Premature Kids Don't Always Catch Up

Medically Reviewed by Annie Finnegan
From the WebMD Archives

Aug. 8, 2000 -- When a premature infant survives without obvious physical or mental disabilities, most parents breathe a sigh of relief, confident that the child will "catch up" to his or her peers by school age. But often, that is not the case. A new study shows that, even at age 10, these children have many more social, behavioral, and academic problems than children who were carried to term.

The study was designed to paint a complete picture of what a very premature child would be like at age 10, compared with a full-term child, in terms of school performance, socialization, and behavioral disorders such as ADHD. This information is increasingly important to parents and educators, as physicians are able to save much smaller and younger babies than ever before.

The researchers looked at 118 preterm children, born at 24 to 31 weeks, and compared them with 119 children who were full-term. (For the child to be considered full-term, mothers must deliver between 38 and 42 weeks.) What they found was a much bleaker picture than they had expected, Jeremie Rentas Barlow, MS, tells WebMD. Barlow conducted the study with others at the University of Syracuse (N.Y.), where she is a doctoral student in psychology; the study was presented at a recent meeting of the American Psychological Association.

The children were born from 1985 to 1986. Information on their progress was collected from parents, teachers, and psychologists when the children were 15 months old and again when they were two, four, seven, and 10 years old.

"We used to follow [premature children] until four and five and until early school age, and we thought that they had caught up. But now that we are following them longer into life, we are finding they are more impaired than we believed they were," she says.

Specifically, 61% of the children who were born prematurely scored lower on achievement tests or were designated as having special needs, compared with 23% of the children who were carried full-term. The number of premature children who were held back a grade in school was double that of the full-term children. In addition, ADHD was four to six times more common in the preterm group than in the general population, Barlow says.

This information was shared with the parents of the children in the study, which served to allay some of their fears, Barlow says.

"I think it was helpful to the parents to understand that it is not their fault, they didn't cause the problems, and that they commonly happen to preterm children," she says. "And also that it's not the end of the world. You can help children learn to read, and you can help increase academic performance, and the drilling and all of that kind of stuff really benefits children. But you have to understand the problem first. It's not that the child is not motivated" but he or she is still experiencing problems associated with early birth.

Many times, parents are surprised when these problems crop up, Barlow says.

"All of a sudden, the child is socially rejected. Or the teacher is calling up, saying [the child is] having certain problems in school. But they didn't have cerebral palsy when they were born; there was no [brain] hemorrhage, so [parents] assume the child is fine," Barlow says.

The researchers did not evaluate the effectiveness of any special services or treatments the children received, but Barlow says school-based supportive programs, along with parental involvement, are crucial.

"I think that with all children, whether they are impaired or not, and more so if they are impaired, it is important to provide educational enrichment," such as reading to them and involving them in activities outside the classroom, says Barlow.