The relationship between multiple developmental difficulties in very low birth weight children at 3½ years of age and the need for learning support at 5 years of age.
VLBW toddlers who show motor plus one other delay need school learning support three times more often—screen them early.
01Research in Context
What this study did
Doctors followed very low birth weight (VLBW) toddlers until school entry. At 3½ years they counted how many developmental areas were delayed. Two years later they checked who needed learning support in mainstream classes.
The team looked for motor delays plus at least one other lag: language, cognition, or vision.
What they found
Kids with two or more problem areas were over three times more likely to need extra help at school. Motor delay alone was not enough; the risk jumped only when a second domain was also behind.
How this fits with other research
Oldfield et al. (2015) saw the same "multiple-hit" pattern in older special-ed students. Once a child collected four or more risks, behavior problems spiked. Both studies say the same thing: count the hits, not just one score.
Greenlee et al. (2024) found higher mom education lowers delay odds in toddlers. Gijs shows that even after social factors, VLBW plus multiple delays still spells trouble. Use both pieces: ask about parent schooling and still screen the child.
Foti et al. (2015) meta-analysis shows reading disabilities bring wide memory and executive gaps. Gijs points to who will land in that group years earlier. Together they form a road map: flag early, then probe phonological and executive skills before formal reading starts.
Why it matters
You can spot the high-risk VLBW preschooler in under 30 minutes. Run a quick motor game and one other screen—language or cognition. If both look shaky, start referral paperwork and parent training now. Don’t wait for kindergarten failure.
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02At a glance
03Original abstract
This study investigated whether multiple developmental difficulties are more frequent in very low birth weight (VLBW) children than in those born full term. The association between multiple developmental difficulties assessed at 3½ years of age and educational provision for the child at 5½ years was also investigated, with 'educational provision' referring to the curriculum, school placement and the level of learning support. There were 143 VLBW children without cerebral palsy (CP) and 41 term-born peers assessed at 3½ years of age. The assessment included 6 measures of development: word comprehension, visual motor integration, visual perception, motor coordination, executive functioning and behaviour. Educational provision was determined at age 5½ years. A mildly abnormal score (score <1 standard deviation) was considered to indicate developmental difficulty. Scores from the six measures of development were analysed to determine the difficulty frequency and the presence of multiple difficulties (>1 difficulty score) in each child. This study showed that at 3½ years of age, the VLBW children had significantly more difficulty with motor coordination than their term-born peers. In addition, 27% of the VLBW children had multiple difficulties compared to 10% in the term-born group. Multiple logistic regression analyses showed that of the difficulties, impaired motor coordination was most strongly associated with the requirement for learning support two years later. Regression analyses showed that having multiple difficulties was significantly associated with the need for learning support (Odds Ratio of 3.4 (95% CI: 1.5-7.8). These results show that the presence of multiple difficulties in a VLBW child of preschool age, can impact the child's educational provision two years later.
Research in developmental disabilities, 2014 · doi:10.1016/j.ridd.2013.10.007