Pattern of learning disabilities in children with extremely low birth weight and broadly average intelligence

Objectives: To examine the prevalence and pattern of specific areas of learning disability (LD) in neurologically normal children with extremely low birth weight (ELBW) ( 5800 g) who have broadly average intelligence compared with full-term, children with normal birth weight of comparable sociodemographic background, and to explore concurrent cognitive correlates of the specific LDs. Design: Longitudinal follow-up; geographically defined region. Setting: Regional follow-up program. Main Outcome Measures: Wechsler Intelligence Scale for Children-Revised, Gray Oral Reading Test-Revised, Test of Written Language-Revised, Wide Range Achievement Test-Revised, Developmental Test of Visual-Motor Integration. Participants: One hundred fourteen (87%) of 131 children with ELBW born between 1982 and 1987 were seen at ages 8 to 9 years. Of the 114 children, 74, who were neurologically normal, with a Verbal or Performance IQ greater than or equal to 85, formed the study group. A group of 30 full-term children with normal birth weight and similar sociodemographic status comprised a comparison group. The children were predominantly white and middle class. Results: Significantly more children with ELBW (65%) met criteria for LD in I or more areas compared, with 13% of the comparison children. In the ELBW group, the most frequently affected area was written output, then arithmetic, then reading. Visuospatial and visual-motor abilities in combination with verbal functioning primarily explained performance in arithmetic and reading among children with ELBW, unlike the control children, whose scores were associated only with verbal functioning. Conclusions: Complex LDs in multiple academic domains are common sequelae among broadly middle class, predominantly white, neurologically normal children with ELBW compared with control peers. The developmental etiology of LDs in children with ELBW and control peers differs.