title: The contribution of visual processing to academic achievement in adolescents born extremely preterm or extremely low birth weight.
abstract: Children born extremely preterm (EP, <28 weeks) and/or extremely low birth weight (ELBW, <1000 g) have more academic deficiencies than their term-born peers, which may be due to problems with visual processing. The aim of this study is to determine (1) if visual processing is related to poor academic outcomes in EP/ELBW adolescents, and (2) how much of the variance in academic achievement in EP/ELBW adolescents is explained by visual processing ability after controlling for perinatal risk factors and other known contributors to academic performance, particularly attention and working memory. A geographically determined cohort of 228 surviving EP/ELBW adolescents (mean age 17 years) was studied. The relationships between measures of visual processing (visual acuity, binocular stereopsis, eye convergence, and visual perception) and academic achievement were explored within the EP/ELBW group. Analyses were repeated controlling for perinatal and social risk, and measures of attention and working memory. It was found that visual acuity, convergence and visual perception are related to scores for academic achievement on univariable regression analyses. After controlling for potential confounds (perinatal and social risk, working memory and attention), visual acuity, convergence and visual perception remained associated with reading and math computation, but only convergence and visual perception are related to spelling. The additional variance explained by visual processing is up to 6.6% for reading, 2.7% for spelling, and 2.2% for math computation. None of the visual processing variables or visual motor integration are associated with handwriting on multivariable analysis. Working memory is generally a stronger predictor of reading, spelling, and math computation than visual processing. It was concluded that visual processing difficulties are significantly related to academic outcomes in EP/ELBW adolescents; therefore, specific attention should be paid to academic remediation strategies incorporating the management of working memory and visual processing in EP/ELBW children.
authors.affiliation: a Clinical Sciences, Murdoch Childrens Research Institute , Melbourne , Australia.|b Department of Obstetrics and Gynaecology , Royal Women's Hospital , Melbourne , Australia.
authors.forename: Carly S
authors.initials: CS
authors.lastname: Molloy
authors.affiliation: a Clinical Sciences, Murdoch Childrens Research Institute , Melbourne , Australia.|c Department of Critical Care Medicine , The Hospital for Sick Children , Toronto , Canada.
authors.forename: Ashley M
authors.initials: AM
authors.lastname: Di Battista
authors.affiliation: a Clinical Sciences, Murdoch Childrens Research Institute , Melbourne , Australia.|d Psychological Sciences & Paediatrics, University of Melbourne , Melbourne , Australia.|e Psychology , Royal Children's Hospital , Melbourne , Australia.
authors.forename: Vicki A
authors.initials: VA
authors.lastname: Anderson
authors.affiliation: a Clinical Sciences, Murdoch Childrens Research Institute , Melbourne , Australia.|b Department of Obstetrics and Gynaecology , Royal Women's Hospital , Melbourne , Australia.
authors.forename: Alice
authors.initials: A
authors.lastname: Burnett
authors.affiliation: a Clinical Sciences, Murdoch Childrens Research Institute , Melbourne , Australia.|f Department of Paediatrics , University of Melbourne , Melbourne , Australia.
authors.forename: Katherine J
authors.initials: KJ
authors.lastname: Lee
authors.affiliation: f Department of Paediatrics , University of Melbourne , Melbourne , Australia.|g Centre for Community Child Health , Royal Children's Hospital , Melbourne , Australia.|h Population Health, Murdoch Childrens Research Institute , Melbourne , Australia.
authors.forename: Gehan
authors.initials: G
authors.lastname: Roberts
authors.affiliation: a Clinical Sciences, Murdoch Childrens Research Institute , Melbourne , Australia.|b Department of Obstetrics and Gynaecology , Royal Women's Hospital , Melbourne , Australia.|f Department of Paediatrics , University of Melbourne , Melbourne , Australia.
authors.forename: Jeanie Ly
authors.initials: JL
authors.lastname: Cheong
authors.affiliation: a Clinical Sciences, Murdoch Childrens Research Institute , Melbourne , Australia.|f Department of Paediatrics , University of Melbourne , Melbourne , Australia.
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Anderson
authors.affiliation: a Clinical Sciences, Murdoch Childrens Research Institute , Melbourne , Australia.|b Department of Obstetrics and Gynaecology , Royal Women's Hospital , Melbourne , Australia.|f Department of Paediatrics , University of Melbourne , Melbourne , Australia.
authors.forename: Lex W
authors.initials: LW
authors.lastname: Doyle
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D004522:Educational Status; D005260:Female; D006801:Humans; D052577:Infant, Extremely Low Birth Weight / Q000254:growth & development*; D062071:Infant, Extremely Premature / Q000254:growth & development*; D008297:Male; D011247:Pregnancy; D011446:Prospective Studies; D014796:Visual Perception / Q000235:genetics*; D055815:Young Adult
keywords: Extremely preterm; academic outcome; attention; extremely low birth weight; visual processing; working memory