Educational outcome at 8 years for children who were born extremely prematurely: A controlled study

Objective: To assess the educational outcome and utilization of special education resources at age 8 years in children who were born extremely prematurely, and to compare this outcome with a matched cohort of children born full-term. Methods: All children with gestational age less than 28 weeks or birthweight of less than 1000 g, born at Royal North Shore Hospital from July 1985 through June 1990 were enrolled in a study of long-term outcome. A cohort of full-term children matched for age, sex and school with non-disabled extremely premature children was enrolled at age 8 years. Children were assessed using standardized measures of cognitive and academic achievement. Information was obtained from teachers regarding educational support and academic progress. Results: Of 82 extremely premature children assessed at age 8 years, 8 (10%) had a severe disability, 13 (16%) had a mild or moderate disability and 61 (74%) were non-disabled (IQ greater than or equal to 85, no neurosensory disability). Thirty-five (43%) required special education support, 22 (27%) were below grade level in reading or mathematics and 25 (30%) were performing at grade level without support. Compared with controls, non-disabled extremely premature children had lower scores on standardized measures of academic achievement and were more likely to be reported by teachers as falling below grade level in reading (48% vs 13%; P < 0.001), mathematics (48% vs 10%; P < 0.001) and spelling (48% vs 17%; P < 0.002), and to require special education support (25% vs 4%; P = 0.004). Conclusion: Parents and professionals caring for extremely premature children need to be alert to the additional support that these children may require at school.