  Expressive one-word picture vocabulary test , 1984 .

[7]  A. Feinstein,et al.  Clinical biostatistics: LIV. The biostatistics of concordance , 1981 .

[8]  L. Doyle,et al.  Extremely-low-birthweight infants: neurological, psychological, growth and health status beyond five years of age. , 1987, Medical Journal of Australia.

[9]  M. Hack,et al.  Children Who Were Very Low Birth Weight: Development and Academic Achievement at Nine Years of Age , 1989, Journal of developmental and behavioral pediatrics : JDBP.

[10]  C. Drillien,et al.  Low‐birthweight Children at Early School‐age: A Longitudinal Study , 1980, Developmental medicine and child neurology.

[11]  A. Feinstein,et al.  THE BIOSTATISTICS OF CONCORDANCE , 1981 .

[12]  K. Michelsson,et al.  Nine‐year Follow‐up of Infants Weighing 1 500 g or Less at Birth , 1984, Acta paediatrica Scandinavica.

[13]  E. Knight-Jones,et al.  The Abilities Of Very Low‐Birthweight Children And Their Classroom Controls , 1990, Developmental medicine and child neurology.

[14]  P. Rosenbaum,et al.  Outcome in infants 501 to 1000 gm birth weight delivered to residents of the McMaster Health Region. , 1984, The Journal of pediatrics.

[15]  F. C. Bennett,et al.  Preschool Motor Skills of Children Born Prematurely and Not Diagnosed as Having Cerebral Palsy , 1988, Journal of Developmental and Behavioral Pediatrics.

[16]  Douglas G. Altman,et al.  Statistics with confidence: Confidence intervals and statistical guidelines . , 1990 .

[17]  A. Fanaroff,et al.  Preschool performance of children with normal intelligence who were very low-birth-weight infants. , 1985, Pediatrics.

[18]  P. Szatmari,et al.  Ontario Child Health Study. I. Methodology. , 1987, Archives of general psychiatry.

[19]  C. Edelbrock,et al.  Behavioral problems and competencies reported by parents of normal and disturbed children aged four through sixteen. , 1981, Monographs of the Society for Research in Child Development.

[20]  K. Wheldall,et al.  CONTROLLED STUDY OF INTELLIGENCE AND SCHOOL PERFORMANCE OF VERY LOW‐BIRTHWEIGHT CHILDREN FROM A DEFINED GEOGRAPHICAL AREA , 1988, Developmental medicine and child neurology.

[21]  R. Nickel,et al.  School performance of children with birth weights of 1,000 g or less. , 1982, American journal of diseases of children.

[22]  W. Tooley,et al.  Learning disabilities in children with birth weights less than or equal to 1500 grams. , 1982, Seminars in perinatology.

[23]  B. Vohr,et al.  Neurodevelopmental and school performance of very low-birth-weight infants: a seven-year longitudinal study. , 1985, Pediatrics.

[24]  M. Hoffman,et al.  Review of Child Development Research , 1966 .

[25]  P. Szatmari,et al.  Intellectual and functional status at school entry of children who weighed 1000 grams or less at birth: a regional perspective of births in the 1980s. , 1990, The Journal of pediatrics.

[26]  P. Szatmari,et al.  PSYCHIATRIC DISORDERS AT FIVE YEARS AMONG CHILDREN WITH BIRTHWEIGHTS < 1OOOg: A REGIONAL PERSPECTIVE , 1990 .

[27]  Sorel Cahan,et al.  Age versus schooling effects on intelligence development. , 1989 .

[28]  John C. Brantley,et al.  Woodcock-Johnson psycho-Educational battery: Woodcock, R. W., & Johnson, M. B. Hingham, MA: Teaching resources, 1977. $92.50 , 1981 .

[29]  W. Tooley,et al.  Very low birth weight infants at 8 and 11 years of age: role of neonatal illness and family status. , 1988, Pediatrics.

[30]  Domenic V. Cicchetti,et al.  The Vineland Adaptive Behavior Scales. , 1989 .

[31]  J. Raven.  Guide to using the Coloured Progressive Matrices. , 1958 .

[32]  N. Desai,et al.  Classroom performance and social factors of children with birth weights of 1,250 grams or less: follow-up at 5 to 8 years of age. , 1986, Pediatrics.

[33]  F. Lefebvre,et al.  OUTCOME AT SCHOOL AGE OF CHILDREN WITH BIRTHWEIGHTS OF 1000 GRAMS OR LESS , 1988, Developmental medicine and child neurology.