Newborns at risk for special education placement: A population-based study

Abstract

Objectives

To establish the contributions of birth weight (BW), gender, socioeconomic status (SES), and parental age on risks for special education (SE) placements in school-age children.

Methods

A population-based sample of 900 school-age children attending the following full-time SE groups: at level 1, children had isolated neurodevelopmental, physical, or other impairments; at level 2, borderline to mild intellectual disability (ID); and at level 3, moderate to severe ID. Three hundred and one children enrolled in mainstream education formed the control group (level 0). For all children with siblings, we defined familiar forms of learning disorders as having a sibling in one of the SE groupings. We performed our analysis for the entire cohort as well as comparing risk factors within the familial and non-familial types of SE groupings.

Results

In multinomial logistic regression analysis, age of father ⩾40 years, low BW (<2500 g or <−2 SD), male sex, and parent's lower SES, all increased the probability of SE placement. In the familial forms of levels 2 and 3, the parental SES was lower and, in addition, in the level 2, the family size was bigger. Furthermore, in the non-familial form of level 2, both the low and the high (⩾4000 g) BW were more common.

Conclusions

Among the known risk factors for learning disabilities (LD), our study highlighted the importance of a higher paternal age and a lower SES especially in the familial forms of LD.

Introduction

Learning disabilities (LD) form a heterogeneous group of disorders with a varying degree of severity ranging from dyslexia or dyscalculia to severe intellectual disability (ID). During recent years, the recognition of LDs has increased in Finland and thus the prevalence rates of LDs have risen. For instance, in 1995, 2.9% of the pupils 7–16-years old attended full-time and 13.9% part-time special education (SE) groups, whereas in 2001, the corresponding numbers raised to 5.2% and 16%.¹ These numbers match the prevalence rates of the LDs in other western countries.2, 3

The reasons for SE placement are diverse, involving both biological and environmental factors. Among these are the associations of increasing maternal and paternal age with the offspring having a lower cognitive capacity.4, 5 In addition, factors such as birth order, family size, a sibling's LD, and especially a family's low social class, may all correlate with LDs.6, 7, 8, 9, 10 Furthermore, earlier studies show that an increasing birth weight (BW) in the normal range correlates positively with favourable cognitive function during childhood and young adult life.11, 12 By contrast, low BW associates with LDs among school-aged children.2, 9, 13, 14, 15 Other potential factors for cognitive impairment are foetal growth restriction and male sex.15, 16, 17, 18

In this clearly defined population-based study, we attempted to establish how these factors at birth associate with the future need for full-time SE (Table 1). Secondly, another objective was to discover whether children with the familial (at least one sibling in SE) and non-familial subtypes of LD displayed differences and if they did, to clarify their distinctive profiles. We chose the levels of full-time SE (Table 1) as the dependent variable since they measure children's abilities globally.