A cumulative risk factor model for early identification of academic difficulties in premature and low birth weight infants.
OBJECTIVE
Premature and low birth weight children have a high prevalence of academic difficulties. This study examines a model comprised of cumulative risk factors that allows early identification of these difficulties.


METHODS
This is a secondary analysis of data from a large cohort of premature (<37 weeks gestation) and LBW (<2500 g) children. The study subjects were 8 years of age and 494 had data available for reading achievement and 469 for mathematics. Potential predictor variables were categorized into 4 domains: sociodemographic, neonatal, maternal mental health and early childhood (ages 3 and 5). Regression analysis was used to create a model to predict reading and mathematics scores.


RESULTS
Variables from all domains were significant in the model, predicting low achievement scores in reading (R (2) of 0.49, model p-value < .0001) and mathematics (R (2) of 0.44, model p-value < .0001). Significant risk factors for lower reading scores, were: lower maternal education and income, and Black or Hispanic race (sociodemographic); lower birth weight and male gender (neonatal); lower maternal responsivity (maternal mental health); lower intelligence, visual-motor skill and higher behavioral disturbance scores (early childhood). Lower mathematics scores were predicted by lower maternal education, income and age and Black or Hispanic race (sociodemographic); lower birth weight and higher head circumference (neonatal); lower maternal responsivity (maternal mental health); lower intelligence, visual-motor skill and higher behavioral disturbance scores (early childhood).


CONCLUSIONS
Sequential early childhood risk factors in premature and LBW children lead to a cumulative risk for academic difficulties and can be used for early identification.
Roberts
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Murdoch Children's Research Institute, Royal Children's Hospital, Flemington Road, Parkville, VIC 3052, Melbourne, Australia. gehan.roberts@rch.org.au
Bellinger
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McCormick
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D002648:Child; D002652:Child Behavior / Q000523:psychology; D004522:Educational Status; D005260:Female; D006801:Humans; D007230:Infant, Low Birth Weight / Q000523:psychology*; D007231:Infant, Newborn; D007859:Learning Disabilities; D008137:Longitudinal Studies; D008297:Male; D008603:Mental Health; D008962:Models, Theoretical; D009034:Mother-Child Relations; D009048:Motor Skills; D011247:Pregnancy; D047928:Premature Birth / Q000523:psychology*; D012307:Risk Factors; D012959:Socioeconomic Factors