title: Special care and school difficulties in 8-year-old very preterm children: the Epipage cohort study.
abstract: OBJECTIVE
  To investigate school difficulties, special care and behavioral problems in 8 year-old very preterm (VPT) children.
  
  
  METHODS
  Longitudinal population-based cohort in nine regions of France of VPT children and a reference group born at 39-40 weeks of gestation (WG). The main outcome measures were information about school, special care and behavioral problems using Strengths and Difficulties Questionnaire from a questionnaire to parents.
  
  
  RESULTS
  Among the 1439 VPT children, 5% (75/1439) were in a specialised school or class, 18% (259/1439) had repeated a grade in a mainstream class and 77% (1105/1439) were in the appropriate grade-level in mainstream class; these figures were 1% (3/327) , 5% (16/327) and 94% (308/327) , respectively, for the reference group. Also, 15% (221/1435) of VPT children in a mainstream class received support at school versus 5% (16/326) of reference group. More VPT children between the ages of five and eight years received special care (55% (794/1436)) than children born at term (38% (124/325)); more VPT children (21% (292/1387)) had behavioral difficulties than the reference group (11% (35/319)). School difficulties, support at school, special care and behavioral difficulties in VPT children without neuromotor or sensory deficits varied with gestational age, socioeconomic status, and cognitive score at the age of five.
  
  
  CONCLUSIONS
  Most 8-year-old VPT children are in mainstream schools. However, they have a high risk of difficulty in school, with more than half requiring additional support at school and/or special care. Referral to special services has increased between the ages of 5 and 8 years, but remained insufficient for those with borderline cognitive scores.
authors.affiliation: INSERM, UMR S953, IFR 69, Epidemiological Research on Perinatal Health and Women's and Children's Health, Paris, France.
authors.forename: Beatrice
authors.initials: B
authors.lastname: Larroque
authors.forename: Pierre-Yves
authors.initials: PY
authors.lastname: Ancel
authors.forename: Laetitia
authors.initials: L
authors.lastname: Marchand-Martin
authors.forename: Gilles
authors.initials: G
authors.lastname: Cambonie
authors.forename: Jeanne
authors.initials: J
authors.lastname: Fresson
authors.forename: Véronique
authors.initials: V
authors.lastname: Pierrat
authors.forename: Jean-Christophe
authors.initials: JC
authors.lastname: Rozé
authors.forename: Loic
authors.initials: L
authors.lastname: Marpeau
authors.forename: Gerard
authors.initials: G
authors.lastname: Thiriez
authors.forename: Corinne
authors.initials: C
authors.lastname: Alberge
authors.forename: Gérard
authors.initials: G
authors.lastname: Bréart
authors.forename: Monique
authors.initials: M
authors.lastname: Kaminski
authors.forename: Stéphane
authors.initials: S
authors.lastname: Marret
mesh_terms: D002648:Child; D002653:Child Behavior Disorders / Q000523:psychology; D002654:Child Care; D015331:Cohort Studies; D005260:Female; D005602:France; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000254:growth & development*; D008297:Male; D012574:Schools; D012944:Social Support; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires