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The incidence of prematurity or low birth weight for gestational age among children with dyslexia
Abstract
Dyslexia is characterized as a specific deficit of reading acquisition. It is one of the most common learning disabilities, persists throughout life, and can have a major impact on someone's socioeconomic success in our knowledge society. Preterm birth is associated with an increased risk of developmental problems including reading disabilities later in life (1-3). Poor reading skills are reported in preterm borns after controlling for IQ, and in particular they are characterised by slow reading (2,3). © 2012 The Author(s)/Acta Paediatrica © 2012 Foundation Acta Paediatrica.
... If something characterizes reading in children born preterm, it is SLOWNESS, which seems to be a characteristic of the processing of verbal information in children born preterm (17,18). And where executive functioning (10,(19)(20)(21)(22)(23)(24) has greater weight than cognitive ability understood as FSIQ (25). ...
... Eficacia Lectora: Si algo caracteriza la lectura en niños nacidos pretérmino es la LENTITUD que parece ser una característica propia del procesamiento de la información verbal en niños nacidos pretérmino (17,18). Y donde el funcionamiento ejecutivo (10,(19)(20)(21)(22)(23)(24) tiene mayor peso que la capacidad cognitiva entendida como CI (25). ...
INTRODUCTION: In the present work it is wanted to know if the learning of reading, in school children born preterm, can be affected by the level of perinatal risk.
PATIENTS AND METHODS: From the initial sample, at one month of life (N=48), for the present study there were 29 children born preterm (17 boys and 12 girls). All children were assessed, retrospectively (at one month of corrected age), with the Perinatal Risk Index (PERI). The definitive sample (N=26) was evaluated with the Magallanes Scale Test for Reading and Writing (EMLE), when they reached the age of 9-11 years. To analyze the association between the variables, contingency tables were made and the X2 statistic was calculated.
RESULTS: First, in the decoding subtest, the analysis shows that the errors made or the level reached by children born preterm do not depend on the level of perinatal risk, although from the clinical point of view, there is clinical relevance. Secondly, in the levels of achievement for the reading speed shown by the children, statistical significance was reached. Finally, the level of perinatal risk does not seem to be associated with the level of reading comprehension.
CONCLUSION: These results are discussed in the light of existing studies on the subject, where, despite the great heterogeneity found in the population of children born preterm in school age, difficulties in executive functioning and the influence of some perinatal risk factors such as medical or respiratory problems or congenital infections are evident.
... The largest differences between the VLBW and control children were found in word recognition, a measure of orthographic decoding, and reading comprehension, supporting our earlier findings that reading deficits in VLBW children were not those typically resulting from developmental phonological dyslexia (12). The results were supported by a Dutch report of a population of VLBW children with dyslexia (23). The prevalence of preterm born children in their study was not higher than in a general population. ...
This Swedish study compared reading skills between seven-year-old children with a very low birth weight (VLBW) and controls with a normal birth weight, exploring associations between reading variables and cognition, parent-rated behaviour, perinatal factors and family factors.
We studied 51 VLBW children, with no major neurodevelopmental impairments and attending their first year at a regular school, and compared them with the 51 sex and age-matched controls. The test battery, carried out at 7.8 ± 0.4 years of age, included reading skills, the Wechsler Intelligence Scale for Children - III and the Child Behaviour Checklist.
VLBW children with a mean birth weight of 1,105g (± 291g) and a gestational age of 28.8 (± 2.2) weeks scored significantly lower in all reading subtests and cognition and demonstrated more behavioural problems than normal birth weight controls. We also found significant associations between poor vocabulary, combined with attention problems, and phonological awareness, rapid naming and spelling control. Perinatal factors had no association with reading function and socioeconomic factors had very few.
VLBW children demonstrated deficits in all reading domains and had poorer cognition and more behavioural problems at the age of seven, with reading ability related to vocabulary and attention. This article is protected by copyright. All rights reserved.
This article is protected by copyright. All rights reserved.
Historicamente, a escola caracterizou-se por ser excludente, privilegiando
determinados grupos em detrimento de outros. De acordo com a Lei Federal
nº 12.796, de 4 de abril de 2013, os alunos com altas habilidades/superdotação
fazem parte do público-alvo da Educação Especial (PAEE), necessitando, então,
de uma reorganização no ensino para que sua inclusão ocorra de forma plena.
Pensando nisso, este artigo objetiva discutir quem é esse público-alvo, suas
características e identificação, bem como algumas estratégias de ensino indicadas
para o atendimento educacional desse alunado. A metodologia utilizada foi a
pesquisa bibliográfica, do tipo revisão de literatura. A discussão de tal temática
é de extrema importância, pois há formas de identificação, encaminhamento
e organização de atendimento educacional adequado para esse tipo de aluno.
Porém, pode-se verificar na prática uma ausência de informação entre os
professores e a própria instituição escolar no que diz respeito ao reconhecimento
desses alunos e as melhores formas de ensiná-los. Dessa forma, é importante que
esses profissionais tenham uma boa formação e atuem de forma crítica, buscando
dar a seus alunos uma educação de qualidade, que contemple as necessidades,
facilidades e dificuldades de todos, possibilitando o pleno desenvolvimento de
suas habilidades.
Palavras-chave: Educação Especial. Altas Habilidades/Superdotação (AH/SD).
Atendimento Educacional.
Prematurity is a major health problem and it is an important life-threatening pathology for the children in their perinatal, new-born and infantile period. We have evaluated the epidemiologic factors for prematurity in Obstetrics Clinic of Sibiu city. We have analysed the epidemiology of 649 preterm babies between 2012 and 2019 in a III grade Maternity Clinic concerning general maternal information, pregnancy pathology and delivery. We have found significant differences between single and multiple pregnancies and between natural conceived pregnancies and assisted reproductive techniques conceived pregnancies concerning the maternal age, number of cortisone doses, modality of delivery and significant differences between normal conceived and assisted reproductive technique conceived new born related to maternal age and pregnancy and labor fetal presentations dystocia. As a conclusion, prematurity is induced by high blood pressure, pregnancy bleeding and infectious complications. Prophylactic cortisone is improving fetal outcome and is a routine practice in our clinic.
To explore associations between specific learning disorder with impairment in reading (dyslexia) and ophthalmic abnormalities in children aged 7 to 9 years.
Cross-sectional analysis was performed on cohort study data from the Avon Longitudinal Study of Parents and Children. Reading impairment was defined according to Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition criteria. Children who achieved >2 SD below the mean in the Neale Analysis of Reading Ability Scale II and level <4 in nonmathematical national key stage 2 tests were defined as having severe reading impairment (SRI). Children with blindness or IQ <70 were excluded.
Data were available for 5822 children, of whom 172 (3%) met the criteria for SRI. No association was found between SRI and strabismus, motor fusion, sensory fusion at a distance, refractive error, amblyopia, convergence, accommodation, or contrast sensitivity. Abnormalities in sensory fusion at near were mildly higher in children with SRI compared with their peers (1 in 6 vs 1 in 10, P = .08), as were children with stereoacuity worse than 60 seconds/arc (1 in 6 vs 1 in 10, P = .001).
Four of every 5 children with SRI had normal ophthalmic function in each test used. A small minority of children displayed minor anomalies in stereoacuity or fusion of near targets. The slight excess of these children among those with SRI may be a result of their reading impairment or may be unrelated. We found no evidence that vision-based treatments would be useful to help children with SRI.
Copyright © 2015 by the American Academy of Pediatrics.
Disruptions to brain development associated with shortened gestation place individuals at risk for the development of behavioral and psychological dysfunction throughout the lifespan. The purpose of the present study was to determine if the benefit for brain development conferred by increased gestational length exists on a continuum across the gestational age spectrum among healthy children with a stable neonatal course. Neurodevelopment was evaluated with structural magnetic resonance imaging in 100 healthy right-handed 6- to 10-year-old children born between 28 and 41 gestational weeks with a stable neonatal course. Data indicate that a longer gestational period confers an advantage for neurodevelopment. Longer duration of gestation was associated with region-specific increases in gray matter density. Further, the benefit of longer gestation for brain development was present even when only children born full term were considered. These findings demonstrate that even modest decreases in the duration of gestation can exert profound and lasting effects on neurodevelopment for both term and preterm infants and may contribute to long-term risk for health and disease.
Learning to associate auditory information of speech sounds with visual information of letters is a first and critical step for becoming a skilled reader in alphabetic languages. Nevertheless, it remains largely unknown which brain areas subserve the learning and automation of such associations. Here, we employ functional magnetic resonance imaging to study letter-speech sound integration in children with and without developmental dyslexia. The results demonstrate that dyslexic children show reduced neural integration of letters and speech sounds in the planum temporale/Heschl sulcus and the superior temporal sulcus. While cortical responses to speech sounds in fluent readers were modulated by letter-speech sound congruency with strong suppression effects for incongruent letters, no such modulation was observed in the dyslexic readers. Whole-brain analyses of unisensory visual and auditory group differences additionally revealed reduced unisensory responses to letters in the fusiform gyrus in dyslexic children, as well as reduced activity for processing speech sounds in the anterior superior temporal gyrus, planum temporale/Heschl sulcus and superior temporal sulcus. Importantly, the neural integration of letters and speech sounds in the planum temporale/Heschl sulcus and the neural response to letters in the fusiform gyrus explained almost 40% of the variance in individual reading performance. These findings indicate that an interrelated network of visual, auditory and heteromodal brain areas contributes to the skilled use of letter-speech sound associations necessary for learning to read. By extending similar findings in adults, the data furthermore argue against the notion that reduced neural integration of letters and speech sounds in dyslexia reflect the consequence of a lifetime of reading struggle. Instead, they support the view that letter-speech sound integration is an emergent property of learning to read that develops inadequately in dyslexic readers, presumably as a result of a deviant interactive specialization of neural systems for processing auditory and visual linguistic inputs.
The aims of this study were to investigate whether specific linguistic difficulties in preterm children persist at eight years and to examine the interrelationships between language and literacy in this population, compared with a control group of full-term children. Sixty-eight monolingual Italian preterms and 26 chronologically matched controls were recruited. Language (grammar comprehension, lexical production and phonological awareness), literacy (reading comprehension, reading and writing) and general cognitive development were investigated. Results showed no general delay in preterms, but slight difficulties in specific linguistic abilities (grammar, lexicon, phoneme synthesis and deletion of the first syllable), more difficulties in literacy (speed in reading and accuracy in writing) and certain correlations among competencies turning out to be different from the control group. In conclusion, our study established that a partially atypical trajectory emerged in preterms, showing specific long-term effects of preterm birth on language and literacy development.
To determine the differential effects of preterm birth and being small for gestational age on the cognitive and motor ability of the child.
A longitudinal cohort of all infants of gestational age < or = 32 weeks born to mothers resident in the counties of Cheshire and Merseyside in 1980-1 was studied. The children were assessed at the age of 8 to 9 years using the Wechsler Intelligence Scale for Children, the Neale analysis of reading ability, and the Stott-Moyes-Henderson test of motor impairment. Adequacy of fetal growth was determined by the birthweight ratio--that is, the ratio of the observed birthweight to the expected birthweight for a given gestational age. Children with clinically diagnosed motor, learning or sensory disabilities were excluded. Information on social variables was obtained by a questionnaire completed by the parents. Of the 182 children, 158 were assessed.
IQ was positively correlated with birthweight ratio but not with birthweight or gestational age. Motor ability was associated with birthweight, gestational age, and birthweight ratio. Reading comprehension was associated with birthweight ratio, but reading rate and accuracy were best explained by social variables and sex. IQ remained associated with birthweight ratio, after adjusting for maternal education, housing status, and number of social service benefits received. Reading ability was related to these social variables but motor ability was not.
The effects of SGA and preterm birth differed: SGA was associated with cognitive ability, as measured by IQ and reading comprehension; motor ability was additionally associated with preterm birth. Reading rate and accuracy were not associated with SGA or preterm birth but were socially determined.
To provide current information on the academic achievement of small-for-gestational-age (SGA) children at age 10 years, to analyze predictors, and to evaluate the smallness of a newborn as a risk factor for school failure.
Prospective, population-based birth cohort study with 10-year follow-up.
The SGA group consisted of 106 children born in 1985 whose birth weight had been below the 2.5th percentile on the population-based fetal growth chart. The control group consisted of 105 appropriate-for-gestational-age (AGA) children born as closely as possible in time to SGA infants and matched for gestational age and mode of delivery. Both groups were evaluated at age 10 years.
Academic achievement.
Twenty-five percent of SGA children were school failures (vs 14% of AGA children; P =.05). There were significantly more SGA than AGA children with unfavorable backgrounds and deficient performances associated with poor academic achievement. Independent predictors of poor academic achievement in SGA and AGA children were inattention-passiveness as rated by their teachers (masked to grouping; corresponding to a 1-point increase in inattention-passiveness score: odds ratio, 5.1; 95% confidence interval, 2.1-12.1), a low verbal IQ score (psychologists masked; corresponding to a 10-point decrease in IQ score: odds ratio, 3.2; 95% confidence interval, 1.6-6.2), and restlessness at the follow-up visit (one examiner masked and the other not; odds ratio, 14.3; 95% confidence interval, 2.1-97.3).
Being SGA at birth has a clinically significant impact on the academic achievement of a 10-year-old child.
To examine the development of reading skills among very-low-birthweight (VLBW) children and to what extent reading difficulties at 9 years of age persist unchanged, are attenuated, or are enhanced at 15 years of age.
Fifty-six VLBW and 52 normal birthweight (NBW) children were assessed on word decoding, word recognition, and reading comprehension at 9 and 15 years of age.
VLBW children showed deficits in reading skill at 9 years of age, while most differences obtained at 15 years of age did not reach significance. VLBW children improved their reading comprehension between 9 and 15 years of age more than NBW children, and when controlling for individual differences in IQ, VLBW children improved both their reading comprehension and word-recognition skill.
The results suggest that VLBW children display positive changes over time in reading skills.
Children born at <32 weeks' gestation are at increased risk of intellectual impairment. Few studies have focused on the majority of preterm children born at 32 to 36 weeks' gestation. We aimed to investigate the association between the full range of gestational ages at birth and the risk of not completing basic school.
This longitudinal, register-based study included all live-born infants in Denmark from 1988 to 1989. Data were obtained from national registers. School achievements were evaluated by using the examination marks. The association between gestational age and not completing basic school was estimated, taking into account the effect of their parents' educational level, being small for gestational age, plurality, and cerebral palsy.
The cohort constituted 120,585 infants, of whom 118,281 (98.6%) were alive in 2007. Of these infants, 5.01% (n = 5.928) were born before 37 weeks' gestation. Of the subjects born before 37 weeks' gestation, 11.5% (95% confidence interval: 10.7-12.4) did not complete basic school compared with 7.5% (95% confidence interval: 7.3-7.6) of those born at term. The percentage of subjects who did not complete basic school increased with decreasing gestational age. The increase was steeper at <31 weeks (4.2% per week) than at 31 to 36 weeks' gestation (0.5% per week).
The risk of not completing basic school increased with decreasing gestational age. The risk was moderate at ≥31 weeks' gestation and increased steeply at <31 weeks' gestation. The increase at <31 weeks' gestation was only partly explained by cerebral palsy.
To construct new Dutch reference curves for birthweight by parity, sex and ethnic background.
Retrospective nationwide study.
Reference curves for birthweight were constructed using the LMS model and were based on 176,000 singleton births in the Netherlands in the year 2001 (approximately 95% of all births in that year).
Separate birthweight curves were constructed for male and female babies born from primiparous and multiparous women from 25 to 43 weeks gestational age. The reference curves are similar to the Swedish references. Birthweight at early gestation was lower than in the previous Dutch reference curves and higher from term onwards. Infants of Hindustani women had a significantly lower birthweight, so that a separate reference curve was constructed.
The new Dutch reference curves show a different pattern than the Dutch reference curves collected more than 50 years ago, reflecting changes in prenatal conditions and care.
We used diffusion tensor imaging to investigate the association between white-matter integrity and reading ability in a cohort of 28 children. Nineteen preterm children (14 males, five females; mean age 11 y 11 mo [SD 1 y 10 mo], mean gestational age 30.5 wks (SD 3.2), mean birthweight was 1455 g [SD 625]); and nine term children (five males, four females; mean age 12 y 8 mo [SD 2 y 5 mo], mean gestational age 39.6 wks (SD 1.2), and mean birthweight 3877 g [SD 473]).
We tested whether fractional anisotropy in a left hemisphere temporoparietal region and in the corpus callosum correlates with birthweight and scores on the following three subtests of the Woodcock-Johnson III Tests of Achievement: word identification, word attack, and passage comprehension.
Preterm children had lower reading scores than a comparison group for all reading subtests (p<0.05). We found significant correlations between birthweight and fractional anisotropy in the whole corpus callosum (p=0.001), and between fractional anisotropy and reading skill in the genu (p=0.001) and body (p=0.001) of the corpus callosum. The correlation between reading skill and fractional anisotropy in a left temporoparietal region previously associated with reading disability was not significant (p=0.095).
We conclude that perinatal white-matter injury of the central corpus callosum may have long-term developmental implications for reading performance.
To provide pediatric endocrinologists, general pediatricians, neonatologists, and primary care physicians with recommendations for the management of short children born small for gestational age (SGA).
A 13-member independent panel of pediatric endocrinologists was convened to discuss relevant issues with respect to definition, diagnosis, and clinical management of short children born SGA. Panel members convened over a series of 3 meetings to thoroughly review, discuss, and come to consensus on the identification and treatment of short children who are born SGA.
SGA is defined as birth weight and/or length at least 2 standard deviations (SDs) below the mean for gestational age (<or=-2 SD). Accurate gestational dating and measurement of birth weight and length are crucial for identifying children who are born SGA. Comprehensive pregnancy, perinatal, and immediate postnatal data may help to confirm the diagnosis. Maternal, placental, and fetal causes of SGA should be sought, although the cause is often not clear. Most children who are SGA experience catch-up growth and achieve a height >2 SD below the mean; this catch-up process is usually completed by the time they are 2 years of age. A child who is SGA and older than 3 years and has persistent short stature (ie, remaining at least 2 SD below the mean for chronologic age) is not likely to catch up and should be referred to a pediatrician who has expertise in endocrinology. Bone age is not a reliable predictor of height potential in children who are SGA. Nevertheless, a standard evaluation for short stature should be performed. A diagnosis of SGA does not exclude growth hormone (GH) deficiency, and GH assessment should be performed if there is clinical suspicion or biochemical evidence of GH deficiency. At baseline, insulin-like growth factor-I, insulin-like growth factor binding protein-3, fasting insulin, glucose, and lipid levels as well as blood pressure should be measured, and all aspects of SGA-not just stature-should be addressed with parents. The objectives of GH therapy in short children who are SGA are catch-up growth in early childhood, maintenance of normal growth in childhood, and achievement of normal adult height. GH therapy is effective and safe in short children who are born SGA and should be considered in those older than 2 to 3 years. There is long-term experience of improved growth using a dosage range from 0.24 to 0.48 mg/kg/wk. Higher GH doses (0.48 mg/kg/wk [0.2 IU/kg/d]) are more effective for the short term. Whether the higher GH dose is more efficacious than the lower dose in terms of adult height results is not yet known. Only adult height results of randomized dose-response studies will give a definite answer. Monitoring is necessary to ensure safety of medication. Children should be monitored for changes in glucose homeostasis, lipids, and blood pressure during therapy. The frequency and intensity of monitoring will vary depending on risk factors such as family history, obesity, and puberty.
Historically the major focus in neonatal neurology has been on brain injury in premature infants born less than 30 gestational weeks. This focus reflects the urgent need to improve the widely recognized poor neurological outcomes that occur in these infants. The most common underlying substrate of cerebral palsy in these premature infants is periventricular leukomalacia (PVL). Nevertheless, PVL also occurs in near-term (late preterm), as well as term, infants, as documented by neuroimaging and autopsy studies. In both very preterm and late preterm infants, gray matter injury is associated with PVL. In this review, we discuss the cellular pathology of PVL and the developmental parameters in oligodendrocytes and neurons that put the late preterm brain at risk in the broader context of brain development and injury close to term. Further research is needed about the clinical and pathologic aspects of brain injury in general and PVL in particular in late preterm infants to optimize management and prevent adverse neurological outcomes in these infants that, however subtle, may be currently underestimated.
To examine the impact and additive effect of phonology and rapid naming deficits on reading, spelling and mathematics achievement in a group of very preterm children at 8 years of age.
All surviving children with a gestational age less than 30 weeks, admitted to the neonatal intensive care unit at Royal Prince Alfred Hospital, in 1994 and 1995, were prospectively enrolled in developmental follow-up. Children with a neurosensory disability or a low intelligence score (FSIQ<or=85 points) were excluded. At 8 years of age standardised psychometric measures of cognition, linguistic ability and academic achievement were administered to a sample of 63 children.
Twenty-four (38.1%) children showed low achievement in reading, spelling or mathematics. Of these, 18 (75%) children showed low achievement in reading. Reading achievement was significantly correlated to phonological awareness, rapid naming and expressive vocabulary. Children with phonological awareness and rapid naming deficits showed significantly more delay in reading than children without such deficits. Children who had rapid naming deficits were more likely to show multiple skill delays. Rapid naming showed significant, though modest correlations with immaturity and illness variables. Maternal education was significantly associated with achievement.
Phonological awareness does predict reading performance in very preterm children. Rapid naming appears to be related to complex multiple academic delays, and may reflect a neurological timing or efficiency factor with effects independent of intelligence and significantly influenced by immaturity and illness.
Children born extremely premature (<28 weeks) or with a very low birth weight (<1500 g) have a poorer school performance than children born at term with a normal birth weight. Much less is known about children of higher gestational ages and birth weights. We studied gestational age after 32 completed weeks and birth weight in relation to the child's school performance at the age of 10 years.
We performed a follow-up study of 5319 children born between January 1990 and June 1992. We got the information on birth weight and gestational age from birth registration forms; when the children were between 9 and 11 years of age, we gathered information about their school performance (reading, spelling, and arithmetic) from questionnaires completed by the parents and the children's primary school teachers.
The association between birth weight and reading, as well as spelling and arithmetic disabilities, showed a graded relationship, with children who weighed <2500 g having the highest risks. Even children who weighed between 3000 and 3499 g had an increased risk of all 3 learning disabilities compared with children who weighed between 3500 and 4000 g. This association persisted after adjustment for potential cofounders and when the analyses were restricted to children born at term (39-40 weeks of gestation), suggesting that the association could not be explained by a low gestational age. Compared with children born at term, reading and spelling difficulties were more often found among children born at gestational age 33 to 36 weeks and 37 to 38 weeks, whereas there was no relation between gestational age and arithmetic difficulties.
Gestational age and birth weight were associated with school performance in the 10-year-old child and the association extended into the reference range of both birth weight and gestational age.
3DM: Differential diagnostics of dys-lexia
- A Vaessen
- Blomert
Vaessen A, Blomert L. 3DM: Differential diagnostics of dys-lexia. Amsterdam: Boom, 2009: 127p. Dutch.
3DM: Differential diagnostics of dyslexia
- A Vaessen
- L Blomert
Vaessen A, Blomert L. 3DM: Differential diagnostics of dyslexia. Amsterdam: Boom, 2009: 127p. Dutch.
Deviant processing of letters and speech sounds as proximate cause of reading failure: a functional magnetic resonance imaging study of dyslexic children
- V Blau
- J Reither
- N Van Atteveldt
- J Seitz
- P Gerretsen
- R Goebel
Blau V, Reither J, van Atteveldt N, Seitz J, Gerretsen P, Goebel
R, et al. Deviant processing of letters and speech sounds as
proximate cause of reading failure: a functional magnetic resonance imaging study of dyslexic children. Brain 2010; 133:
868-79.