Predictors of academic difficulties in preterm children compared with term-born children at the age of 5 years

Aims: Aim of the study was to examine performance in cognitive and academic skills in preterm children (gestational age < 32 weeks) compared with a control group of term-born children at the age of 5 years.

Methods: 140 preterm children (gestational age < 32 weeks; no severe neurological handicaps) were compared with 50 term-born children at the age of 5 years. The WWPSI-III was used to assess intellectual skills. Moreover, working memory functions were examined using the digit span and the Corsi block-tapping test. Phonemic awareness as precursor to reading was measured with the BISC and basic math skills as precursors to mathematics were tested with the TEDI-MATH.

Results: Compared with the control group, preterm children exhibited a significantly lower intellectual profile. Within the intellectual profile the processing speed as well as (verbal and nonverbal) working memory functions proved to be the main problem. Moreover preterm children scored significantly worse than term-born children at tests assessing preschool skills such as phonemic awareness and basic math skills.

Conclusion: Preterm children are at higher risk for poorer academic achievement. Our results show a significantly lower cognitive profile (main problem areas: processing speed, working memory) and significantly lower scores on preschool skills. These deficits are known to be most relevant for later learning disabilities. Therefore we recommend that a standardized detailed psychological examination for preterm children at 5 years of age is performed early to detect children at risk and to prevent later learning difficulties.