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Pattern of Learning Disabilities in Children With Extremely Low Birth Weight and Broadly Average Intelligence
Ruth Eckstein Grunau, PhD;
Michael F. Whitfield, MD;
Cynthia Davis, PhD
Arch Pediatr Adolesc Med. 2002;156:615-620.
Objectives To examine the prevalence and pattern of specific areas of learning
disability (LD) in neurologically normal children with extremely low birth
weight (ELBW) ( 800 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 1
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.
From the Centre for Community Health and Health Evaluation Research,
British Columbia Research Institute for Children's and Women's Health (Dr
Grunau), Department of Pediatrics, University of British Columbia (Drs Grunau
and Whitfield), and Newborn Care, Children's and Women's Health Centre of
British Columbia (Drs Grunau, Whitfield, and Davis), Vancouver, British Columbia.
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