Perinatal morbidity, mild motor delay, and later school outcomes.

Four dimensions of motor competence were evaluated in 4-year-old term and preterm children and were related to academic achievement and use of school services at age 8 years. The objective of the study was to evaluate a graduated 'stair-step' effect between perinatal morbidity, mild motor delay, and later school outcomes in 168 children (88 females, 80 males) stratified into four study groups: 134 healthy term infants > or = 37 weeks' gestation, birthweight > or = 2500g); 134 preterm infants < or = 37 weeks' gestation divided into healthy preterm (n=41), clinically ill preterms (n=59), and preterm infants with neurological illness (n=34). Significant differences were found in total, fine and gross motor performance, and visual-motor integration at age 4 years. Scores for the preterm groups decreased with increasing morbidity. At age 4 years, mild motor delay was found in all preterm groups. Children with mild motor delay had lower academic achievement scores (Wide Range Achievement Test-3) and higher rates of school service use at age 8 years. Perinatal morbidity and compromised motor performance are important precursors of educational underachievement.