Attention in 3-Year-Old Children with VLBW and Relationships with Early School Outcomes

ABSTRACT

Aim: To compare attention skills of children with a very low birth weight (VLBW) with children with a normal birth weight (NBW) when entering primary school, and explore the association of attention skills with school career 2 years later. Methods: Participants were 151 children with VLBW and 41 with NBW. Attention was assessed at 3 years and 8 months of corrected age (CA) and school career at 5½ years of CA. Children performed two tests, parents completed three questionnaires, and an assessor systematically observed children's attention. Results: Children with VLBW had significantly lower mean scores on five of the six measures. Significantly more children with VLBW had scores in the clinical range on the Child Behavior Checklist completed by the parents (13% versus 0%) and scores representing dysfunction on assessor observations (19% versus 2%). At 5½ years of age, 36% of the children with VLBW followed special education or had grade retention. Dysfunctional attention as observed by the assessor was most strongly associated with need for learning support at 5½ years of age. Conclusions: At preschool age, children with VLBW have attention difficulties. Attentive behavior at preschool age is a predictor of school career 2 years later.

KEYWORDS:

• Attention
• behavior
• children born preterm
• educational provision
• preterm infant
• very low birth weight

ACKNOWLEDGMENTS

We thank all of the participating parents and children, Richard van Seenus Nederland BV for supplying the ALVEMA MAXIT chair, the Amsterdam's Public Health Service for help with collecting the matched term group, and M. J. Wolf for her assistance in the design of this study and support during data collection.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the article.

FUNDING

This study was funded by the Netherlands Organisation for Health Research and Development (ZonMw project 622300032) and Innovatiefonds Zorgverzekeraars (project 576).

ABOUT THE AUTHORS

Gijs Verkerk, PhD, Martine Jeukens-Visser, PhD, Karen Koldewijn, PhD, and Frans Nollet, MD, PhD, are affiliated with the Department of Rehabilitation, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands. Bregje Houtzager, PhD, is affiliated with Emma Children's Hospital, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands. Aleid van Wassenaer-Leemhuis, MD, PhD, and Joke Kok, MD, PhD, are affiliated with Department of Neonatology, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands.