TY - JOUR T1 - LEarning problems in kindergarten students with extremely preterm birth AU - Taylor H, Klein N, Anselmo MG, Minich N, Espy KA, Hack M Y1 - 2011/09/01 N1 - 10.1001/archpediatrics.2011.137 JO - Archives of Pediatrics & Adolescent Medicine SP - 819 EP - 825 VL - 165 IS - 9 N2 - Objectives  To assess learning problems among kindergarten students with extremely preterm birth and to identify risk factors.Design  Cohort study.Setting  Children's hospital.Participants  A cohort of 148 children born between January 1, 2001, and December 31, 2003, with extremely preterm birth, defined as less than 28 weeks' gestation or having a birth weight of less than 1000 g, and 111 classmate control individuals born at term with normal birth weight.Interventions  The children were enrolled in the study during their first year in kindergarten and were assessed on measures of learning progress.Main Outcome Measures  Achievement testing, teacher ratings of learning progress, and individual educational assistance.Results  Children with extremely preterm birth had lower mean standard scores than controls on achievement tests of spelling (8.52; 95% confidence interval, 4.58-12.46) and applied mathematics (11.02; 6.76-15.28). They had higher rates of substandard learning progress by teacher report in written language (odds ratio, 4.23; 95% CI, 2.32-7.73) and mathematics (7.08; 2.79-17.95). Group differences in mathematics achievement and in teacher ratings of learning progress were statistically significant even in children without neurosensory deficits or low global cognitive ability. Neonatal risk factors, early childhood neurodevelopmental impairment, and socioeconomic status predicted learning problems in children with extremely preterm birth; however, many children with problems were not enrolled in a special education program.Conclusions  Learning problems in children with extremely preterm birth are evident in kindergarten and are associated with neonatal and early childhood risk factors. Our findings support efforts to provide more extensive monitoring and interventions before and during the first year of school. SN - 1072-4710 M3 - doi: 10.1001/archpediatrics.2011.137 UR - http://dx.doi.org/10.1001/archpediatrics.2011.137 ER -