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Poor attention rather than hyperactivity/impulsivity predicts academic achievement in very preterm and full-term adolescents

Published online by Cambridge University Press:  21 May 2012

J. Jaekel ,
D. Wolke  and
P. Bartmann
J. Jaekel
Affiliation:
Institute of Neonatology, University Hospital Bonn, Bonn, Germany Department of Psychology and HSRI (Warwick Medical School), University of Warwick, Coventry, UK
D. Wolke*
Affiliation:
Department of Psychology and HSRI (Warwick Medical School), University of Warwick, Coventry, UK
P. Bartmann
Affiliation:
Institute of Neonatology, University Hospital Bonn, Bonn, Germany
*
*Address for correspondence: D. Wolke, Ph.D., Department of Psychology and HSRI (Warwick Medical School), University of Warwick, Coventry CV4 7AL, UK. (Email: D.Wolke@warwick.ac.uk).
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Abstract

Background

Very preterm (VP) children are at particular risk for attention deficit/hyperactivity disorder (ADHD) of the inattentive subtype. It is unknown whether the neurodevelopmental pathways to academic underachievement are the same as in the general population. This study investigated whether middle childhood attention or hyperactivity/impulsivity problems are better predictors of VP adolescents' academic achievement.

Method

In a geographically defined prospective whole-population sample of VP (<32 weeks gestation) and/or very low birth weight (<1500 g birth weight) (VLBW/VP; n = 281) and full-term control children (n = 286) in South Germany, ADHD subtypes were assessed at 6 years 3 months and 8 years 5 months using multiple data sources. Academic achievement was assessed at 13 years of age.

Results

Compared with full-term controls, VLBW/VP children were at higher risk for ADHD inattentive subtype [6 years 3 months: odds ratio (OR) 2.8, p < 0.001; 8 years 5 months: OR 1.7, p = 0.020] but not for ADHD hyperactive-impulsive subtype (6 years 3 months: OR 1.4, p = 0.396; 8 years 5 months: OR 0.9, p = 0.820). Childhood attention measures predicted academic achievement in VLBW/VP and also full-term adolescents, whereas hyperactive/impulsive behaviour did not.

Conclusions

Attention is an important prerequisite for learning and predicts long-term academic underachievement. As ADHD inattentive subtype and cognitive impairments are frequent in VLBW/VP children, their study may help to identify the neurofunctional pathways from early brain development and dysfunction to attention problems and academic underachievement.

Keywords

Academic achievementattention deficit/hyperactivity disorder of the inattentive subtypecognitive problemsvery preterm and/or very low birth weight children
Type
Original Articles
Information
Psychological Medicine , Volume 43 , Issue 1 , January 2013 , pp. 183 - 196
Copyright
Copyright © Cambridge University Press 2012

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