{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T00:14:59Z","timestamp":1791159299777,"version":"4.1.0"},"reference-count":36,"publisher":"American Academy of Pediatrics (AAP)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2003,11,1]]},"abstract":"<jats:p>Objective. To examine the effects of bronchopulmonary dysplasia (BPD) and very low birth weight (VLBW) on the cognitive and academic achievement of a large sample of 8-year-old children.<\/jats:p><jats:p>Methods. Infants who were VLBW and had BPD (n = 98) or did not have BPD (n = 75) and term infants (n = 99) were followed prospectively to age 8. Groups were compared on measures assessing 4 broad areas of functioning: intelligence, achievement, gross motor, and attentional skills. Measures included the Wechsler Intelligence Scale for Children III, the Woodcock Johnson Test of Achievement-Revised, the Bruininks-Oseretsky Test of Motor Proficiency, the Tactual Performance Test (spatial memory), and the Continuous Performance Test (attention). School outcomes were assessed by parent and teacher report, as well as from school records. Groups were comparable on socioeconomic status, sex, and race. The total sample of BPD, VLBW, and term children was compared on all outcome measures. In addition, neurologic risk was assessed in the present sample and included the following: intraventricular hemorrhage, echodense lesions, porencephaly, hydrocephalus, ventriculoperitoneal shunt, meningitis, and periventricular leukomalacia. Individual difference analyses were conducted for neurologically intact children in all 3 groups. Finally, treatment effects were examined by comparing BPD children who had received steroids as part of their treatment with BPD children who had not.<\/jats:p><jats:p>Results. The BPD group demonstrated deficits compared with VLBW and term children in intelligence; reading, mathematics, and gross motor skills; and special education services. VLBW children differed from term children in all of the above areas, except reading recognition, comprehension, and occupational therapy. Attentional differences were obtained between BPD and term children only. The BPD group (54%) was more likely to be enrolled in special education classes than VLBW (37%) or term children (25%). In addition, more BPD children (20%) achieved full-scale IQ scores &amp;lt;70, in the mental retardation range, compared with either VLBW (11%) or term (3%) children, with all VLBW children significantly more likely than term children to achieve IQs in the subaverage category. After controlling for birth weight and neurologic problems, BPD and\/or duration on oxygen predicted lower performance IQ, perceptual organization, full-scale IQ, motor and attentional skills, and special education placement. The qualitative classification of BPD (present or absent) was a significant predictor for lower scores on measures of applied problems; motor skills; and incidence of speech-language, occupational, and physical therapies. Individual difference analyses were performed to ascertain whether differences between the risk groups were primarily attributable to neurologic complications. Even with the neurologically intact sample of BPD and VLBW children, differences between the term comparison group and both the BPD and VLBW groups were found for many outcome measures. When birth weight and neurologic complications were controlled, BPD and severity of BPD were associated with lower performance and full-scale IQ, poorer perceptual organization, attention, and motor skills, as well as lower school achievement and greater participation in special education, including occupational, physical, and speech-language therapies. Treatment protocol may in part be responsible for differences observed in our BPD sample. Steroid and nonsteroid groups of BPD children differed significantly in performance IQ (72.8 vs 84.8) and full-scale IQ (77.0 vs 85.2); perceptual organization (74.0 vs 85.2); Bruininks-Oseretsky Test of Motor Proficiency score (36.6 vs 44.7); and participation in special education (78% vs 48%), occupational therapy (71% vs 44%), and physical therapy (71% vs 41%). In every instance, BPD children who received steroids fared more poorly than BPD children who did not receive steroids.<\/jats:p><jats:p>Conclusions. BPD and duration on oxygen have long-term adverse effects on cognitive and academic achievement above and beyond the effects of VLBW. The problems that have been identified at 8 years of age highlight the need for continued monitoring of the learning, behavior, and development of BPD children to intervene with children who are at risk for school problems.<\/jats:p>","DOI":"10.1542\/peds.112.5.e359","type":"journal-article","created":{"date-parts":[[2004,8,14]],"date-time":"2004-08-14T00:43:47Z","timestamp":1092444227000},"page":"e359-e359","source":"Crossref","is-referenced-by-count":300,"title":["Cognitive and Academic Consequences of Bronchopulmonary Dysplasia and Very Low Birth Weight: 8-Year-Old Outcomes"],"prefix":"10.1542","volume":"112","author":[{"given":"Elizabeth J.","family":"Short","sequence":"first","affiliation":[{"name":"Department of Psychology, Case Western Reserve University, Cleveland, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nancy K.","family":"Klein","sequence":"additional","affiliation":[{"name":"Department of Education, Cleveland State University, Cleveland, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara A.","family":"Lewis","sequence":"additional","affiliation":[{"name":"Department of Pediatrics\/School of Medicine, Rainbow Babies and Children\u2019s Hospital, Case Western Reserve University, Cleveland, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Fulton","sequence":"additional","affiliation":[{"name":"Department of Pediatrics\/School of Medicine, Rainbow Babies and Children\u2019s Hospital, Case Western Reserve University, Cleveland, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheri","family":"Eisengart","sequence":"additional","affiliation":[{"name":"Department of Pediatrics\/School of Medicine, Rainbow Babies and Children\u2019s Hospital, Case Western Reserve University, Cleveland, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolyn","family":"Kercsmar","sequence":"additional","affiliation":[{"name":"Department of Pediatrics\/School of Medicine, Rainbow Babies and Children\u2019s Hospital, Case Western Reserve University, Cleveland, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jill","family":"Baley","sequence":"additional","affiliation":[{"name":"Department of Pediatrics\/School of Medicine, Rainbow Babies and Children\u2019s Hospital, Case Western Reserve University, Cleveland, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lynn T.","family":"Singer","sequence":"additional","affiliation":[{"name":"Department of Pediatrics\/School of Medicine, Rainbow Babies and Children\u2019s Hospital, Case Western Reserve University, Cleveland, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2003,11,1]]},"reference":[{"key":"2021120820303432700_R1","unstructured":"National Heart, Lung, and Blood Institute, Division of Lung Diseases and Offices of Prevention, Education and Control. Bronchopulmonary Dysplasia. Washington, DC: National Institutes of Health; 1998. Publ. No. 98-4081"},{"key":"2021120820303432700_R2","doi-asserted-by":"crossref","unstructured":"Mercier C, Soll R. Clinical trials of natural surfactant in respiratory distress syndrome. Clin Perinat.1993;20:711\u2013735","DOI":"10.1016\/S0095-5108(18)30375-0"},{"key":"2021120820303432700_R3","doi-asserted-by":"crossref","unstructured":"Martin RJ, Walsh-Sukys MC. Bronchopulmonary dysplasia\u2014no simple solution. N Engl J Med.1999;340:1036\u20131038","DOI":"10.1056\/NEJM199904013401311"},{"key":"2021120820303432700_R4","doi-asserted-by":"crossref","unstructured":"Dobbing J. Vulnerable periods in the developing brain. In: Dobbing J, ed. Brain, Behavior, and Iron in the Diet. New York, NY: Springer-Verlag; 1990:1\u201317","DOI":"10.1007\/978-1-4471-1766-7_1"},{"key":"2021120820303432700_R5","doi-asserted-by":"crossref","unstructured":"Kurzner SI, Garg M, Bautista DB, Sargent CW, Bowman M, Keens TG. Growth failure in bronchopulmonary dysplasia: elevated metabolic rates and pulmonary mechanics. J Pediatr.1988;112:73\u201380","DOI":"10.1016\/S0022-3476(88)80126-4"},{"key":"2021120820303432700_R6","doi-asserted-by":"crossref","unstructured":"Singer LT, Yamashita TS, Lilien L, Collin M, Baley J. A longitudinal study of infants with bronchopulmonary dysplasia and very low birthweight. Pediatrics.1997;100:987\u2013993","DOI":"10.1542\/peds.100.6.987"},{"key":"2021120820303432700_R7","unstructured":"Volpe J. Neurology of the Newborn. 3rd ed. Philadelphia, PA: W B Saunders; 1995"},{"key":"2021120820303432700_R8","doi-asserted-by":"crossref","unstructured":"Meisels SJ, Plunkett JW, Roloff DW, Pasick PL, Steifel GS. Growth and development of preterm infants with respiratory distress syndrome and bronchopulmonary dysplasia. Pediatrics.1987;77:345\u2013352","DOI":"10.1542\/peds.77.3.345"},{"key":"2021120820303432700_R9","doi-asserted-by":"crossref","unstructured":"O\u2019Shea MT, Goldstein DJ, deRegnier RA, Sheaffer CI, Roberts DD, Dillard RG. Outcome at 4 to 5 years of age in children recovered from neonatal chronic lung disease. Dev Med Child Neurol.1996;38:830\u2013839","DOI":"10.1111\/j.1469-8749.1996.tb15118.x"},{"key":"2021120820303432700_R10","doi-asserted-by":"crossref","unstructured":"Hughes CA, O\u2019Gorman LA, Shyr Y, Schork MA, Bozynski MEA, McCormick MC. Cognitive performance at school age of very low birth weight infants with bronchopulmonary dysplasia. J Dev Behav Pediatr.1999;20:1\u20138","DOI":"10.1097\/00004703-199902000-00001"},{"key":"2021120820303432700_R11","doi-asserted-by":"crossref","unstructured":"Giacoia GP, Venkataraman PS, West-Wilson KI, Faulkner MJ. Follow-up of school-age children with bronchopulmonary dysplasia. J Pediatr.1997;130:400\u2013408","DOI":"10.1016\/S0022-3476(97)70231-2"},{"key":"2021120820303432700_R12","doi-asserted-by":"crossref","unstructured":"Majnemer A, Riley P, Shevell M, Birnbaum R, Greenstone H, Coates AL. Severe bronchopulmonary dysplasia increases risk for later neurological and motor sequelae in preterm survivors. Dev Med Child Neurol.2000;42:53\u201360","DOI":"10.1111\/j.1469-8749.2000.tb00025.x"},{"key":"2021120820303432700_R13","doi-asserted-by":"crossref","unstructured":"Vohr BR, Garcia Coll C, Lobato D, Yunis KA, O\u2019Dea C, Oh W. Neurodevelopmental and medical status of low-birthweight survivors of bronchopulmonary dysplasia at 10 to 12 years of age. Dev Med Child Neurol.1991;33:690\u2013697","DOI":"10.1111\/j.1469-8749.1991.tb14946.x"},{"key":"2021120820303432700_R14","doi-asserted-by":"crossref","unstructured":"Bregman J. Developmental outcome in very low birthweight infants: current status and future trends. Pediatr Clin North Am.1998;45:673\u2013690","DOI":"10.1016\/S0031-3955(05)70035-3"},{"key":"2021120820303432700_R15","doi-asserted-by":"crossref","unstructured":"Northway WH, Moss RB, Carlisle KB, et al. Late pulmonary sequelae of bronchopulmonary dysplasia. N Engl J Med.1990;26:1793\u20131799","DOI":"10.1056\/NEJM199012273232603"},{"key":"2021120820303432700_R16","doi-asserted-by":"crossref","unstructured":"Papile L, Burnstein J, Burnstein R, Koffer H. Incidence and evolution of subependymal and intraventricular hemorrhage: a study of infants with birth weights less than 1500 grams. J Pediatr.1978;92:529\u2013534","DOI":"10.1016\/S0022-3476(78)80282-0"},{"key":"2021120820303432700_R17","unstructured":"Wechsler D. Wechsler Intelligence Scale for Children. 3rd ed. San Antonio, TX: The Psychological Corporation; 1991"},{"key":"2021120820303432700_R18","unstructured":"Woodcock R, Mather N. Woodcock-Johnson Test of Achievement Test Revised: Standard and Supplemental Battery. Allen, TX: DLM Teaching Resources; 1987"},{"key":"2021120820303432700_R19","unstructured":"Bruininks RH. Bruininks-Oseretsky Test of Motor Proficiency. Circle Pines, MN: American Guidance Service; 1978"},{"key":"2021120820303432700_R20","unstructured":"Reitan RM. Neuropsychological Evaluation of Young Children. Tucson, AZ: Neuropsychology Press; 1994"},{"key":"2021120820303432700_R21","unstructured":"Connors CK. Connors Continuous Performance Test. North Tonawanda, NY: Multi-Health Systems; 1995"},{"key":"2021120820303432700_R22","unstructured":"Connors CK. Connors Rating Scale Manual. Toronto, Ontario, Canada: Multi Health Systems; 1990"},{"key":"2021120820303432700_R23","doi-asserted-by":"crossref","unstructured":"Robertson CT, Ethes PC, Goldson E, Kyle JM. Eight-year school performance, neurodevelopmental and growth outcome of neonates with bronchopulmonary dysplasia: a comparative study. Pediatrics.1992;89:365\u2013372","DOI":"10.1542\/peds.89.3.365"},{"key":"2021120820303432700_R24","doi-asserted-by":"crossref","unstructured":"Lewis BA, Singer LT, Fulton S, et al. Eight year speech and language outcomes of children with a history of bronchopulmonary dysplasia and very low birth weight. J Commun Disord.2002;35:393\u2013406","DOI":"10.1016\/S0021-9924(02)00085-0"},{"key":"2021120820303432700_R25","doi-asserted-by":"crossref","unstructured":"Farrell PA, Fiascone JM. Bronchopulmonary dysplasia in the 1990\u2019s: a review for the pediatrician. Curr Probl Pediatr.1997;27:133\u2013163","DOI":"10.1016\/S0045-9380(97)80017-5"},{"key":"2021120820303432700_R26","doi-asserted-by":"crossref","unstructured":"Saigal S, Rosenbaum PL, Szatmari P, Campbell D. Learning disabilities and school problems in a regional cohort of extremely low birth weight (1000g) children: a comparison with term controls. J Dev Behav Pediatr.1991;12:294\u2013300","DOI":"10.1097\/00004703-199110000-00002"},{"key":"2021120820303432700_R27","doi-asserted-by":"crossref","unstructured":"Klein NK, Hack M, Breslau N. Children who were very low birth weight: developmental and academic achievement at nine years of age. J Dev Behav Pediatr.1989;10:32\u201337","DOI":"10.1097\/00004703-198902000-00007"},{"key":"2021120820303432700_R28","doi-asserted-by":"crossref","unstructured":"McCormick MC, Brooks-Gunn J, Workman-Daniels K, Turner J, Peckkham GJ. The health and developmental status of very low-birth-weight children at school age. JAMA.1992;267:2204\u20132208","DOI":"10.1001\/jama.267.16.2204"},{"key":"2021120820303432700_R29","doi-asserted-by":"crossref","unstructured":"Singer LT, Martin RJ, Hawkins SW, Benson-Szekely LJ, Yamashita TS, Carlo WA. Oxygen desaturation complicates feeding in infants with bronchopulmonary dysplasia after discharge. Pediatrics.1992;90:380\u2013384","DOI":"10.1542\/peds.90.3.380"},{"key":"2021120820303432700_R30","unstructured":"Perlman J. Neurologic manifestations in infants with severe bronchopulmonary dysplasia. Int Pediatr.1990;82:108\u2013111"},{"key":"2021120820303432700_R31","unstructured":"Groothius J, Gutierrez K, Lauer B. Respiratory syncytial virus infection in children with bronchopulmonary dysplasia. Pediatrics.1988;110:199\u2013203"},{"key":"2021120820303432700_R32","doi-asserted-by":"crossref","unstructured":"Bader D, Ramos A, Lew C, et al. Childhood sequelae of infant lung disease. J Pediatr.1987;110:693\u2013699","DOI":"10.1016\/S0022-3476(87)80004-5"},{"key":"2021120820303432700_R33","doi-asserted-by":"crossref","unstructured":"Smythe J, Tabachnik E, Duncan W, et al. Pulmonary function and bronchial hyper-reactivity in long-term survivors of BPD. Pediatrics.1981;68:336\u2013340","DOI":"10.1542\/peds.68.3.336"},{"key":"2021120820303432700_R34","doi-asserted-by":"crossref","unstructured":"Gross SJ, Iannuzzi DM, Kveselis DA, Anbar RD. Effect of preterm birth on pulmonary function at school age: a prospective controlled study. J Pediatr.1998;133:188\u2013192","DOI":"10.1016\/S0022-3476(98)70219-7"},{"key":"2021120820303432700_R35","doi-asserted-by":"crossref","unstructured":"Jacob SV, Coates AL, Lands LC, et al. Long-term pulmonary sequelae of severe bronchopulmonary dysplasia. Pediatrics.1998;22:193\u2013200","DOI":"10.1016\/S0022-3476(98)70220-3"},{"key":"2021120820303432700_R36","doi-asserted-by":"crossref","unstructured":"Singer LT, Siegel AC, Lewis B, Hawkins S, Yamashita T, Baley J. Preschool language outcomes of children with history of bronchopulmonary dysplasia and very low birth weight. J Dev Behav Pediatr.2001;22:19\u201326","DOI":"10.1097\/00004703-200102000-00003"}],"container-title":["Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/112\/5\/e359\/1002820\/pe110300e359.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/112\/5\/e359\/1002820\/pe110300e359.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,29]],"date-time":"2023-04-29T05:35:50Z","timestamp":1682746550000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/pediatrics\/article\/112\/5\/e359\/28801\/Cognitive-and-Academic-Consequences-of"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2003,11,1]]},"references-count":36,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2003,11,1]]},"published-print":{"date-parts":[[2003,11,1]]}},"URL":"https:\/\/doi.org\/10.1542\/peds.112.5.e359","relation":{},"ISSN":["0031-4005","1098-4275"],"issn-type":[{"value":"0031-4005","type":"print"},{"value":"1098-4275","type":"electronic"}],"subject":[],"published":{"date-parts":[[2003,11,1]]}}}