BIRTH-WEIGHT AND SPECIAL EDUCATIONAL-NEEDS - EFFECTS OF AN INCREASE IN THE SURVIVAL OF VERY-LOW-BIRTH-WEIGHT INFANTS IN LONDON

Objectives - To assess the contribution of children with different bir th weights to special educational needs within a single health distric t, and to determine whether this pattern changed over the time when th e survival of very low birthweight (VLBW) infants was increasing. Sett ing - An inner London health district. Study design - A cohort of chil dren born to local parents between January 1974 and December 1980 was selected from birth notifications, including only those infants who su rvived for more than one month. Community child health records were th en inspected to identify children from the cohort who had been formall y assessed for special educational needs before their 8th birthday. Th e risk of special educational needs was compared for the years 1974-77 and 1977-80 (the first and second halves of the period studied). Subj ects - The infant cohort consisted of 31846 children. Altogether 260 ( 0.8%) of these were later assessed formally. Results - VLBW infants we re 4.4 times more likely to be assessed than normal birthweight infant s. Formal assessment within the district occurred in three of 68 VLBW infants from the first half of the period studied, and three of 120 fr om the second half. Conclusion - Although VLBW infants are at higher r isk, an increase in their survival was not associated with any increas e in their contribution to the group with special educational needs wi thin our district. Their contribution, as a group, to the total number of children with special educational needs is very small.