High Rates of School Readiness Difficulties at 5 Years of Age in Very Preterm Infants Compared with Term Controls

Objective: School readiness is best understood as a framework for assessing profiles of strengths and vulnerabilities of the preschool- age child. Very preterm (VPT) children are at high risk of difficulties in school, and understanding their school readiness skills has the potential to aid successful transition into school. The aim of this study was to determine the school readiness skills of a cohort of VPT children, compared with term controls. Methods: VPT children (gestational age < 30 wk or birth weights < 1250 g) and term controls were enrolled from a tertiary maternity hospital, Melbourne, Australia into a prospective cohort study. At age 5 years, school readiness skills were evaluated using a combination of parent questionnaires and direct assessments. The 5 domains of school readiness assessed were health and physical development, social-emotional skills, approaches to learning, communication skills, and cognitive skills. Results: VPT children had standard scores similar to 1/2 to 1 SD below those of the term controls in all domains of school readiness, and these differences were not greatly affected by adjustment for social risk differences. Overall, 44% of the VPT group had vulnerabilities in more than 1 domain of school readiness, compared with only 16% of the term controls. Conclusions: VPT children are more likely than term controls to have significant vulnerabilities in multiple domains of school readiness, and these differences are mostly independent of social risk.