Community-based screening to detect school readiness problems in very preterm children.

Area of Science:

• Neonatal care
• Developmental pediatrics
• Public health screening

Background:

• Very preterm (VPT) children (born ≤32 weeks) often experience school readiness challenges.
• Routine follow-up for VPT children's developmental progress is frequently insufficient.

Purpose of the Study:

• To evaluate the performance of VPT children in the Before School Check (B4SC) screening program.
• To assess school readiness at four years of age in VPT children using a community-based approach.

Main Methods:

• A cohort of VPT children (2005-2009) from neonatal intensive care units was compared to a national control group.
• Outcomes included Parental Evaluation of Developmental Status (PEDS), Strengths and Difficulties Questionnaire (SDQ-P and SDQ-T), and vision/hearing screenings.
• Perinatal and demographic data were sourced from the Australia and New Zealand Neonatal Network database.

Main Results:

• VPT children were significantly more likely than controls to have abnormal outcomes in PEDS, SDQ-P, SDQ-T, vision, and hearing screenings.
• Abnormal screening results in VPT children were associated with factors including low birthweight z-score, cranial ultrasound abnormalities, and younger maternal age.
• Referral rates for further assessment following abnormal screens were suboptimal, particularly for PEDS and SDQ outcomes.

Conclusions:

• Community-based screening programs like B4SC can identify VPT children with school readiness difficulties.
• The effectiveness of these screening programs may be limited by low rates of appropriate referrals for VPT children requiring further evaluation.