The Journal of Pediatrics
Volume 152, Issue 2 , Pages 256-262.e1, February 2008

Specific Language Difficulties and School Achievement in Children Born at 25 Weeks of Gestation or Less

  • Dieter Wolke, PhD

      Affiliations

    • Department of Psychology and Warwick Medical School, Health Sciences Research Institute, University of Warwick, Coventry, UK
    • Corresponding Author InformationReprint requests: Dieter Wolke, PhD, University of Warwick, Department of Psychology and Health Sciences Research Institute, Warwick Medical School, Coventry CV4 7AL, UK.
    • ,
  • Muthanna Samara, MSc

      Affiliations

    • Department of Psychology and Warwick Medical School, Health Sciences Research Institute, University of Warwick, Coventry, UK
    • ,
  • Melanie Bracewell, MD

      Affiliations

    • Institute of Neuroscience, University of Nottingham, Nottingham, UK.
    • ,
  • Neil Marlow, MD

      Affiliations

    • Institute of Neuroscience, University of Nottingham, Nottingham, UK.
    • ,
  • EPICure Study Group

      Affiliations

    • A list of EPICURE Study Group members is available at www.jpeds.com.

Received 30 March 2007; received in revised form 18 June 2007; accepted 28 June 2007. published online 08 October 2007.

Objective

To determine whether language and educational problems are specific or due to general cognitive deficits in children born at 25 weeks’ gestation or less.

Study design

A national cohort study assessed 241 of 308 (78%) surviving children at a median age of 6 years, 4 months along with 160 of these children’s classmates. Formal tests included standard cognitive, language, phonetic, and speech assessments. The children’s school achievement was rated by classroom teachers.

Results

Mean cognitive scores for index children were 82 (standard deviation [SD] ± 19) compared with 106 (SD ± 12) for the peer group. Extremely preterm children had an increased risk of language problems (odds ratio [OR] = 10; 95% confidence interval [CI] = 3 to 32), speech problems (OR = 4.4; 95% CI = 3 to 7), and overall school difficulties (OR = 25; 95% CI = 12 to 54). Extremely preterm boys were twice as likely to show deficits as extremely preterm girls, but no such sex-based differences were apparent in the comparison group. Differences in general cognitive scores explained specific language or phonetic awareness deficits, but not speech ratings or educational difficulties, in the extremely preterm children.

Conclusions

Language or phonetic difficulties are not specific and indicate general cognitive functional difficulties. The findings have implications for models of global deviation of brain development in extremely preterm children.

Abbreviations: CI, Confidence interval, K-ABC, Kaufman Assessment Battery for Children, MPC, Mental Processing Composite, OR, Odds ratio, PAT, Phonological Abilities Test, PLS-3, Preschool Language Scale-3, SD, Standard deviation, VLBW, Very low birth weight

To access this article, please choose from the options below

Login to an existing account or Register a new account.

  • Purchase this article for 30.00 USD (You must login/register to purchase this article)

    Online access for 24 hours. The PDF version can be downloaded as your permanent record.

  • Subscribe to this title

    Get unlimited online access to this article and all other articles in this title 24/7 for one year.

  • Claim access now

    For current subscribers with Society Membership or Account Number.

  • Visit SciVerse ScienceDirect to see if you have access via your institution.
 

PII: S0022-3476(07)00650-6

doi:10.1016/j.jpeds.2007.06.043

The Journal of Pediatrics
Volume 152, Issue 2 , Pages 256-262.e1, February 2008

Article Tools