Bryan L. Williams, Ph.D.,Associate Professor

What is it?

Who or what is responsible for it?

What are the consequences of poor achievement?

• Wide-spread attention to teacher quality in the education literature

(Borman & Kimball, 2005; Darling-Hammond, 2006; Hopkins & Stern,

1996; Newton et al., 2010).

• Value-Added Modeling (VAM) of the effect of teacher quality: some

evidence that teacher quality and effectiveness are positively related to

changes in performance over course of an academic year (Newton et

al., 2010; Wayne & Youngs, 2003).

• Maybe we should consider maternal and child health…

• Maybe prematurity, low birth weight, and maternal risk factors account for a significant proportion of unexplained, within-classroom variance in student achievement.

Being born too early increases the risk of:• Neonatal morbidity and mortality

• Early and long term neurological impairment

• Lower quality of life

Our ability to decrease prematurity is

increasing• Prenatal care

• Reexamination of standard clinical practice

• Interpregnancy and pre-conception care

Jain (2008) points out, “Needless to say, the

growing brain and body are deceptively

capable of keeping adverse effects masked

until cognitive and motor functions can be

meaningfully tested”.

What is the longer term consequences of

prematurity on children across the

gestational age spectrum?

What is the relationship

between prematurity,

birthweight for gestational age,

and performance on the

standardized test among

children born in Georgia?

Electronic Birth Record (1998-2003)

CRCT Test (2004-2010)

Grades 1-3

Linked Georgia Birth-

Education Data Set

Mother-

Infant

Hospital

Discharge

Data

Criterion-Referenced Competency Tests (CRCT)

• Designed to measure how well students acquire the skills and

knowledge described in the Georgia Performance Standards

• Administered in Grades 1-8

• Domains of interest:

English Language Arts

Reading

Source: http://www.doe.k12.ga.us/ci_testing.aspx?PageReq=CI_TESTING_CRCT

Inherent truncated variability of minimal competency

tests

Inability to obtain non-resident births

Incomplete or inaccurate maternal and infant records

Lack of earlier outcome measure (i.e., Pre-K)

Inability to assess longitudinal changes in achievement

NH White54%

NH Black36%

Hispanic10%

Maternal Ethnicity

NH White52%NH Black

37%

Hispanic11%

Child Ethnicity

• Births that have matching student

information

• Singleton births

• Infants with birth weight 400 g to 5000 g

• Infants of gestational age 20 to 43 weeks

• Infants without recorded congenital

anomalies and chromosomal defects

31%22% 19% 16% 17%

55%60% 60% 60% 59%

13%18%

22%25% 24%

0%

10%

20%

30%

40%

50%

60%

70%

Extreme Premature

(<28)

Moderately Premature

(29-33)

Late Premature

(34-36)

Term (37-41) Post Term (>41)

Does Not Meet Meets Exceeds X2=972.95;df=8; p.

< .0001N=354,781

23%

14% 11% 9% 10%

53% 55%52%

50% 50%

24%

31%

37%41% 39%

0%

10%

20%

30%

40%

50%

60%

Extreme Premature

(<28)

Moderately Premature

(29-33)

Late Premature

(34-36)

Term (37-41) Post Term (>41)

Does Not Meet Meets ExceedsX2=1092.2df=8;

p. < .0001N=354,815

32%

19%15% 12% 13%

50%

55%52%

51% 50%

18%

26%

33%

37% 37%

0%

10%

20%

30%

40%

50%

60%

Extreme Premature

(<28)

Moderately Premature

(29-33)

Late Premature

(34-36)

Term (37-41) Post Term (>41)

Does Not Meet Meets Exceeds X2=1587.5;df=8;

p. < .0001N=354,764

READING ELA MATH

AGA 340.0 329.0 338.5

SGA 333.3 323.2 330.6

310.0

315.0

320.0

325.0

330.0

335.0

340.0

345.0

Sta

nd

ard

ized

Scale

CR

CT

Sco

re

R2=.045 (p. < .05)

R2=.045 (p. < .05)

R2=.055 (p. < .05)

Covariates appearing in the model are evaluated at the following values: Mothers Age In Years = 26.11.

Standardized Scale Scores by Gestational Age

323.4

331.7

335.7

339.0 338.3

315.1

321.6

325.0

328.2 327.8

317.5

327.9

333.3

337.3 336.9

300.0

305.0

310.0

315.0

320.0

325.0

330.0

335.0

340.0

345.0

Extreme (<28)

Moderate (29-33)

Late (34-36) Term (37-41) Post Term (> 41)

CR

CT

Scal

ed

Sco

re 1

stG

rad

e

Gestational Age Category

Reading SS (n=354,815)

ELA SS (n=354,781)

MATH SS (n=354,764)

2.85

2.442.72

1.471.36 1.38

1.17 1.15 1.12 1.06 1.07 1.091

10

Extr

eme …

Mo

der

at…

Late

…

Post

…

Ad

just

ed

Od

ds

Rat

io

Gestational Age

Adjusted for maternal age at birth, maternal education, maternal race/ethnicity, child

race/ethnicity, sex of child, and year of birth

Math

Englis

h L

anguage A

rts

Readin

g

aOR for Association Of Gestational Age With Child’s 1st Grade CRCT Failure

Prematurity and Risk (odds) of CRCT Failure

Prematurity and Birthweight by Gestational Age on ELA Failure

Adjusted for maternal age at birth, maternal education, maternal race/ethnicity, child race/ethnicity, sex of child, and year of birth

aOR for Association of the Interaction Between Birthweight for Gestational Age and Prematurity on Failure of the ELA Test Only

5.43

2.45

1.611.35 1.17 1.15

0.98 1.09

0.10

1.00

10.00

Extreme (20-28)

Moderate (29-33)

Late Preterm (34-36)

Post Term (>42)

Ad

just

ed

Od

ds

Rat

ios

Gestational Age

SG

A

SG

A

SG

A

SG

A

AG

A

AG

A

AG

A

AG

A

Summary• Being born ‘preterm’ versus ‘term’ increases a first-grade child’s

risk of failure of all three components of the CRCT.

• Small for gestational age infants scored significantly lower on all three components of the CRCT.

• Being small for gestational age significantly increases a first-grade child’s risk of failure on the English Language Arts test among those born extremely, moderately, and late preterm.

Prematurity is an injury that can hurt a child for a

very long time

Not all premature infants are injured in the same

way

Like most injuries many forms of prematurity can

be prevented

• Teacher/school variables vs. maternal/infant

variables as predictor of school performance

• Factors under schools’ control

• Fairness of high stakes testing

Next Steps

• Link hospital discharge, Pregnancy Risk Assessment Monitoring System (PRAMS), and spatial data to existing data set

• Examine the impact of the neighborhood on maternal child health and academic achievement

• Obtain earlier and more relevant measures of development

Attention Cornhusker Nation