Academic attainment and special educational needs in extremely preterm children at 11 years of age: the EPICure Study

Samantha Johnson ^1*, Enid M Hennessy ², Rebecca Smith Ms³, Rebecca Trikic ³, Dieter Wolke ⁴ and Neil Marlow ¹

¹ Institute for Women's Health, UCL, United Kingdom
² Barts and The London, Queen Mary's School of Medicine and Dentistry, United Kingdom
³ University of Nottingham, United Kingdom
⁴ University of Bristol, United Kingdom

^* To whom correspondence should be addressed. E-mail: sam.johnson{at}nottingham.ac.uk.

Accepted 14 January 2009

Abstract

Aim: To assess academic attainment and special educational needs (SEN) in extremely preterm (EP) children in middle childhood.

Methods: Of 307 EP (=25 weeks) survivors born in the UK and Ireland in 1995, 219 (71%) were re-assessed at 11 years, with a comparison group of 153 classmates born at term, using standardised tests of cognitive ability and academic attainment and teacher reports of school performance and special educational needs (SEN). Multiple imputation was used to correct for selective dropout.

Results: EP children had significantly lower scores than classmates for cognitive ability (-20 points; 95%CI: -23,-17), reading (-18 points; -22,-15) and mathematics (-27 points; -31,-23). Twenty-nine (13%) EP children attended special school. In mainstream schools, 105 (57%) EP children had SEN (OR: 10; 6, 18) and 103 (55%) required SEN resource provision (OR: 10; 5, 18). Teachers rated 50% of EP children with attainment below the average range compared with 5% of classmates (OR: 18; CI: 8, 41). EP children who are entered for mainstream education an academic year early due to preterm birth had similar academic attainment but required more SEN support (OR: 2; 1.1,3.8).

Conclusions: EP survivors remain at high risk for learning impairments and poor academic attainment in middle childhood. A significant proportion require full-time specialist education and over half of those attending mainstream schools require additional health or educational resources in order to access the national curriculum. The prevalence and impact of SEN is likely to increase as these children approach the transition to secondary school.