Taylor Rebecca, Pascoe Leona, Scratch Shannon, Doyle Lex W, Anderson Peter, Roberts Gehan
Centre for Community Child Health, Royal Children's Hospital, Melbourne, Australia.
Department of Paediatrics, University of Melbourne, Melbourne, Australia.
J Paediatr Child Health. 2016 Jul;52(7):759-64. doi: 10.1111/jpc.13186. Epub 2016 May 18.
We aimed to compare the academic outcomes of a cohort of children born very preterm (VPT, <32 weeks of gestation) and children born at term at age 7 years and assess the ability of a pre-academic skill screen at age five to predict later academic impairment in children born VPT at age seven.
One hundred ninety-four children born VPT (born with either gestational age <30 weeks or birthweight <1250 g) and 70 controls born at term from a prospective birth cohort were compared on academic outcomes (Wide Range Achievement Test, WRAT4) at age seven using regression analyses. Receiver-operating characteristic curves were used to determine whether pre-academic skills (Kaufman Survey of Early Academic and Language Skills, K-SEALS) at age five predicted academic impairment at age seven in 174 of the VPT cohort.
At the age of 7 years, children born VPT had lower mean word reading (-9.7, 95% CI: -14.7 to -4.6), spelling (-8.3, 95% CI: -13.3 to -3.3) and math computation (-10.9, 95% CI: -15.3 to -6.5) scores (all P-values ≤0.001) compared with controls born at term, even after adjusting for social risk and time since school commencement. In terms of pre-academic screening, the Numbers, Letters and Words subtest of the K-SEALS had adequate sensitivity and specificity (70-80%) for predicting children with academic impairment at age seven.
Children born VPT underperformed in academic outcomes at age seven compared with controls born at term. A pre-academic screening tool used at school entry can predict children born VPT at risk of academic impairment at age seven who could benefit from targeted early intervention.
我们旨在比较一组极早产（VPT，妊娠<32周）儿童和足月儿7岁时的学业成绩，并评估5岁时的学前技能筛查对预测VPT儿童7岁时后期学业障碍的能力。
使用回归分析，比较了194名VPT出生的儿童（胎龄<30周或出生体重<1250g）和来自前瞻性出生队列的70名足月儿对照在7岁时的学业成绩（广泛成就测验，WRAT4）。使用受试者工作特征曲线来确定5岁时的学前技能（考夫曼早期学业和语言技能调查，K-SEALS）是否能预测VPT队列中174名儿童7岁时的学业障碍。
7岁时，即使在调整了社会风险和入学后的时间后，VPT出生的儿童在单词阅读（-9.7，95%CI：-14.7至-4.6）、拼写（-8.3，95%CI：-13.3至-3.3）和数学计算（-10.9，95%CI：-15.3至-6.5）方面的平均得分均低于足月儿对照（所有P值≤0.001）。在学前筛查方面，K-SEALS的数字、字母和单词子测验在预测7岁时有学业障碍的儿童方面具有足够的敏感性和特异性（70-80%）。
与足月儿对照相比，VPT出生的儿童在7岁时的学业成绩较差。入学时使用的学前筛查工具可以预测VPT出生的儿童在7岁时有学业障碍的风险，这些儿童可能从有针对性的早期干预中受益。
