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Pattern of learning disabilities in children with extremely low birth weight and broadly average intelligence
Ruth Eckstein Grunau1, Michael F Whitfield, Cynthia Davis
1Centre for Community Health and Health Evaluation Research, British Columbia Research Institute for Children's and Women's Health, University of British Columbia, 4480 Oak St, Vancouver, British Columbia V6H 3V4, Canada. rgrunau@cw.bc.ca
Insights
Learning disabilities (LDs) are common in children with extremely low birth weight (ELBW), affecting written output, arithmetic, and reading. These complex LDs differ in developmental origin compared to peers with normal birth weight.
Area of Science:
- Developmental Psychology
- Neuroscience
- Pediatrics
Background:
- Extremely low birth weight (ELBW) infants face increased risks for developmental challenges.
- Learning disabilities (LDs) can manifest in specific academic domains, impacting long-term educational outcomes.
- Understanding the cognitive underpinnings of LDs in ELBW children is crucial for targeted interventions.
Purpose of the Study:
- To determine the prevalence and pattern of specific learning disabilities (LDs) in neurologically normal children with extremely low birth weight (ELBW).
- To compare LDs in ELBW children with average intelligence to those of full-term, normal birth weight children.
- To investigate the cognitive factors associated with LDs in ELBW children.
Main Methods:
- A longitudinal follow-up study was conducted in a geographically defined region.
- One hundred fourteen neurologically normal ELBW children (birth weight ≤ 800g) were assessed at 8-9 years of age.
- A comparison group of 30 full-term, normal birth weight children with similar sociodemographic backgrounds was included.
Main Results:
- Children with ELBW showed significantly higher rates of LDs (65%) compared to the control group (13%).
- The most affected academic areas in ELBW children were written output, arithmetic, and reading.
- Visuospatial, visual-motor, and verbal abilities explained arithmetic and reading performance in ELBW children, unlike controls.
Conclusions:
- Complex learning disabilities across multiple academic domains are common in neurologically normal ELBW children.
- The developmental pathways leading to LDs in ELBW children differ from those in typically developing children.
- These findings highlight the need for early identification and support for learning challenges in ELBW survivors.
Objectives:
To examine the prevalence and pattern of specific areas of learning disability (LD) in neurologically normal children with extremely low birth weight (ELBW) (< or = 800 g) who have broadly average intelligence compared with full-term children with normal birth weight of comparable sociodemographic background, and to explore concurrent cognitive correlates of the specific LDs.
Design:
Longitudinal follow-up; geographically defined region.
Setting:
Regional follow-up program.
Main Outcome Measures:
Wechsler Intelligence Scale for Children-Revised, Gray Oral Reading Test-Revised, Test of Written Language-Revised, Wide Range Achievement Test-Revised, Developmental Test of Visual-Motor Integration.
Participants:
One hundred fourteen (87%) of 131 children with ELBW born between 1982 and 1987 were seen at ages 8 to 9 years. Of the 114 children, 74, who were neurologically normal, with a Verbal or Performance IQ greater than or equal to 85, formed the study group. A group of 30 full-term children with normal birth weight and similar sociodemographic status comprised a comparison group. The children were predominantly white and middle class.
Results:
Significantly more children with ELBW (65%) met criteria for LD in 1 or more areas compared with 13% of the comparison children. In the ELBW group, the most frequently affected area was written output, then arithmetic, then reading. Visuospatial and visual-motor abilities in combination with verbal functioning primarily explained performance in arithmetic and reading among children with ELBW, unlike the control children, whose scores were associated only with verbal functioning.
Conclusions:
Complex LDs in multiple academic domains are common sequelae among broadly middle class, predominantly white, neurologically normal children with ELBW compared with control peers. The developmental etiology of LDs in children with ELBW and control peers differs.