TY - JOUR

T1 - Learning disabilities among extremely preterm children without neurosensory impairment

T2 - Comorbidity, neuropsychological profiles and scholastic outcomes

AU - Johnson, Samantha

AU - Strauss, Victoria

AU - Gilmore, Camilla

AU - Jaekel, Julia

AU - Marlow, Neil

AU - Wolke, Dieter

N1 - Publisher Copyright: © 2016 Elsevier Ireland Ltd

PY - 2016/12/1

Y1 - 2016/12/1

N2 - Background 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. Aims This study explored comorbidity in intellectual disability (ID) and learning disabilities (LD) in children born extremely preterm (EP; < 26+ 0 weeks’ gestation). Subjects and study design A UK national cohort of 161 EP children and 153 term-born controls without neurosensory impairments was assessed at 11 years of age (the EPICure Study). Outcome measures 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. Results 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. Conclusions 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.

AB - Background 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. Aims This study explored comorbidity in intellectual disability (ID) and learning disabilities (LD) in children born extremely preterm (EP; < 26+ 0 weeks’ gestation). Subjects and study design A UK national cohort of 161 EP children and 153 term-born controls without neurosensory impairments was assessed at 11 years of age (the EPICure Study). Outcome measures 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. Results 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. Conclusions 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.

KW - Academic attainment

KW - Extremely preterm

KW - Learning disabilities

KW - Mathematics

KW - Reading

KW - Special educational needs

UR - http://www.scopus.com/inward/record.url?scp=84981203377&partnerID=8YFLogxK

U2 - 10.1016/j.earlhumdev.2016.07.009

DO - 10.1016/j.earlhumdev.2016.07.009

M3 - Journal article

C2 - 27517525

AN - SCOPUS:84981203377

VL - 103

SP - 69

EP - 75

JO - Early Human Development

JF - Early Human Development

SN - 0378-3782

ER -