Academic Achievement Deficits and Their Neuropsychological Correlates in Children Born Extremely Preterm

Author(s): Akshoomoff, Natacha; Joseph, Robert M.; Taylor, H. Gerry; Allred, Elizabeth N.; Heeren, Timothy; O'Shea, Thomas M.; Kuban, Karl K. | Abstract: ObjectiveThe purpose of this study was to examine the risks associated with learning disabilities (LD) in a large sample of children born extremely preterm. We predicted higher than expected rates of LD, particularly in math, and children with LD in math, reading, or both would have lower IQs and specific patterns of neuropsychological deficits.MethodWe evaluated academic achievement, rates of LD, and their neuropsychological correlates in the Extremely Low Gestational Age Newborn (ELGAN) Study cohort of 10-year-old children born at 23 to 27 weeks gestational age. Primary analyses focused on children without intellectual disability (verbal IQ g 70 and nonverbal IQ g 70; N=668). Low achievement was defined as a standard score ≤ 85 on the reading or math measures.ResultsThe risk of low math achievement scores (27%) was 1.5 times higher than the risk of low reading achievement scores (17%). Children were classified as having LD based on low achievement criteria in reading only (RD, 6.4% of sample), math only (MD, 16.2%), both reading and math (RD/MD, 8.3%), or no reading or math disabilities (No LD, 69.1%). Although all three LD groups had multiple neuropsychological weaknesses compared to the No LD group, the RD and MD groups had different patterns of neuropsychological impairment.ConclusionThese children from the ELGAN cohort had higher than expected rates of LD, particularly in mathematics, even after taking socioeconomic status into consideration. These results point to specific cognitive weaknesses that differ between extremely preterm children with RD and MD and the utility of neuropsychological assessments in addressing low academic achievement.