Can learning disabilities in children who were extremely low birth weight be identified at school entry?

This prospective study was designed to test the hypothesis that a significant proportion of extremely low birth weight (ELBW) children identified as "at risk" for school problems at age 5 years by the Florida Kindergarten Screening Battery (FKSB) will present with specific learning disability (LD) when retested at age 8 years. A regional cohort of 81 of 84 ELBW survivors born between 1980 and 1982 were reassessed at age 8 years by Wechsler Intelligence Scale for Children-Revised (WISC-R), Wide Range Achievement Test-Revised (WRAT-R), and tests of motor function. The association of FKSB risk status and WRAT-R reading subtest for predicting general reading disability in the overall sample at age 8 years resulted in a sensitivity of 0.68, specificity of 0.48, and a likelihood ratio of 1.3. Of the 43 "normal" children at age 5 years with no neurosensory impairments and IQ > or = 84 (McCarthy GCI), 49% were considered to be at "mild" to "high" risk for future LD. The prevalence of specific LD (reading disorder) at age 8 years in children with normal IQ (WISC-R > or = 85) was 28%. The positive predictive value of the 5-year FKSB for identifying children with specific LD at age 8 years was 0.20 (sensitivity 0.33, specificity 0.48). We conclude the FKSB is not an efficient tool for predicting either general or specific LD in ELBW children.