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November 1992

Kindergarten Readiness After Extreme Prematurity

Author Affiliations

From the Departments of Pediatrics (Drs Msall and Rogers) and Social and Preventive Medicine (Dr Buck), School of Medicine and Biomedical Sciences, State University of New York, Buffalo, and the Nursing Department, Robert Warner Rehabilitation Center, Children's Hospital of Buffalo (NY) (Ms Catanzaro).

Am J Dis Child. 1992;146(11):1371-1375. doi:10.1001/archpedi.1992.02160230129033

• Objective.  —To assess kindergarten readiness among survivors of extreme prematurity and to identify predictors of special education requirements.

Design.  —Historic cohort design.

Setting.  —Regionalized tertiary pediatric center. Participants.—One hundred forty-nine (97%) of 153 children who were alive at follow-up (mean±SD age, 52.7±9.9 months).

Selection Procedures.  —Study cohort included infants (gestation, 23 to 28 weeks), born between 1983 and 1986 (N=194), who were alive at follow-up (N=153, 79% survival).

Interventions.  —None.

Measurements and Results.  —Standardized neurodevelopmental and psychometric evaluations were administered by a multidisciplinary team that was blinded to the neonatal course. Thirty-one children (21 %) had major neurodevelopmental impairments. By using the McCarthy Scales of Children's Abilities for children free of major impairments, 61 (63%) had one or more minor neurodevelopmental impairments noted. Half of the surviving children were thought to require special education resources at kindergarten entry. Multivariate logistic regression identified three significant predictors of special education: low socioeconomic status, nonwhite race, and male gender.

Conclusions.  —Social and demographic variables were associated with minor neurodevelopmental impairments and special education requirements among extremely premature children. Continued developmental follow-up and targeted interventions to reduce the risk of educational underachievement appear to be warranted.(AJDC. 1992;146:1371-1375)

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