Are prematurely born children at higher risk of lower academic performance?

Published in the open access journal JAMA Network Open, this systematic review and meta-analysis considers the associations between premature birth and academic achievement in reading and maths.

Melinda McBryde and colleagues looked at 33 unique studies comparing the academic outcomes of school-age children who were born prematurely (n=4,006) with children born full-term (n=3,317). The meta-analysis compared mean scores from standardised tests of reading and maths (and associated subskills).

The results showed that children who were born prematurely scored lower on reading comprehension and applied mathematical problems than their full-term peers. Premature children also scored lower than their term-born peers in maths calculation, decoding, mathematical knowledge, word identification and mathematical fluency.

Extremely premature children (those born at less than 28 weeks’ gestation) had significantly lower reading performance compared with children born full-term. However, children born at 28 to 32 weeks’ gestation did not exhibit later reading deficits compared with full-term peers.

Looking at the ages when assessments were carried out, in reading, prematurely born children ages 5 to 8 performed significantly worse than full-term peers, as did those ages 9 to 11. Reading deficits were significant but less pronounced when children were assessed at 12 to 18. In contrast, the magnitude of deficits in maths in prematurely born children was similar across age groups.

Source: Academic outcomes of school-aged children born preterm: A systematic review and meta-analysis (April 2020), JAMA Network Open. 2020;3(4)

2 thoughts on “Are prematurely born children at higher risk of lower academic performance?”

  1. These are important findings that must lead to early adequate school provision for these children, who in the UK, account for 8% of school population. Simply, to accept the fact of their underachievement, especially during primary school years, is not acceptable for such a large percentage of children. Early underachievement through the lack of suitable provision results later in poor outcomes as children turn off learning and put up their own barriers to learning, or develop avoidance tactics for what doesn’t come naturally to them (often through the lack of meta-cognitive skills and adequate school provision for their particular needs) Poor educational experience and comparisons with others, rather than own starting points, or low teacher expectations, are not conducive to self-motivation and enjoyment of learning – both essential for progress and better outcomes. As these children are not recognised as a particular cohort who needs special provision and teachers have no knowledge of their potential difficulties, they can suffer from curriculum exclusion, which further reinforces their underachievement and alienation. It needs to be recognised that prematurity is not a diagnosis, but just a risk factor for potential difficulties in certain areas of learning. When these difficulties are addressed early on, they lead to improved outcomes by these children. PRISM resources, evidence/informed and available free, identify the main areas of potential learning difficulties and provide a range of strategies to use with children born preterm. I provide training for schools and education professionals.

  2. These are important findings that must lead to early adequate school provision for these children, who in the UK, account for 8% of school population. Simply, to accept the fact of their underachievement, especially during primary school years, is not acceptable for such a large percentage of children. Early underachievement through the lack of suitable provision results later in poor outcomes as children turn off learning and put up their own barriers to learning, or develop avoidance tactics for what doesn’t come naturally to them (often through the lack of meta-cognitive skills and adequate school provision for their particular needs). Poor educational experience and comparisons with others, rather than own starting points, or low teacher expectations, are not conducive to self-motivation and enjoyment of learning – both essential for progress and better outcomes. As these children are not recognised as a particular cohort who needs special provision and teachers have no knowledge of their potential difficulties, they can suffer from curriculum exclusion, which further reinforces their underachievement and alienation. It needs to be recognised that prematurity is not a diagnosis, but just a risk factor for potential difficulties in certain areas of learning. When these difficulties are addressed early on, they lead to improved outcomes by these children. PRISM resources, evidence-informed and available free, identify the main areas of potential learning difficulties and provide a range of strategies to use with children born preterm. I provide training for schools and education professionals.

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