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High Rates of School Readiness Difficulties at 5 Years of Age in Very Preterm Infants Compared with Term Controls

Roberts, Gehan PhD*†‡∥; Lim, Jeremy BHlthSc (Hons)‡§; Doyle, Lex W. MD*‡∥; Anderson, Peter J. PhD*‡§

Journal of Developmental & Behavioral Pediatrics: February-March 2011 - Volume 32 - Issue 2 - p 117-124
doi: 10.1097/DBP.0b013e318206d5c9
Original Article

Objective: School readiness is best understood as a framework for assessing profiles of strengths and vulnerabilities of the preschool-age child. Very preterm (VPT) children are at high risk of difficulties in school, and understanding their school readiness skills has the potential to aid successful transition into school. The aim of this study was to determine the school readiness skills of a cohort of VPT children, compared with term controls.

Methods: VPT children (gestational age <30 wk or birth weights <1250 g) and term controls were enrolled from a tertiary maternity hospital, Melbourne, Australia into a prospective cohort study. At age 5 years, school readiness skills were evaluated using a combination of parent questionnaires and direct assessments. The 5 domains of school readiness assessed were health and physical development, social-emotional skills, approaches to learning, communication skills, and cognitive skills.

Results: VPT children had standard scores ∼½ to 1 SD below those of the term controls in all domains of school readiness, and these differences were not greatly affected by adjustment for social risk differences. Overall, 44% of the VPT group had vulnerabilities in more than 1 domain of school readiness, compared with only 16% of the term controls.

Conclusions: VPT children are more likely than term controls to have significant vulnerabilities in multiple domains of school readiness, and these differences are mostly independent of social risk.

From *The Premature Infant Follow-up Program, The Royal Women's Hospital; †Department of Paediatrics, The University of Melbourne; ‡Critical Care and Neurosciences, Murdoch Childrens Research Institute, Royal Children's Hospital; §Department of Psychology; ∥Department of Obstetrics and Gynaecology, The University of Melbourne, Melbourne, Australia.

Received July 2010; accepted October 2010.

This work was supported by post-doctoral fellowship training grant 607384 and a Centre for Clinical Research Excellence in Newborn Medicine grant 546519 from the National Health and Medical Research Council of Australia.

Dr. Roberts had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Address for reprints: Dr. Gehan Roberts, Department of Obstetrics and Gynaecology, The Royal Women's Hospital, 20 Flemington Road, Parkville 3052, Australia; e-mail:

© 2011 Lippincott Williams & Wilkins, Inc.