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Published on: August 25, 2014
School readiness in children born preterm
Kamini Raghuram1, Nicole Bando2, Magdalena Janus3
1Department of Pediatrics, Mount Sinai Hospital, Toronto, ON, Canada. kamini.raghuram@sinaihealth.ca.
Insights
Children born preterm, especially very preterm, are at risk for delayed school readiness. Early identification and interventions are crucial for improving academic outcomes and school adjustment.
Area of Science:
- Neuroscience
- Developmental Pediatrics
- Educational Psychology
Background:
- Preterm birth (<37 weeks gestational age) affects 7-9% of children globally, with 15% born very preterm (<32 weeks GA).
- Neonatal intensive care and social factors impact brain development during a critical growth period.
- School readiness, crucial for academic success, is influenced by genetics and early life experiences.
Purpose of the Study:
- To provide a comprehensive review of school readiness in preterm children.
- To identify risk factors, interventions, and practice implications.
- To highlight the vulnerability of preterm children to school readiness delays.
Main Methods:
- This is a narrative review of existing literature.
- The review synthesizes information on school readiness in preterm populations.
- It examines factors affecting development and potential interventions.
Main Results:
- Preterm children, particularly those born very preterm, face significant challenges with school readiness.
- Academic underachievement is common, necessitating grade repetition or remedial support.
- Even children with typical early assessments can experience later school difficulties.
Conclusions:
- Targeted interventions before school entry can enhance school readiness for preterm children.
- Routine neurodevelopmental assessments at school entry are needed for early identification of issues.
- Addressing school readiness delays can improve long-term academic trajectories and school adjustment.
Abstract:
Approximately 7-9% of children worldwide are born preterm [<37 weeks gestational age (GA)], and ~15% of these preterm births occur at <32 weeks GA (very preterm). Advances in modern medicine have dramatically improved the survival of preterm children. However, preterm birth influences a vulnerable period of brain growth in which there is rapid gain in volume, maturation, and connectivity. Several aspects of neonatal intensive care, including altered sensory exposures and acute illness, compounded by social risk factors affect the developing brain. School readiness, understood as the state of child developmental health at school entry, is an outcome of genetic predisposition and the experiences and environment children are exposed to since birth and is a predictor of future academic trajectory. Children born preterm face a range of challenges, especially at times of transition, such as school entry. Academic underachievement in preterm children is common as evidenced by higher needs for grade repetition and remedial assistance. Educational concerns may be prevented most efficiently before school entry with supportive services that promote school readiness. This narrative review will allow readers to gain a comprehensive understanding of school readiness in children born preterm, associated risk factors, potential interventions, and implications for practice. IMPACT: Children born preterm, particularly those born very preterm, remain vulnerable to delays in school readiness, even in the context of having standardized assessments showing performance within the typical range at earlier stages in childhood (i.e. in toddlerhood). Routine neurodevelopmental assessment of preterm children at entry to school is not performed, although there is increasing recognition of issues impacting academic performance and adjustment into school. This review summarizes the available literature around school readiness in preterm children, which will allow for early recognition of school readiness difficulties and opportunities for targeted interventions to improve longer term outcomes.
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