Very low-birth-weight children at 9 years: school performance and behaviorin relation to risk factors

Objectives To investigate the school performance and behavior of very low-b irth-weight children in comparison with controls, and relate the findings t o risk factors. Methods All children with birth weight below 1501 g (VLBW) and normal birth weight (NBW) controls, born in the south-east region of Sweden during a 15 -month period in 1987-88, were enrolled in a prospective follow-up study; 8 1 % (n = 70) and 82% (n = 72), respectively, were re-examined at the age of 9 years regarding growth, neurological status, neurofunctional classificat ion and academic achievement tests (Raven's matrices, mathematics, vocabula ry, reading ability). The need for special education at school was assessed and four behavioral problem scores were also assessed (hyperactivity, fine motor skills, gross motor skills, social skills). Children with known hand icaps were not re-examined. Results VLBW children were shorter and lighter than controls, and differed from them with regard to neurological functional classification. As a group , they produced poorer results in all academic achievement tests except voc abulary, and also in two out of four behavioral subscales (hyperactivity an d fine motor skills). When the comparison was restricted to children with n ormal Raven scores, almost all the differences disappeared. VLBW children h ad more reading difficulties but were less often than expected defined as d yslexic compared to NEW children.