title: Poor attention rather than hyperactivity/impulsivity predicts academic achievement in very preterm and full-term adolescents.
abstract: BACKGROUND
  Very preterm (VP) children are at particular risk for attention deficit/hyperactivity disorder (ADHD) of the inattentive subtype. It is unknown whether the neurodevelopmental pathways to academic underachievement are the same as in the general population. This study investigated whether middle childhood attention or hyperactivity/impulsivity problems are better predictors of VP adolescents' academic achievement.
  
  
  METHODS
  In a geographically defined prospective whole-population sample of VP (<32 weeks gestation) and/or very low birth weight (<1500 g birth weight) (VLBW/VP; n = 281) and full-term control children (n = 286) in South Germany, ADHD subtypes were assessed at 6 years 3 months and 8 years 5 months using multiple data sources. Academic achievement was assessed at 13 years of age.
  
  
  RESULTS
  Compared with full-term controls, VLBW/VP children were at higher risk for ADHD inattentive subtype [6 years 3 months: odds ratio (OR) 2.8, p < 0.001; 8 years 5 months: OR 1.7, p = 0.020] but not for ADHD hyperactive-impulsive subtype (6 years 3 months: OR 1.4, p = 0.396; 8 years 5 months: OR 0.9, p = 0.820). Childhood attention measures predicted academic achievement in VLBW/VP and also full-term adolescents, whereas hyperactive/impulsive behaviour did not.
  
  
  CONCLUSIONS
  Attention is an important prerequisite for learning and predicts long-term academic underachievement. As ADHD inattentive subtype and cognitive impairments are frequent in VLBW/VP children, their study may help to identify the neurofunctional pathways from early brain development and dysfunction to attention problems and academic underachievement.
authors.affiliation: Institute of Neonatology, University Hospital Bonn, Bonn, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Jaekel
authors.forename: D
authors.initials: D
authors.lastname: Wolke
authors.forename: P
authors.initials: P
authors.lastname: Bartmann
mesh_terms: D000124:Achievement; D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000145:classification / Q000209:etiology / Q000503:physiopathology*; D002648:Child; D004521:Educational Measurement; D005260:Female; D005858:Germany; D005865:Gestational Age; D006801:Humans; D006948:Hyperkinesis / Q000209:etiology / Q000503:physiopathology; D007175:Impulsive Behavior / Q000209:etiology / Q000503:physiopathology; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000503:physiopathology*; D019102:Infant, Very Low Birth Weight; D008297:Male; D009035:Mothers / Q000523:psychology; D011237:Predictive Value of Tests; D011446:Prospective Studies