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Taylor HG, Benkart RA, Vrantsidis DM, Quach J, Busch TA, Horn T, Neel ML, Maitre NL. School Readiness Predictors of Early Academic Achievement in Children Born Very Preterm. J Dev Behav Pediatr 2024; 45:e235-e242. [PMID: 38896564 DOI: 10.1097/dbp.0000000000001275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 03/08/2024] [Indexed: 06/21/2024]
Abstract
OBJECTIVE This study examined associations of school readiness measures obtained before school entry with academic achievement at early school age in children born very preterm (VPT, gestational age ≤ 30 weeks) and children born full term (FT, GA ≥ 37 weeks). METHOD The sample included 38 children born VPT and 30 born FT recruited at age 4 years and followed to early school age. Measures of readiness included tests of global cognition, executive function, motor abilities, and preacademic skills, as well as caregiver behavior ratings. Tests of math, reading, and spelling were administered to assess school-age achievement. Analyses that controlled for socioeconomic status and accounted for inclusion of siblings compared the groups on the achievement tests and identified measures of readiness related to school-age achievement. RESULTS Achievement difficulties were more pronounced in the VPT group and associated with problems in multiple readiness domains. Effect sizes for these associations were largest for measures of spatial ability, executive function, and preacademic skills. Some associations remained significant when controlling for global cognitive ability at age 4 years, and others were significant only for the VPT group. CONCLUSION Findings suggest that deficits on tests in multiple readiness domains assessed before school entry in children born VPT or FT are associated with early school-age achievement. The most pronounced readiness deficits in the VPT group at age 4 years were also among those most closely associated with later difficulties in achievement. Further research is needed to refine assessment of school readiness in children born VPT.
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Affiliation(s)
- H Gerry Taylor
- Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH
- Department of Pediatrics, The Ohio State University, Columbus, OH
| | - Rebekah A Benkart
- Department of Human Development and Family Sciences, Oregon State University, Corvallis, OR
| | | | - Jessica Quach
- Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH
| | | | - Timothy Horn
- Department of School Psychology, University of Florida, Gainesville, FL; and
| | - Mary Lauren Neel
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA
| | - Nathalie L Maitre
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA
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Bando N, Walton K, O'Connor DL, Janus M, Unger SL. Examination of school readiness and factors related to developmental vulnerability in children born very low birth weight. Child Care Health Dev 2022; 49:444-455. [PMID: 36070087 DOI: 10.1111/cch.13058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 08/02/2022] [Accepted: 09/03/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Many children born very low birth weight (VLBW) experience school struggles with preparedness requiring adequate physical, social, behavioural, cognitive and communication skills. A global assessment of proficiency is necessary to identify those at risk in any such area and direct early intervention accordingly. Study objectives were to characterize developmental vulnerability and school readiness scores in these key domains in a sample of children born VLBW versus their provincial public school system peers and identify early-life infant and parent factors related to suboptimal school readiness. METHODS The Early Development Instrument teacher assessments of school readiness were collected for a Canadian VLBW sample (NCT02759809). Comparisons between children born VLBW and peers were made. Group differences between children born VLBW considered vulnerable (<10th percentile, not developmentally ready for learning) and not vulnerable were tested and linear regression explored associations between early-life factors and domain scores. RESULTS Of 77 available Early Development Instrument assessments, median (interquartile range) assessment age was 6.0 (5.7, 6.2) years, birth weight 950 (793, 1250) grammes and birth gestation 27.4 (25.6, 29.7) weeks. A higher proportion of children born VLBW versus peers exhibited vulnerability in Physical Health and Well-being (24.7% vs. 16.1%, p = 0.04), Communication Skills and General Knowledge (23.4% vs. 10.2%, p = 0.0001) and vulnerability in ≥2 domains (26.0% vs. 14.4%, p = 0.004). Children born VLBW classified as vulnerable versus not vulnerable had lower birth gestation and 5-min Apgar. Adjusted regression models found Apgar <7 associated with lower scores for Physical Health and Well-being (-0.86; 95%CI: -1.71, -0.00; p = 0.049), Social Competence (-1.77; 95%CI: -2.92, -0.62; p = 0.003), Emotional Maturity (-1.55; 95%CI: -2.43, -0.66; p = 0.0009) and Communication Skills and General Knowledge (-1.63; 95%CI: -3.19, -0.06; p = 0.04). CONCLUSIONS This VLBW sample exhibited poor school readiness in multiple domains. Identification of lower birth gestation and Apgar may assist targeted early interventions to mitigate vulnerability.
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Affiliation(s)
- Nicole Bando
- Translational Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Kathryn Walton
- Translational Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Deborah L O'Connor
- Translational Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada.,Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada.,Paediatrics, Sinai Health, Toronto, Ontario, Canada
| | - Magdalena Janus
- Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Sharon L Unger
- Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada.,Paediatrics, Sinai Health, Toronto, Ontario, Canada.,Division of Neonatology, The Hospital for Sick Children, Toronto, Ontario, Canada.,Paediatrics, University of Toronto, Toronto, Ontario, Canada
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Taylor HG, Vrantsidis DM, Neel ML, Benkart R, Busch TA, de Silva A, Udaipuria S, Maitre NL. School Readiness in 4-Year-Old Very Preterm Children. CHILDREN 2022; 9:children9030323. [PMID: 35327695 PMCID: PMC8947581 DOI: 10.3390/children9030323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 02/10/2022] [Accepted: 02/21/2022] [Indexed: 11/22/2022]
Abstract
The aims of this study were to identify the aspects of school readiness that best distinguish very preterm (VPT) preschoolers from full-term (FT) controls, determine the extent to which readiness problems in the VPT group reflected global cognitive weaknesses or more specific deficits, and identify distinct profiles of readiness problems. Fifty-three VPT (gestational age ≤ 30 weeks) 4-year-olds were compared to 38 FT (gestational age ≥ 37 weeks) controls on measures of global cognitive ability, executive function, motor skills, early literacy and numeracy, and psychosocial functioning. Latent class analysis (LCA) was also conducted to identify individual readiness profiles. The VPT group had the most pronounced difficulties on tests of spatial and nonverbal cognitive abilities, executive function, motor skills, phonological processing, and numeracy. The VPT group also had sex-related difficulties in processing speed, social functioning, and emotion regulation. These differences were evident in analyses of both continuous scores and rates of deficits. The VPT group’s difficulties in motor skills, and VPT females’ difficulties in social functioning and emotion regulation, were evident even when controlling for global cognitive ability. LCA suggested four profiles of readiness, with the majority of the VPT group assigned to profiles characterized by relative weaknesses in either cognitive abilities or psychosocial functioning or by more global readiness problems. The findings support the need to evaluate multiple aspects of school readiness in VPT preschoolers and inform efforts to design more targeted early educational interventions.
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Affiliation(s)
- H. Gerry Taylor
- Abigail Wexner Research Institute, Nationwide Children’s Hospital, Columbus, OH 43215, USA; (D.M.V.); (M.L.N.); (R.B.); (T.A.B.); (A.d.S.)
- Department of Pediatrics, The Ohio State University, Columbus, OH 43210, USA
- Correspondence: ; Tel.: +1-614-722-3184
| | - Daphne M. Vrantsidis
- Abigail Wexner Research Institute, Nationwide Children’s Hospital, Columbus, OH 43215, USA; (D.M.V.); (M.L.N.); (R.B.); (T.A.B.); (A.d.S.)
| | - Mary Lauren Neel
- Abigail Wexner Research Institute, Nationwide Children’s Hospital, Columbus, OH 43215, USA; (D.M.V.); (M.L.N.); (R.B.); (T.A.B.); (A.d.S.)
- Department of Pediatrics, The Ohio State University, Columbus, OH 43210, USA
| | - Rebekah Benkart
- Abigail Wexner Research Institute, Nationwide Children’s Hospital, Columbus, OH 43215, USA; (D.M.V.); (M.L.N.); (R.B.); (T.A.B.); (A.d.S.)
| | - Tyler A. Busch
- Abigail Wexner Research Institute, Nationwide Children’s Hospital, Columbus, OH 43215, USA; (D.M.V.); (M.L.N.); (R.B.); (T.A.B.); (A.d.S.)
| | - Aryanne de Silva
- Abigail Wexner Research Institute, Nationwide Children’s Hospital, Columbus, OH 43215, USA; (D.M.V.); (M.L.N.); (R.B.); (T.A.B.); (A.d.S.)
- Department of Pediatrics, The Ohio State University, Columbus, OH 43210, USA
| | - Shivika Udaipuria
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA;
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Gire C, Garbi A, Zahed M, Beltran Anzola A, Tosello B, Datin-Dorrière V. Neurobehavioral Phenotype and Dysexecutive Syndrome of Preterm Children: Comorbidity or Trigger? An Update. CHILDREN (BASEL, SWITZERLAND) 2022; 9:239. [PMID: 35204960 PMCID: PMC8870742 DOI: 10.3390/children9020239] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Revised: 01/29/2022] [Accepted: 02/09/2022] [Indexed: 06/14/2023]
Abstract
Premature birth is a worldwide public health priority. One in ten children is born before 37 weeks of gestational age and, in developed countries, survival rates without major neonatal morbidity are increasing. Although severe sequelae associated with these births have decreased, their neurobehavioral difficulties, often associated in multiple fields, remain stable but still widespread. These neurobehavioral difficulties hamper the normal development of academic achievements and societal integration and intensify the children's needs for rehabilitation during their preschool and academic years. Severe sequelae increase when gestational age decreases. This is even truer if the socio-cultural background is impeded by low income, education and language skills as compared with defined averages. However, moderate and/or minor neurocognitive and/or behavioral difficulties are almost identical for a moderate or a late preterm birth. Obtaining a better clinical description of neurobehavioral characteristics of those pretermly born, once they reach preschool age, is essential to detect behavioral issues as well as early specific cognitive difficulties (working memory, planning, inhibition, language expression and reception, attention and fine motor skills, etc.). Such information would provide a better understanding of the executive functions' role in brain connectivity, neurodevelopment and neuroanatomical correlation with premature encephalopathy.
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Affiliation(s)
- Catherine Gire
- Department of Neonatology, North Hospital, University Hospital of Marseille, Chemin des Bourrelys, CEDEX 20, 13915 Marseille, France; (C.G.); (A.G.); (M.Z.); (A.B.A.)
- CEReSS—Health Service Research and Quality of Life Center, Faculty of Medicine, Aix-Marseille University, 27 Boulevard Jean Moulin, 13005 Marseille, France
| | - Aurélie Garbi
- Department of Neonatology, North Hospital, University Hospital of Marseille, Chemin des Bourrelys, CEDEX 20, 13915 Marseille, France; (C.G.); (A.G.); (M.Z.); (A.B.A.)
| | - Meriem Zahed
- Department of Neonatology, North Hospital, University Hospital of Marseille, Chemin des Bourrelys, CEDEX 20, 13915 Marseille, France; (C.G.); (A.G.); (M.Z.); (A.B.A.)
| | - Any Beltran Anzola
- Department of Neonatology, North Hospital, University Hospital of Marseille, Chemin des Bourrelys, CEDEX 20, 13915 Marseille, France; (C.G.); (A.G.); (M.Z.); (A.B.A.)
- CEReSS—Health Service Research and Quality of Life Center, Faculty of Medicine, Aix-Marseille University, 27 Boulevard Jean Moulin, 13005 Marseille, France
| | - Barthélémy Tosello
- Department of Neonatology, North Hospital, University Hospital of Marseille, Chemin des Bourrelys, CEDEX 20, 13915 Marseille, France; (C.G.); (A.G.); (M.Z.); (A.B.A.)
- CNRS, EFS, ADES, Aix Marseille Universite, 13915 Marseille, France
| | - Valérie Datin-Dorrière
- Department of Neonatal Medicine, Caen University Hospital, Avenue Cote De Nacre, 14000 Caen, France;
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Bills SE, Johnston JD, Shi D, Bradshaw J. [Formula: see text] Social-environmental moderators of neurodevelopmental outcomes in youth born preterm: A systematic review. Child Neuropsychol 2021; 27:351-370. [PMID: 33342364 PMCID: PMC7969400 DOI: 10.1080/09297049.2020.1861229] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 12/03/2020] [Indexed: 10/22/2022]
Abstract
Objective: Preterm birth represents a significant medical event that places infants at a markedly greater risk for neurodevelopmental problems and delays. Although the impact of medical factors on neurodevelopment for those born preterm has been thoroughly explored, less is known about how social-environmental factors (e.g., socioeconomic status, family functioning) moderate outcomes. This review explores the quantity and methodological rigor of research on social-environmental factors as moderators of the relationship between preterm birth and neurodevelopmental outcomes.Methods: Articles published between January 1980 and December 2016 were identified from a comprehensive meta-analysis and systematic review on neurodevelopmental outcomes following preterm birth. A systematic review of MEDLINE was conducted to identify articles published from January 2017 through April 2019.Results: Eighty articles met the inclusion criteria. The majority of studies matched preterm and control groups on social-environmental factors (n = 49). The remaining studies included social-environmental factors as moderators (n = 13) or correlates (n = 11) of neurodevelopmental outcomes. Only seven studies did not include reports on social-environmental factors.Conclusions: This systematic review suggests that social-environmental factors are often considered to be ancillary risk factors to the larger medical risk imparted by prematurity. Studies typically focused on socioeconomic status rather than more modifiable parent/family factors that can be targeted through intervention (e.g., parental mental health) and evidenced mixed findings regarding the significance of social-environmental factors as moderators. Further research is needed to identify the relative influence of social-environmental factors to inform future psychosocial interventions.
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Affiliation(s)
- Sarah E. Bills
- Department of Psychology, University of South Carolina, Columbia, SC, 29208, USA
| | - Julia D. Johnston
- Department of Psychology, University of South Carolina, Columbia, SC, 29208, USA
| | - Dexin Shi
- Department of Psychology, University of South Carolina, Columbia, SC, 29208, USA
| | - Jessica Bradshaw
- Department of Psychology, University of South Carolina, Columbia, SC, 29208, USA
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de Silva A, Neel ML, Maitre N, Busch T, Taylor HG. Resilience and vulnerability in very preterm 4-year-olds. Clin Neuropsychol 2020; 35:904-924. [DOI: 10.1080/13854046.2020.1817565] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Aryanne de Silva
- Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, OH, USA
- Department of Pediatrics, The Ohio State University, Columbus, OH, USA
| | - Mary Lauren Neel
- Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, OH, USA
- Department of Pediatrics, The Ohio State University, Columbus, OH, USA
| | - Nathalie Maitre
- Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, OH, USA
- Department of Pediatrics, The Ohio State University, Columbus, OH, USA
| | - Tyler Busch
- Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, OH, USA
| | - H. Gerry Taylor
- Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, OH, USA
- Department of Pediatrics, The Ohio State University, Columbus, OH, USA
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Adrian JA, Bakeman R, Akshoomoff N, Haist F. Cognitive functions mediate the effect of preterm birth on mathematics skills in young children. Child Neuropsychol 2020; 26:834-856. [PMID: 32396760 DOI: 10.1080/09297049.2020.1761313] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Children born preterm are at risk for cognitive deficits and lower academic achievement. Notably, mathematics achievement is generally most affected. Here, we investigated the cognitive functions mediating early mathematics skills and how these are impacted by preterm birth. Healthy children born preterm (gestational age at birth < 33 weeks; n = 51) and children born full term (n = 27) were tested at ages 5, 6, and 7 years with a comprehensive battery of tests. We categorized items of the TEMA-3: Test for Early Mathematics Abilities Third Edition into number skills and arithmetic skills. Using multiple mediation models, we assessed how the effect of preterm birth on mathematics skills is mediated by spatial working memory, inhibitory control, visual-motor integration, and phonological processing. Both number and arithmetic skills showed group differences, but with different developmental trajectories. The initial performance gap observed in the preterm children decreased over time for number skills but increased for arithmetic skills. Phonological processing, visual-motor integration, and inhibitory control were poorer in children born preterm. These cognitive functions, particularly phonological processing, had a mediating effect on both types of mathematics skills. These findings help define and chart the trajectory of the specific cognitive skills directly influencing math deficit phenotypes in children born very preterm. This knowledge provides guidance for targeted evaluation and treatment implementation.
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Affiliation(s)
- Julia Anna Adrian
- Department of Cognitive Science, UC San Diego , San Diego, CA, USA.,Center for Human Development, UC San Diego , San Diego, CA, USA
| | - Roger Bakeman
- Department of Psychology, Georgia State University , Atlanta, GA, USA
| | - Natacha Akshoomoff
- Center for Human Development, UC San Diego , San Diego, CA, USA.,Department of Psychiatry, UC San Diego , San Diego, CA, USA
| | - Frank Haist
- Center for Human Development, UC San Diego , San Diego, CA, USA.,Department of Psychiatry, UC San Diego , San Diego, CA, USA
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Abstract
OBJECTIVES Research on developmental outcomes of preterm birth has traditionally focused on adverse effects. This study investigated the prevalence and correlates of resilience in 146 extremely preterm/extremely low birth weight (EPT/ELBW) children (gestational age <28 weeks and/or birth weight <1000 g) attending kindergarten and 111 term-born normal birth weight (NBW) controls. METHODS Adaptive competence (i.e., "resilience" in the EPT/ELBW group) was defined by scores within grade expectations on achievement tests and the absence of clinically elevated parent ratings of child behavior problems. The "adaptive" children who met these criteria were compared to the "maladaptive" children who did not on child and family characteristics. Additional analyses were conducted to assess the conjoint effects of group (ELBW vs. NBW) and family factors on adaptive competence. RESULTS A substantial minority of the EPT/ELBW group (45%) were competent compared to a majority of NBW controls (73%), odds ratio (95% confidence interval)=0.26 (0.15, 0.45), p<.001. Adaptive competence was associated with higher cognitive skills, more favorable ratings of behavior and learning not used to define adaptive competence, and more advantaged family environments in both groups, as well as with a lower rate of earlier neurodevelopmental impairment in the EPT/ELBW group. Higher socioeconomic status and more favorable proximal home environments were associated with competence independent of group, and group differences in competence persisted across the next two school years. CONCLUSIONS The findings document resilience in kindergarten children with extreme prematurity and highlight the role of environmental factors as potential influences on outcome. (JINS, 2019, 25, 362-374).
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Taylor HG, Orchinik L, Fristad MA, Minich N, Klein N, Espy KA, Schluchter M, Hack M. Associations of Attention Deficit Hyperactivity Disorder (ADHD) at School Entry with Early Academic Progress in Children Born Prematurely and Full-Term Controls. LEARNING AND INDIVIDUAL DIFFERENCES 2019; 69:1-10. [PMID: 31223221 PMCID: PMC6586420 DOI: 10.1016/j.lindif.2018.10.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- H Gerry Taylor
- Center for Biobehavioral Health, Nationwide Children's Hospital Research Institute and Department of Pediatrics, The Ohio State University, Columbus, OH
- Department of Pediatrics, Case Western Reserve University and Rainbow Babies & Children's Hospital, University Hospitals Cleveland Medical Center, Cleveland, OH
| | - Leah Orchinik
- Department of Pediatrics, Nemours/Alfred I. DuPont Hospital for Children, Wilmington, DE and Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA
| | - Mary A Fristad
- Department of Psychiatry and Behavioral Health, The Ohio State University, Columbus, OH
| | - Nori Minich
- Department of Pediatrics, Case Western Reserve University and Rainbow Babies & Children's Hospital, University Hospitals Cleveland Medical Center, Cleveland, OH
| | - Nancy Klein
- Department of Education, Cleveland State University, Cleveland, OH
| | | | - Mark Schluchter
- Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH
| | - Maureen Hack
- Department of Pediatrics, Case Western Reserve University and Rainbow Babies & Children's Hospital, University Hospitals Cleveland Medical Center, Cleveland, OH
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