Preterm birth and adult wealth: mathematics skills count

Each year, 15 million babies are born preterm worldwide. Preterm birth is associated with adverse neurodevelopmental outcomes across the lifespan. Recent registry-based studies suggest that preterm birth is associated with lower wealth in adulthood, but the mediating mechanisms are unknown. This study investigated whether the relationship between preterm birth and low adult wealth is mediated by poor academic abilities and educational qualifications. Participants were members of two British population-based birth cohorts born in 1958 and 1970. Results showed that preterm birth was associated with decreased wealth at 42 years of age. This association was mediated by poorer intelligence, reading and, in particular, mathematics attainment in middle childhood, and lower educational qualifications in young adulthood. Findings were similar in both cohorts, suggesting that these mechanisms may be time invariant. Special educational support in childhood may prevent preterm children from becoming less wealthy as adults

Explaining the relationship between number line estimation and mathematical achievement: the role of visuomotor integration and visuospatial skills

Performance on number line tasks, typically used as a measure of numerical representations, are reliably related to children's mathematical achievement. However, recent debate has questioned what precisely performance on the number line estimation task measures. Specifically, there has been a suggestion that this task may measure not only numerical representations but also proportional judgment skills; if this is the case, then individual differences in visuospatial skills, not just the precision of numerical representations, may explain the relationship between number line estimation and mathematical achievement. The current study investigated the relationships among visuospatial skills, visuomotor integration, number line estimation, and mathematical achievement. In total, 77 children were assessed using a number line estimation task, a standardized measure of mathematical achievement, and tests of visuospatial skills and visuomotor integration. The majority of measures were significantly correlated. In addition, the relationship between one metric from the number line estimation task (R2 LIN) and mathematical achievement was fully explained by visuomotor integration and visuospatial skill competency. These results have important implications for understanding what the number line task measures as well as the choice of number line metric for research purposes

Mathematics difficulties in children born very preterm: current research and future directions

Children born very preterm have poorer attainment in all school subjects, and a markedly greater reliance on special educational support than their term-born peers. In particular, difficulties with mathematics are especially common and account for the vast majority of learning difficulties in this population. In this paper, we review research relating to the causes of mathematics learning difficulties in typically developing children, and the impact of very preterm birth on attainment in mathematics. Research is needed to understand the specific nature and origins of mathematics difficulties in very preterm children to target the development of effective intervention strategies

Universal gestational age effects on cognitive and basic mathematic processing

Prematurity has adverse effects on basic mathematic processing following birth at all gestations <36 weeks and on IQ and mathematic attainment <34 weeks GA. The ability to predict IQ and mathematic processing scores from one cohort to another among children cared for in different eras and countries indicates that universal neurodevelopmental factors explain the effects of gestation at birth. In contrast, mathematic attainment may be improved by schooling

Understanding arithmetic concepts: the role of domain-specific and domain-general skills

A large body of research has identified cognitive skills associated with overall mathematics achievement, focusing primarily on identifying associates of procedural skills. Conceptual understanding, however, has received less attention, despite its importance for the development of mathematics proficiency. Consequently, we know little about the quantitative and domain-general skills associated with conceptual understanding. Here we investigated 8 – 10-year-old children’s conceptual understanding of arithmetic, as well as a wide range of basic quantitative skills, numerical representations and domain-general skills. We found that conceptual understanding was most strongly associated with performance on a number line task. This relationship was not explained by the use of particular strategies on the number line task, and may instead reflect children’s knowledge of the structure of the number system. Understanding the skills involved in conceptual learning is important to support efforts by educators to improve children’s conceptual understanding of mathematics

Learning disabilities among extremely preterm children without neurosensory impairment: Comorbidity, neuropsychological profiles and scholastic outcomes

Background: Children born extremely preterm are at high risk for intellectual impairment, learning disabilities, executive dysfunction and special educational needs, but little is understood about the comorbidity of intellectual and learning disorders in this population. Aims: This study explored comorbidity in intellectual disability (ID) and learning disabilities (LD) in children born extremely preterm (EP; <26+0 weeks’ gestation). Subjects and study design: A UK national cohort of 161 EP children and 153 term-born controls without neurosensory impairments was assessed at 11 years of age (the EPICure Study). Outcome measures: IQ, mathematics and reading attainment, executive function, visuospatial processing and sensorimotor skills were assessed using standardised tests, and curriculum-based attainment and special educational needs (SEN) using teacher reports. Results: Overall, 75 (47%) EP children and 7 (4.6%) controls had ID or LD (RR 10.12; 95% CI 4.81, 21.27). Comorbidity in ID/LD was more common among EP children than controls (24% vs. 0%). EP children with comorbid ID/LD had significantly poorer neuropsychological abilities and curriculum-based attainment than EP children with isolated or no disabilities. LD were associated with a 3 times increased risk for SEN. However, EP children with ID alone had poorer neuropsychological abilities and curriculum-based attainment than children with no disabilities, yet there was no increase in SEN provision among this group. Conclusions: EP children are at high risk for comorbid intellectual and learning disabilities. Education professionals should be aware of the complex nature of EP children’s difficulties and the need for multi-domain assessments to guide intervention

Early and long-term outcome of infants born extremely preterm

There is no question that birth at extremely low gestational ages presents a significant threat to an infant's survival, health and development. Growing evidence suggests that gestational age may be conceptualised as a continuum in which births before 28 weeks of gestation (extremely preterm: EP) represent the severe end of a spectrum of health and developmental adversity. Although comprising just 1%-2% of all births, EP deliveries pose the greatest challenge to neonatal medicine and to health, education and social services for the provision of ongoing support for survivors with additional needs. Studying the outcomes of these infants remains critical for evaluating and enhancing clinical care, planning long-term support and for advancing our understanding of the life-course consequences of immaturity at birth. Here we review literature relating to early and long-term neurodevelopmental, cognitive, behavioural and educational outcomes following EP birth focusing on key themes and considering implications for intervention

Teachers' knowledge and approaches to supporting preterm children in the classroom

Background & aimsTeachers in the UK receive little training about the long-term consequences of preterm birth on children's development. Our aim was to assess knowledge and elicit suggestions for improving educational practice in the US by means of a mixed-method study.Methods246 US teachers (92.7% female) completed the validated Preterm Birth – Knowledge Scale (PB-KS). Of the participating teachers, 50.9% reported professional experience with preterm born children. A representative subsample of 35 teachers responded to a case vignette by describing how they would support the child in the classroom. Answers were coded using thematic content analysis.ResultsOverall, the mean PB-KS score was 15.21 (SD = 5.31). Participating teachers who had professional experience with a preterm child had higher mean PB-KS scores than teachers without (16.95 vs. 15.24, p = .012). Qualitative responses provided specific content for classroom intervention.ConclusionsOur findings show that US teachers have limited knowledge of the long-term impact of preterm birth. They provided important indicators for the design of targeted classroom interventions to support the learning of preterm children.</div

Methods for constructing normalised reference scores: an application for assessing child development

The use of the lambda-mu-sigma (LMS) method for estimating centiles and producing reference ranges has received much interest in clinical practice, especially for assessing growth in childhood. However, this method may not be directly applicable where measures are based on a score calculated from question response categories that is bounded within finite intervals, for example, in psychometrics. In such cases, the main assumption of normality of the conditional distribution of the transformed response measurement is violated due to the presence of ceiling (and floor) effects, leading to biased fitted centiles when derived using the common LMS method. This paper describes the methodology for constructing reference intervals when the response variable is bounded and explores different distribution families for the centile estimation, using a score derived from a parent-completed assessment of cognitive and language development in 24 month-old children. Results indicated that the z-scores, and thus the extracted centiles, improved when kurtosis was also modeled and that the ceiling effect was addressed with the use of the inflated binomial distribution. Therefore, the selection of the appropriate distribution when constructing centile curves is crucial. </p

Methods for constructing normalised reference scores: an application for assessing child development

The use of the lambda-mu-sigma (LMS) method for estimating centiles and producing reference ranges has received much interest in clinical practice, especially for assessing growth in childhood. However, this method may not be directly applicable where measures are based on a score calculated from question response categories that is bounded within finite intervals, for example, in psychometrics. In such cases, the main assumption of normality of the conditional distribution of the transformed response measurement is violated due to the presence of ceiling (and floor) effects, leading to biased fitted centiles when derived using the common LMS method. This paper describes the methodology for constructing reference intervals when the response variable is bounded and explores different distribution families for the centile estimation, using a score derived from a parent-completed assessment of cognitive and language development in 24 month-old children. Results indicated that the z-scores, and thus the extracted centiles, improved when kurtosis was also modeled and that the ceiling effect was addressed with the use of the inflated binomial distribution. Therefore, the selection of the appropriate distribution when constructing centile curves is crucial. </p