title: Learning disabilities among extremely preterm children without neurosensory impairment: Comorbidity, neuropsychological profiles and scholastic outcomes.
abstract: Children born extremely preterm are at high risk for intellectual disability, learning disabilities, executive dysfunction and special educational needs, but little is understood about the comorbidity of intellectual and learning disabilities in this population.
  
  
  
  This study explored comorbidity in intellectual disability (ID) and learning disabilities (LD) in children born extremely preterm (EP; <26+0weeks' gestation).
  
  
  
  A UK national cohort of 161 EP children and 153 term-born controls without neurosensory impairments was assessed at 11years of age (the EPICure Study).
  
  
  
  IQ, mathematics and reading attainment, executive function, visuospatial processing and sensorimotor skills were assessed using standardised tests, and curriculum-based attainment and special educational needs (SEN) using teacher reports.
  
  
  
  Overall, 75 (47%) EP children and 7 (4.6%) controls had ID or LD (RR 10.12; 95% CI 4.81, 21.27). Comorbidity in ID/LD was more common among EP children than controls (24% vs. 0%). EP children with comorbid ID/LD had significantly poorer neuropsychological abilities and curriculum-based attainment than EP children with an isolated disability or no disabilities. LD were associated with a 3 times increased risk for SEN. However, EP children with ID alone had poorer neuropsychological abilities and curriculum-based attainment than children with no disabilities, yet there was no increase in SEN provision among this group.
  
  
  
  EP children are at high risk for comorbid intellectual and learning disabilities. Education professionals should be aware of the complex nature of EP children's difficulties and the need for multi-domain assessments to guide intervention.
authors: Department of Health Sciences, University of Leicester, Leicester, UK. Electronic address: sjj19@le.ac.uk.
authors: Samantha
authors: S
authors: Johnson
authors: Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.
authors: Victoria
authors: V
authors: Strauss
authors: Mathematics Education Centre, Loughborough University, Epinal Way, Loughborough, Leicestershire, LE11 3TU, UK.
authors: Camilla
authors: C
authors: Gilmore
authors: Department of Child and Family Studies, College of Education, Health, and Human Sciences, The University of Tennessee Knoxville, 1215 West Cumberland Ave., Knoxville, TN 37996, USA; Department of Developmental Psychology, Ruhr-University Bochum, Universitätsstr. 150, 44801 Bochum, Germany; Department of Psychology and Health Sciences Research Institute and Division of Mental Health and Wellbeing, Warwick Medical School, University of Warwick, Coventry, UK.
authors: Julia
authors: J
authors: Jaekel
authors: Institute for Women's Health, University College London, 74 Huntley Street, London, WC1E 6AU, UK.
authors: Neil
authors: N
authors: Marlow
authors: Department of Psychology and Health Sciences Research Institute and Division of Mental Health and Wellbeing, Warwick Medical School, University of Warwick, Coventry, UK.
authors: Dieter
authors: D
authors: Wolke
mesh_terms: D002648:Child; D002657:Child Development; D015897:Comorbidity; D005260:Female; D006801:Humans; D062071:Infant, Extremely Premature / Q000254:growth & development*; D007231:Infant, Newborn; D008607:Intellectual Disability / Q000453:epidemiology*; D007859:Learning Disabilities / Q000453:epidemiology*; D008297:Male
keywords: Academic attainment; Extremely preterm; Learning disabilities; Mathematics; Reading; Special educational needs