Educational and social competencies at 8 years in children with threshold retinopathy of prematurity in the CRYO-ROP multicenter study.
OBJECTIVE
To describe the educational status and special education services at 8 years among children who had threshold retinopathy of prematurity (ROP).


METHODS
A prospective study was conducted of a cohort of children who had birth weight of <1251 g and threshold ROP in the Cryotherapy for Retinopathy of Prematurity multicenter study. At age 5.5 years, visual status, functional skills, and social information were obtained. At 8 years, special education classes, developmental disabilities, rehabilitation therapies, and academic and social competencies were determined by questionnaire. Visual status was considered favorable/unfavorable on the basis of the better eye.


RESULTS
Of 255 survivors, 216 (85%) were evaluated at both 5.5 and 8 years. Major impairments were significantly more prevalent in children with unfavorable versus favorable visual status: cerebral palsy (39% vs 16%), developmental disability (57% vs 22%), autism (9% vs 1%), and epilepsy (23% vs 3%). Special education services (63% vs 27%), below-grade-level academic performance (84% vs 48%), and school-based rehabilitation services were significantly less common in children with favorable visual status. Favorable visual status, favorable functional ratings at 5.5 years, markers of higher socioeconomic status, and nonblack race were associated with significantly lower rates of both special education placement and below-grade-level academic performance at age 8. On multivariate logistic regression, only favorable visual status and functional status remained significant predictors for decreasing special education placement.


CONCLUSIONS
Threshold ROP is associated with high rates of developmental, educational, and social challenges in middle childhood; preserved vision was associated with a clear advantage, with more than half of the children with favorable visual status performing at grade level.
Msall
Michael E
ME
Pritzker School of Medicine, University of Chicago, Comer Children's and La Rabida Children's Hospitals, Chicago, Illinois, USA.
Phelps
Dale L
DL
Hardy
Robert J
RJ
Dobson
Velma
V
Quinn
Graham E
GE
Summers
C Gail
CG
Tremont
Michelle R
MR
D000704:Analysis of Variance; D001321:Autistic Disorder / Q000150:complications; D002547:Cerebral Palsy / Q000150:complications; D002648:Child; D002675:Child, Preschool; D017679:Cryotherapy; D002658:Developmental Disabilities / Q000150:complications* / Q000534:rehabilitation; D004519:Education, Special / Q000706:statistics & numerical data; D004522:Educational Status; D004827:Epilepsy / Q000150:complications; D006801:Humans; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D016015:Logistic Models; D011446:Prospective Studies; D012178:Retinopathy of Prematurity / Q000150:complications* / Q000628:therapy; D012307:Risk Factors; D012919:Social Behavior; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D017741:Survivors