Related Experiment Video
Updated: Jun 24, 2026
Measuring the Functional Abilities of Children Aged 3-6 Years Old with Observational Methods and Computer Tools
Published on: June 20, 2020
Academic attainment and special educational needs in extremely preterm children at 11 years of age: the EPICure study
S Johnson1, E Hennessy, R Smith
1Institute for Women's Health, University College, 286-96 Chenies Mews, London WC1E 6HX, UK. s.j.johnson@ucl.ac.uk
Insights
Extremely preterm children face significant learning challenges, with lower academic attainment and higher rates of special educational needs (SEN) in middle childhood. Many require additional support to succeed in school.
Area of Science:
- Pediatric Medicine
- Developmental Psychology
- Educational Psychology
Background:
- Extremely preterm birth (< or =25 weeks) poses risks for long-term neurodevelopmental outcomes.
- Understanding academic attainment and special educational needs (SEN) is crucial for supporting these children.
Purpose of the Study:
- To assess academic attainment and SEN in extremely preterm children during middle childhood.
- To compare outcomes with term-born classmates.
Main Methods:
- Longitudinal study of 219 extremely preterm survivors (born 1995) assessed at 11 years.
- Comparison group of 153 term-born classmates.
- Standardized tests for cognitive ability, academic attainment, and teacher reports on school performance and SEN.
- Multiple imputation used to address selective dropout.
Main Results:
- Extremely preterm children scored significantly lower in cognitive ability, reading, and mathematics.
- 13% attended special schools; 57% in mainstream schools had SEN, and 55% required SEN resource provision.
- Teachers rated 50% of extremely preterm children as below average attainment, versus 5% of controls.
Conclusions:
- Extremely preterm survivors are at high risk for learning impairments and poor academic attainment.
- A substantial proportion require specialist education or additional resources in mainstream settings.
- The impact of SEN is likely to increase as these children transition to secondary school.
Aim:
To assess academic attainment and special educational needs (SEN) in extremely preterm children in middle childhood.
Methods:
Of 307 extremely preterm (< or =25 weeks) survivors born in the UK and Ireland in 1995, 219 (71%) were re-assessed at 11 years of age and compared to 153 classmates born at term, using standardised tests of cognitive ability and academic attainment and teacher reports of school performance and SEN. Multiple imputation was used to correct for selective dropout.
Results:
Extremely preterm children had significantly lower scores than classmates for cognitive ability (-20 points; 95% CI -23 to -17), reading (-18 points; -22 to -15) and mathematics (-27 points; -31 to -23). Twenty nine (13%) extremely preterm children attended special school. In mainstream schools, 105 (57%) extremely preterm children had SEN (OR 10; 6 to 18) and 103 (55%) required SEN resource provision (OR 10; 6 to 18). Teachers rated 50% of extremely preterm children as having below average attainment compared with 5% of classmates (OR 18; 8 to 41). Extremely preterm children who entered compulsory education an academic year early due to preterm birth had similar academic attainment but required more SEN support (OR 2; 1.0 to 3.6).
Conclusions:
Extremely preterm survivors remain at high risk for learning impairments and poor academic attainment in middle childhood. A significant proportion require full-time specialist education and over half of those attending mainstream schools require additional health or educational resources to access the national curriculum. The prevalence and impact of SEN are likely to increase as these children approach the transition to secondary school.
Related Concept Videos
01:23Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption
01:30Information Processing Approach