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Kindergarten readiness after extreme prematurity
M E Msall1, G M Buck, B T Rogers
1Department of Pediatrics, School of Medicine and Biomedical Sciences, State University of New York, Buffalo.
Insights
Kindergarten readiness is a concern for survivors of extreme prematurity. Low socioeconomic status, nonwhite race, and male gender predict special education needs in these children.
Area of Science:
- Pediatric developmental neurology
- Neonatal follow-up studies
- Educational psychology
Background:
- Extreme prematurity (gestation 23-28 weeks) poses significant risks for long-term neurodevelopmental outcomes.
- Assessing kindergarten readiness is crucial for early intervention and educational planning for these vulnerable children.
Purpose of the Study:
- To evaluate kindergarten readiness in survivors of extreme prematurity.
- To identify predictors of the need for special education services in this cohort.
Main Methods:
- A historic cohort design was employed, following 153 children born between 1983-1986 (23-28 weeks gestation).
- Neurodevelopmental and psychometric evaluations were conducted by a blinded multidisciplinary team.
- Multivariate logistic regression analyzed predictors of special education requirements.
Main Results:
- Twenty-one percent of children had major neurodevelopmental impairments.
- An additional 63% of children without major impairments exhibited minor neurodevelopmental issues.
- Half of the survivors required special education resources for kindergarten entry.
- Low socioeconomic status, nonwhite race, and male gender were significant predictors of needing special education.
Conclusions:
- Social and demographic factors are strongly associated with neurodevelopmental impairments and special education needs in extremely premature children.
- Ongoing developmental surveillance and targeted interventions are essential to mitigate educational underachievement.
Objective:
To assess kindergarten readiness among survivors of extreme prematurity and to identify predictors of special education requirements.
Design:
Historic cohort design.
Setting:
Regionalized tertiary pediatric center.
Participants:
One hundred forty-nine (97%) of 153 children who were alive at follow-up (mean +/- SD age, 52.7 +/- 9.9 months).
Selection Procedures:
Study cohort included infants (gestation, 23 to 28 weeks), born between 1983 and 1986 (N = 194), who were alive at follow-up (N = 153, 79% survival).
Interventions:
None.
Measurements And Results:
Standardized neurodevelopmental and psychometric evaluations were administered by a multidisciplinary team that was blinded to the neonatal course. Thirty-one children (21%) had major neurodevelopmental impairments. By using the McCarthy Scales of Children's Abilities for children free of major impairments, 61 (63%) had one or more minor neurodevelopmental impairments noted. Half of the surviving children were thought to require special education resources at kindergarten entry. Multivariate logistic regression identified three significant predictors of special education: low socio-economic status, nonwhite race, and male gender.
Conclusions:
Social and demographic variables were associated with minor neurodevelopmental impairments and special education requirements among extremely premature children. Continued developmental follow-up and targeted interventions to reduce the risk of educational underachievement appear to be warranted.