Which newborns in New York City are at risk for special education placement?

Academic achievement varies with gestational age among children born at term

OBJECTIVE

The goal of this study was to examine the degree to which children born within the "normal term" range of 37 to 41 weeks' gestation vary in terms of school achievement.

METHODS

This study analyzed data from 128050 singleton births born between 37 and 41 weeks' gestation in a large US city. Data were extracted from city birth records to assess a number of obstetric, social, and economic variables, at both the individual and community levels. Birth data were then matched with public school records of standardized city-wide third-grade reading and math tests. Specifically, we assessed (1) whether children born within the normal term range of 37 to 41 weeks' gestation show differences in reading and/or math ability 8 years later as a function of gestational age, and (2) the degree to which a wide range of individual- and community-level social and biological factors mediate this effect.

RESULTS

Analyses revealed that gestational age within the normal term range was significantly and positively related to reading and math scores in third grade, with achievement scores for children born at 37 and 38 weeks significantly lower than those for children born at 39, 40, or 41 weeks. This effect was independent of birth weight, as well as a number of other obstetric, social, and economic factors.

CONCLUSIONS

Earlier normal term birth may be a characteristic considered by researchers, clinicians, and parents to help identify children who may be at risk for poorer school performance.

Newborns at risk for special education placement: a population-based study

OBJECTIVES

To establish the contributions of birth weight (BW), gender, socioeconomic status (SES), and parental age on risks for special education (SE) placements in school-age children.

METHODS

A population-based sample of 900 school-age children attending the following full-time SE groups: at level 1, children had isolated neurodevelopmental, physical, or other impairments; at level 2, borderline to mild intellectual disability (ID); and at level 3, moderate to severe ID. Three hundred and one children enrolled in mainstream education formed the control group (level 0). For all children with siblings, we defined familiar forms of learning disorders as having a sibling in one of the SE groupings. We performed our analysis for the entire cohort as well as comparing risk factors within the familial and non-familial types of SE groupings.

RESULTS

In multinomial logistic regression analysis, age of father 40 years, low BW (<2500g or <-2 SD), male sex, and parent's lower SES, all increased the probability of SE placement. In the familial forms of levels 2 and 3, the parental SES was lower and, in addition, in the level 2, the family size was bigger. Furthermore, in the non-familial form of level 2, both the low and the high (4000g) BW were more common.

CONCLUSIONS

Among the known risk factors for learning disabilities (LD), our study highlighted the importance of a higher paternal age and a lower SES especially in the familial forms of LD.

Identification of early risk factors for language impairment

The current study is a population-based investigation of birth risk factors for school-identified specific language impairment (SLI). The sample consisted of 244,619 students (5,862 SLI) born in Florida between 1989 and 1990 who were in the Florida public school system at ages 6-7. Epidemiological measures of effect were used to investigate both individual- and population-level risk for SLI. Very low birth weight (VLBW), low 5-min Apgar score, late or no prenatal care, high birth order, and low maternal education were associated with highest individual-level risk. Low maternal education and having an unmarried mother was associated with the highest population-level risk. The results not only suggest who needs to be screened for a future developmental disability, but identify a group of children who are at-risk for an SLI placement in school. Early intervention services for these children may be the most effective approach to reducing the incidence of school-identified SLI.

[Use of amitriptyline in attention deficit hyperactivity disorder]

We studied the action of amitriptyline (AMI) in the attention deficit hyperactivity disorder (ADHD). Twenty-five children who came to consultation for ADHD were analyzed, in two groups: the group which used AMI (n = 18) at 1.6 mg/kg/day and the group which used placebo (n = 7). Both groups were submitted to two assessments in a 30 days interval, which consisted of the evolutive neurological evolution examination (ENE) and the WISC scale subtests on numbers, drawings to be completed and the code. The results showed that the AMI produced an improvement in performance in the motor persistence tests.

Failure of Birth Data to Predict Early School Difficulties Among Inner-city First Graders

OBJECTIVES.: To determine a set of perinatal characteristics that predict school difficulties in inner-city children by comparing first graders requiring remediation with first graders progressing normally. METHODS.: In a case-control study, maternal surveys about perinatal characteristics were completed for 74 of 90 remedial pre-first and 62 of 90 randomly selected first graders in the Rochester, NY, City School District. RESULTS.: Pre-first graders, as compared with first graders, were more likely to have had birth weights <2,500 g (27% versus 6%). During pregnancy, their mothers were more likely to have been unemployed (73% versus 50%), to have received WIC (68% versus 50%), to have been covered by Medicaid (58% versus 37%), and to have received late or no prenatal care (9% versus 2%). Of these factors, only low birth weight was independently associated with remedial kindergarten placement. CONCLUSION.: Potential risk factors, unfortunately, were fairly prevalent in both groups of inner-city children. While the remedial group was shown to be at greater risk, these findings have little utility in identifying subsets most likely to require remediation at school entry. Because resources aimed at preventing the long-term consequences of early school failure are limited, better means of identifying educational risk at an early age are urgently needed.