Kindergarten readiness after extreme prematurity.
OBJECTIVE
To assess kindergarten readiness among survivors of extreme prematurity and to identify predictors of special education requirements.


METHODS
Historic cohort design.


METHODS
Regionalized tertiary pediatric center.


METHODS
One hundred forty-nine (97%) of 153 children who were alive at follow-up (mean +/- SD age, 52.7 +/- 9.9 months).


METHODS
Study cohort included infants (gestation, 23 to 28 weeks), born between 1983 and 1986 (N = 194), who were alive at follow-up (N = 153, 79% survival).


METHODS
None.


RESULTS
Standardized neurodevelopmental and psychometric evaluations were administered by a multidisciplinary team that was blinded to the neonatal course. Thirty-one children (21%) had major neurodevelopmental impairments. By using the McCarthy Scales of Children's Abilities for children free of major impairments, 61 (63%) had one or more minor neurodevelopmental impairments noted. Half of the surviving children were thought to require special education resources at kindergarten entry. Multivariate logistic regression identified three significant predictors of special education: low socio-economic status, nonwhite race, and male gender.


CONCLUSIONS
Social and demographic variables were associated with minor neurodevelopmental impairments and special education requirements among extremely premature children. Continued developmental follow-up and targeted interventions to reduce the risk of educational underachievement appear to be warranted.
Msall
M E
ME
Department of Pediatrics, School of Medicine and Biomedical Sciences, State University of New York, Buffalo.
Buck
G M
GM
Rogers
B T
BT
Catanzaro
N L
NL
D002675:Child, Preschool; D002658:Developmental Disabilities / Q000453:epidemiology*; D004519:Education, Special; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000254:growth & development*; D008297:Male; D012959:Socioeconomic Factors