Preterm children's academic difficulties in the early years on mainstream schooling

Abstract

Introduction: Preterm infants born before 37 weeks of gestation constitute up to 10% of all births, and can display development that, frequently, differs from those of full- term infants. Studies indicate that school children born preterm present with a, generally, higher incidence of performing poorly academically. Purpose: This PhD study investigated the perceptions of paediatric OTs regarding the type of difficulties with which children born preterm present, and explored the emerging role of occupational therapy in this area. Method: In the first, quantitative part of this study, paediatric OTs completed a postal questionnaire (N=353). The second, qualitative part, used asynchronous, online discussions (N=13), by utilising the virtual learning environment of WebCT, to further explore the topic. Research questions: The survey was also designed to capture: - information on the extent of this paediatric population within OT services, and how identifiable and accessible it is - OT practices when working with these children including detecting early risk-, amelioration on identified sensorimotor difficulties and prevention of future problems interfering with the main stream school curriculum - what informs therapists' clinical decision making.

The discussion groups provided a forum for OTs' reflexive comment- on the issues emerging from the questionnaire analysis.

Findings: Despite sensorimotor and attentional difficulties reaching the highest frequencies, the findings revealed rather a combination of problems in most developmental domains. Writing emerged as the predominant problematic area within the school curriculum. A persistence- of sensorimotor difficulties throughout the preschool years also emerged. More frequent and/or severity difficulties, more medical issues, a higher co morbidity of specific learning difficulties with other conditions for the preterm group, were other findings.

Discussion: These insights could lead to a further exploration of the need for differentiating assessment and treatment practices for this group, and will be discussed in this presentation. Occupational therapy was highlighted as particularly advantageous- for this population due to a number of specific contributions e.g. ability to detect subtle- difficulties at a young age. The findings of the study constitute tacit, professional knowledge, and they are based on clinicians' views. This presentation will briefly discussed how this PhD study has informed current research at present, which investigates the effect of preterm birth on the school outcome of this specific paediatric group, with the use of longitudinal data.

KEYWORDS: Prematurity; Specific Learning Difficulties; Early Intervention; Paediatric Occupational Therapy; School; Clinical Decision Making; Assessment; Intervention; Survey; WebCT; Asynchronous Online Discussions