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A Comparison of School-Age Outcomes

Carey L. Halsey, MSEd; Marc F. Collin, MD; Craig L. Anderson, MD

Arch Pediatr Adolesc Med. 1996;150(8):790-794.

Abstract
Objective
To document 7-year developmental and educational outcomes in a cohort of predominantly white, middle-class, extremely low-birth-weight (ELBW, <1000 g) children to address the incidence of increased developmental disability and the need for special educational services.

Design
Observational study.

Patients
Fifty-four ELBW children and 58 comparison children, who were matched for race, gender, and socioeconomic status (30 with low birth weights [1500-2500 g] and 28 with birth weights >2500 g). The ELBW cohort was drawn from 104 presurfactant survivors born between 1984 and 1986 and cared for in a single hospital.

Setting
Suburban, university-based tertiary referral center.

Main Outcome Measures
Teachers' reports of classroom placement and special education services and tests of cognitive, motor, language, and visual-motor integration abilities were studied.

Results
Twenty-seven (50%) of 54 ELBW children were in regular classrooms with no special services compared with 21 (70%) of 30 in the low-birth-weight group and 27 (93%) of 28 in the full-term group, indicating a significant trend toward increasing need for special services with decreasing birth weight across the 3 groups (P<.001). The ELBW group scored significantly lower than the comparison groups on all tests, although generally within the average range. Seventy-nine percent of ELBW children had average cognitive scores, but they averaged 14 to 17 points lower than the 2 comparison groups. Twenty percent of the ELBW children had significant disabilities including cerebral palsy, mental retardation, autism, and low intelligence with severe learning problems.

Conclusions
Even with optimal socioeconomic environments, 20% of ELBW children are significantly disabled, and 1 of every 2 ELBW children requires special educational services. Objective testing pinpointed weakness on all measures compared with matched peer groups.

Arch Pediatr Adolesc Med. 1996;150:790-794

Author Affiliations
From the Loyola University Medical Center, Maywood, Ill (Ms Halsey and Dr Anderson); and the MetroHealth Medical Center, Cleveland, Ohio (Dr Collin).

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