Very Low Birth Weight Infants at 8 and 11 Years of Age: Role of Neonatal Illness and Family Status

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Abstract
The intellectual and educational status of 108 children with very low birth weight (≤1,500 g), born from 1965 to 1978, was evaluated and tested on standard tests (eight children with severe handicaps were excluded) at 8 years of age. Fifty-seven were further evaluated at 11 years of age. Six categorical outcomes were defined a priori, based on the Wechsler Intelligence Scale for Children-Revised IQ and discrepancies between Verbal and Performance scores and Bender Gestalt Test score. Proportions at 8 years of age were: 4.6% very low IQ (below 70), 13.9% low IQ (70 to 84), and, for those with IQ greater than 84, 12.0% language disability, 12.0% performance disability, 21.4% visual-motor disability, and 36.1% normal. Learning disabilities, determined by discrepancies between IQ and Wide Range Achievement Test scores, included 16.7% of all children. Outcome proportions at 11 years of age were essentially comparable to those at 8 years of age; outcome constancy was present in 52.6%. Ratings of neonatal illness and parent education level strongly influenced the likelihood of outcome at 8 years of age. When ratings were dichotomized (ie, low v high neonatal illness and low v high parent education), the level of neonatal illness primarily influenced the likelihood of normal outcome, whereas the level of parent education influenced the degree of severity of the disability.