Kindergarten readiness after extreme prematurity
M. E. Msall, G. M. Buck, B. T. Rogers and N. L. Catanzaro
Department of Pediatrics, School of Medicine and Biomedical Sciences, State University of New York, Buffalo.
OBJECTIVE--To assess kindergarten readiness among survivors of extreme
prematurity and to identify predictors of special education requirements.
DESIGN--Historic cohort design. SETTING--Regionalized tertiary pediatric
center. PARTICIPANTS--One hundred forty-nine (97%) of 153 children who were
alive at follow-up (mean +/- SD age, 52.7 +/- 9.9 months). SELECTION
PROCEDURES--Study cohort included infants (gestation, 23 to 28 weeks), born
between 1983 and 1986 (N = 194), who were alive at follow-up (N = 153, 79%
survival). INTERVENTIONS--None. MEASUREMENTS AND RESULTS--Standardized
neurodevelopmental and psychometric evaluations were administered by a
multidisciplinary team that was blinded to the neonatal course. Thirty-one
children (21%) had major neurodevelopmental impairments. By using the
McCarthy Scales of Children's Abilities for children free of major
impairments, 61 (63%) had one or more minor neurodevelopmental impairments
noted. Half of the surviving children were thought to require special
education resources at kindergarten entry. Multivariate logistic regression
identified three significant predictors of special education: low
socio-economic status, nonwhite race, and male gender. CONCLUSIONS--Social
and demographic variables were associated with minor neurodevelopmental
impairments and special education requirements among extremely premature
children. Continued developmental follow-up and targeted interventions to
reduce the risk of educational underachievement appear to be warranted.
