Cognitive status, language attainment, and prereading skills of 6-year-oldvery preterm children and their peers: the Bavarian longitudinal study

The prevalence of intellectual-, language-, and prereading-skill deficits w as investigated in a geographically defined whole-population sample of very preterm children at 6 years of age in southern Germany. The sample consist ed of the following: 264 very preterm children (75.6% of German-speaking su rvivors); 264 term controls (matched for sex, socioeconomic status [SES], m arital status and age of mother); and a representative normative sample for Bavaria (N=311). Compared with term peers, very preterm children scored si gnificantly lower (approximately -1 SD) on the measures of cognitive and la nguage skills and had major cognitive deficits (<-2 SD) 10 to 35 times more often than the controls. Deficits in speech articulation and prereading sk ills (<10th centile) were three to five times more frequent in very preterm children. More than 18% of very preterm children had cognitive deficits in more than five areas of functioning, compared with no control children, Th e differences between very preterm children and controls remained highly si gnificant when only very preterm children (N=229) and controls (N=261) with out major neurosensory impairment were considered. Little evidence for spec ific cognitive deficits was found once mental processing measured in the Ka ufman Assessment Battery for Children (II-BBC) was controlled for. The effe ct of preterm birth on cognitive abilities was found to be larger than the influence of SES, In conclusion, there was a high prevalence of long-term m ultiple cognitive problems in very preterm children. These persistent, cogn itive problems appear to be of pre- or neonatal (treatment) rather than pos tnatal social origin.