Effects of extreme prematurity and kindergarten neuropsychological skills on early academic progress

Abstract

Objective: The study was designed to investigate the effect of extreme prematurity on growth in academic achievement across the early school years and the validity of kindergarten neuropsychological skills as predictors of achievement.

Method: A 2001-2003 birth cohort of 145 extremely preterm/extremely low birth weight (EPT/ELBW) children from a single medical center, along with 111 normal birth weight (NBW) classmate controls, were recruited during their first year in kindergarten and followed annually across the next 2 years in school. Mixed model analysis was conducted to compare the groups on growth in achievement across years and examine kindergarten neuropsychological skills as predictors of growth.

Results: The EPT/ELBW group scored significantly below NBW controls on all achievement tests across years and had higher rates of special education placement and grade repetition. Despite limited catch-up of the EPT/ELBW group to the NBW controls in spelling, group differences were generally stable. Differences in spelling and mathematics achievement remained significant when controlling for global intelligence or excluding children who had intellectual or neurosensory impairments or repeated a grade. Higher scores on kindergarten tests of multiple neuropsychological ability domains predicted higher achievement levels and steeper growth in achievement.

Conclusions: The findings document persistent academic weaknesses in EPT/ELBW children across the early school years. Results point to the need for preschool interventions to enhance academic readiness and suggest that neuropsychological skills assessed in kindergarten are useful in identifying individual differences in early learning progress. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Figure 1.

Mean W scores on WJ-III-ACH Spelling for the extremely preterm/extremely low birth weight (EPT/ELBW) groups across years 1–3. Scores are estimated means from mixed model analysis controlling for socioeconomic status, sex, race, age, time in school at the year 1 assessment, and family membership. Analysis revealed significantly more growth for the EPT/ELBW group from years 1–3, beta (se) = 8.22 (2.85), t (211) = 2.88, p=.004.

Figure 2.

Estimates mean W scores on WJ-III-ACH Letter-Word Identification for children at low and high levels of executive function (EF), as defined by scores 1 SD below and above the sample mean. Scores are means from mixed model analysis controlling for socioeconomic, sex, race, age, time in school at the year 1 assessment, and family membership. Analysis revealed significantly faster growth at a high level of EF from years 1–2, beta (se) = 5.50 (2.18), t (240) = 2.52, p=.012, and from years 1–3, beta (se) = 7.93 (2.75), t (245) = 2.89, p =.004.