A Comparison of Developmental Outcomes of Adolescent Neonatal Intensive Care Unit Survivors Born with a Congenital Heart Defect or Born Preterm.

OBJECTIVE: To compare cognitive, motor, behavioral, and functional outcomes of adolescents born with a congenital heart defect (CHD) and adolescents born preterm. STUDY DESIGN: Adolescents (11-19 years old) born with a CHD requiring open-heart surgery during infancy (n = 80) or born preterm ≤29 weeks of gestational age (n = 128) between 1991 and 1999 underwent a cross-sectional evaluation of cognitive (Leiter International Performance Scale-Revised), motor (Movement Assessment Battery for Children-II), behavioral (Strengths and Difficulties Questionnaire), and functional (Vineland Adaptive Behavior Scale-II) outcomes. Independent samples t tests and Pearson χ2 or Fisher exact tests were used to compare mean scores and proportions of impairment, respectively, between groups. RESULTS: Adolescents born with a CHD and adolescents born preterm had similar cognitive, motor, behavioral, and functional outcomes. Cognitive deficits were detected in 14.3% of adolescents born with a CHD and 11.8% of adolescents born preterm. Motor difficulties were detected in 43.5% of adolescents born with a CHD and 50% of adolescents born preterm. Behavioral problems were found in 23.7% of adolescents in the CHD group and 22.9% in the preterm group. Functional limitations were detected in 12% of adolescents born with a CHD and 7.3% of adolescents born preterm. CONCLUSIONS: Adolescents born with a CHD or born preterm have similar profiles of developmental deficits. These findings highlight the importance of providing long-term surveillance to both populations and guide the provision of appropriate educational and rehabilitation services to better ameliorate long-term developmental difficulties.

Social dominance in children with cerebral palsy during a problem-solving task with peers.

PURPOSE: Children with cerebral palsy tend to have poorer social competence outcomes than their peers without a disability in mainstream school settings. To understand their social competence, this study compared children with cerebral palsy with paired children without cerebral palsy with respect to their ability to access resources, defined here as "social dominance", in a problem-solving situation. METHOD: Children with cerebral palsy were randomly paired to a peer (teammate) and put in a competitive context where each team of two children was instructed to solve an impossible problem. To control for social status, a sociometric measure was administered previously in the classroom (Social Preference score). Behaviors related to social dominance (prosocial and coercive behaviors) were coded using an observation scale validated for this study. RESULTS: The results showed that regardless of social status, children with cerebral palsy were less socially dominant than controls without cerebral palsy. Furthermore, their teams seemed to be less dominant than teams composed of two controls. CONCLUSIONS: The lower social competence in children with cerebral palsy could be partly explained by their reduced social dominance behavior in activities requiring speed and fluidity as an expression of executive functions. This might be viewed as a marker for social risks in the integration process at school. Implications for rehabilitation Gross Motor Function Classification System level I or II cerebral palsy is a condition that affects not only motor abilities but also social competence in children. Lower social competence in children with cerebral palsy could be partly explained by reduced social dominance behavior in activities such as problem solving with peers. To improve social competence, rehabilitation interventions should include social participation opportunities in which children with cerebral palsy are encouraged to take an active role in the activity.

Sociometric status and the attribution of intentions in a sample of adolescents with cerebral palsy.

Purpose To examine how cerebral palsy (CP) and sociometric status at age 10 explain the development of a cognitive bias across two groups of adolescents aged 15. Method Children with CP (N = 60) and without CP (N = 57) are part of a follow-up study. Three categories of sociometric status (popular, average, rejected) were obtained by conducting a class-wide interview in the class of the target children at age 10. At 15 years old, the same children (CP and non-CP) were asked to complete the Home Interview With Child questionnaire measuring a cognitive bias (hostile attribution of intentions (AI)). Results Children with CP, especially girls, were significantly more rejected and less popular than controls at age 10. At age 15, among all participants, sociometric rejected and popular children tended to have a higher percentage of hostile AI than sociometric average children. Conclusions There were no significant results for the combined effect of CP and sociometric status on the development of hostile AI at age 15. However, knowing the risk incurred by children with CP of being socially rejected, attention should be paid in the rehabilitation process to opportunities for social participation to facilitate the development of social competence. Implications for Rehabilitation Level I or II cerebral palsy (CP) is a condition that affects not only motor abilities but also social competence in children. Sociometric status in a group tends to affect the development of the ability to interprete intentions of others during adolescence. Sociometric measures in the class of children with CP could be a useful tool in the rehabilitation process in order to better define social participation opportunities. To improve social participation attempts, rehabilitation interventions should target social initiating skills, flexibility in interpreting peers' behaviours, and ability to react effectively to negative peer treatment.

Twenty-year Follow-up of Kangaroo Mother Care Versus Traditional Care.

BACKGROUND AND OBJECTIVES: Kangaroo mother care (KMC) is a multifaceted intervention for preterm and low birth weight infants and their parents. Short- and mid-term benefits of KMC on survival, neurodevelopment, breastfeeding, and the quality of mother-infant bonding were documented in a randomized controlled trial (RCT) conducted in Colombia from 1993 to 1996. The aim of the present study was to evaluate the persistence of these results in young adulthood. METHODS: From 2012 to 2014, a total of 494 (69%) of the 716 participants of the original RCT known to be alive were identified; 441 (62% of the participants in the original RCT) were re-enrolled, and results for the 264 participants weighing ≤1800 g at birth were analyzed. The KMC and control groups were compared for health status and neurologic, cognitive, and social functioning with the use of neuroimaging, neurophysiological, and behavioral tests. RESULTS: The effects of KMC at 1 year on IQ and home environment were still present 20 years later in the most fragile individuals, and KMC parents were more protective and nurturing, reflected by reduced school absenteeism and reduced hyperactivity, aggressiveness, externalization, and socio-deviant conduct of young adults. Neuroimaging showed larger volume of the left caudate nucleus in the KMC group. CONCLUSIONS: This study indicates that KMC had significant, long-lasting social and behavioral protective effects 20 years after the intervention. Coverage with this efficient and scientifically based health care intervention should be extended to the 18 million infants born each year who are candidates for the method.

Factors Associated With Moderate to Vigorous Physical Activity in Adolescents Born Preterm.

PURPOSE: Little is known about the physical activity of adolescents born prematurely. This study aimed to: 1) describe relationships between moderate to vigorous physical activity (MVPA) in adolescents born prematurely and various factors and, 2) compare their MVPA level to guidelines. METHOD: A secondary analysis was performed using data from 64 adolescents (16.1 ± 2.5 years old, born £29 weeks gestation; 57.8% girls). Time spent in MVPA was based on accelerometry data. Sociodemographic, prematurity and comorbidity variables were based on questionnaire data or, for movement difficulty, from the results of the Movement Assessment Battery for Children-Second Edition. RESULTS: Multiple regression analysis showed that participants who were older (b = -4.52, p < .001), female (b = 14.18, p = .014), with movement difficulty (b = 18.64, p = .014), with health problems (b = 11.78, p = .036) and without hyperactive behavior (trend, b = 2.04, p = .099) spent less time in MVPA. Together these variables explained 44.4% of the variance in MVPA. Most participants (79.7%) did not meet Canadian MVPA guidelines. CONCLUSION: Study results suggest that physical activity interventions should especially target adolescents born prematurely who are older, female, with health problems, and with marked movement difficulties.

Social participation of children age 8-12 with SLI.

PURPOSE: Two objectives are being pursued: (1) to describe the level of social participation of children aged 8-12 presenting a specific language impairment (SLI) and (2) to identify personal and family factors associated with their level of social participation. METHOD: This cross-sectional study was conducted among 29 children with SLI and one of their parents. Parental stress and family adversity were measured as risk factors. The measure of life habits (LIFE-H) adapted to children aged 5-3 was used to measure social participation. RESULTS: The assumption that social participation of these children is impaired in relation to the communication dimension was generally confirmed. The statements referring to the "communication in the community" and "written communication" are those for which the results are weaker. "Communication at home" is made easier albeit with some difficulties, while "telecommunication" is totally preserved. A high level of parental stress is also confirmed, affecting the willingness of parents to support their child's autonomy. CONCLUSIONS: The achievement of a normal lifestyle of children with SLI is upset in many spheres of life. Methods of intervention must better reflect the needs and realities experienced by these children in their various living environments, in order to optimize social participation, and consequently, to improve their well-being and that of their families. The need to develop strategies to develop children's independence and to reduce parental stress must be recognized and all stakeholders need to be engaged in the resolution of this challenge. IMPLICATIONS FOR REHABILITATION: The realization of life habits of SLI children is compromised at various levels, especially in the domain related to "communication in the community" and "written communication". Speech-language pathologists must consider providing ongoing support throughout the primary years of these children and during adolescence, to promote and facilitate the continued realization of life habits of SLI persons. Providing ongoing support throughout the primary years and thereafter is needed to facilitate the continuing realization of life habits of SLI persons. Parents of children with SLI experience considerable stress in relation to the exercise of their parental roles. It is important to intervene and to support parents to promote autonomy for their SLI children.

Child and environmental factors associated with leisure participation in adolescents born extremely preterm.

BACKGROUND: Developmental impairments persist among adolescents born extremely preterm, and these individuals are at an increased risk for chronic disease later in life. Participating in active and positive leisure activities may act as a buffer against negative outcomes, but involvement in active-physical and skill-based activities is low in youth born preterm. AIMS: To explore the child and environmental determinants of leisure participation among adolescents born extremely preterm. STUDY DESIGN: Cross-sectional study. SUBJECTS: Participants were recruited from the hospital's Neonatal Follow-Up Program and included 128 adolescents born preterm (mean gestational age: 26.5 weeks). OUTCOME MEASURES: Leisure participation was assessed using the Children's Assessment of Participation and Enjoyment. Potential determinants were assessed using standardized tests and questionnaires. Selected factors were entered into five separate multivariable regression models. RESULTS: Child and environmental factors contributed between 21% (skill-based) and 52% (active physical) of the adjusted variance for participation intensity. Lower gestational age was associated with greater participation in recreational activities. Male sex, higher maternal education and better motor competence were associated with involvement in active-physical activities. Being older and feeling socially accepted were associated with participation in social activities. Families oriented to hobbies and higher maternal education were associated with participation in skill-based activities. Preference was the strongest determinant of participation in all five leisure activities. CONCLUSIONS: Activities should be adapted to individual skill level, include family and peers, foster social acceptance and be driven by the adolescent's preferences. Although certain factors cannot be modified, they can be used to identify adolescents at risk for low participation.

Participation and enjoyment of leisure activities in adolescents born at ≤ 29 week gestation.

BACKGROUND AND OBJECTIVES: Motor, cognitive, social and behavioral problems have been found to persist in adolescents born extremely preterm. Leisure participation has been associated with health benefits; however, few studies have explored leisure participation in this population. The aim of this study was to describe leisure participation in adolescents born at ≤29week gestation. Secondary aims were to identify potential differences in participation related to sex, age, motor competence, and cognitive ability, and between adolescents born preterm and their siblings born at term. METHODS: This cross-sectional study included 128 adolescents (mean age: 16.0years; 67 females) with a mean gestational age of 26.5weeks. All participants, as well as 22 siblings born at term, completed the Children's Assessment of Participation and Enjoyment. RESULTS: Participation levels were highest in social and recreational activities, and lowest in active-physical and skill-based activities. Boys participated in more active-physical activities (p=0.01) and more often (p<0.001) than girls, whereas girls had higher participation levels in social and self-improvement activities (p<0.05) than boys. Older adolescents engaged in more social activities (p=0.01) and more frequently (p=0.002) than younger adolescents. Overall, participants with poor motor and cognitive skills had lower participation levels in active-physical and social activities. Adolescents born preterm participated in fewer recreational activities compared to term-born siblings (p=0.013). CONCLUSIONS: Engagement in active-physical and skill-based leisure activities needs to be promoted in boys, and especially in girls with a history of prematurity. Activities should be adapted to sex and individual skill level in order to promote participation.

Intervention for improving comprehension in 4-6 year old children with specific language impairment: practicing inferencing is a good thing.

Few studies report on therapy to improve language comprehension in children with specific language impairment (SLI). We address this gap by measuring the effect of a systematic intervention to improve inferential comprehension using dialogic reading tasks in conjunction with pre-determined questions and cues. Sixteen children with a diagnosis of SLI aged 4-6 participated in 10 weekly treatment sessions carried out by their regular therapists. Baseline and maintenance periods were also tabulated. Two experimental measures and a standardized test revealed that children's total scores and the quality of their responses post-treatment were better than those obtained pre-treatment. However, perhaps due to the use of non-equivalent probes, this change could not be interpreted solely as a significant effect of intervention. These results nevertheless suggest that a systematically designed intervention focusing on the comprehension of specific types of questions requiring inferencing and using a carefully scaffolded cueing strategy can be beneficial.

Social participation by children with developmental coordination disorder compared to their peers.

PURPOSE: Two objectives are being pursued: (1) to describe and compare the level of social participation of children aged 5-13 with developmental coordination disorder (DCD) to children of the same age with typical development (TD) and (2) to describe and compare the level of social participation of two subgroups of youths with DCD, e.g. children with dyspraxia affecting both the motor sphere and the verbal sphere (mixed dyspraxia) and children with developmental dyspraxia. METHOD: This cross-sectional study was conducted among 27 youngsters with DCD: 9 having developmental dyspraxia and 18 having mixed dyspraxia, compared to 27 same-age peers with TD. Life habits (LIFE-H) for children was used to measure social participation. RESULTS: Levels of lifestyle achievements among youngsters with DCD are significantly lower than those of TD youngsters in all categories. Noteworthy differences were found between subgroups of youngsters with DCD in the categories of life habits related to communication and education. The group with mixed dyspraxia obtained the lowest scores. CONCLUSIONS: The achievement of a normal lifestyle by youngsters with DCD is upset in all spheres of life. The impact of DCD on the level of participation of these youngsters is quite significant and affects all lifestyles measured in this study. Children with mixed dyspraxia are particularly affected. These facts must be taken into consideration by anyone involved in the lives of these youngsters. IMPLICATIONS FOR REHABILITATION: It is necessary to encourage social participation of DCD sufferers aged 5-13 in all spheres of life. Special attention should be paid to those who have a speech disorder. Life habits concerning communication and education may be related; greater efforts should be made to limit the negative impact on other lifestyles. Social participation of DCD sufferers should be measured periodically and appropriate resources must be made available to promote training and support for clinicians. It is important to provide tools to measure social participation for both stakeholders and parents.

Peripheral magnetic stimulation to decrease spasticity in cerebral palsy.

Muscle spasticity in pediatric cerebral palsy limits movement and disrupts motor performance, thus its reduction is important in rehabilitation to optimize functional motor development. Our pilot study used repetitive peripheral magnetic stimulation, because this emerging technology influences spinal and cerebral synaptic transmission, and its antispastic effects were reported in adult neurologic populations. We tested whether five sessions of tibial and common peroneal nerve stimulation exerted acute and long-term effects on spasticity of the ankle plantar flexor muscles in five spastic diparetic children (mean age, 8 years and 3 months; standard deviation, 1 year and 10 months). Muscle resistance to fast stretching was measured with a manual dynamometer as a spasticity indicator. A progressive decrease was observed for the more impaired leg, reaching significance at the third session. This sustained reduction of spasticity may reflect that the peripheral stimulation improved the controls over the spinal circuitry. It thus suggests that a massive stimulation-induced recruitment of sensory afferents may be able to influence central nervous system plasticity in pediatric cerebral palsy.

Brain motor excitability and visuomotor coordination in 8-year-old children born very preterm.

OBJECTIVE: Our study aimed to test in 8 years old children born very prematurely whether a faulty primary motor cortex (M1) functioning could parallel visuomotor coordination difficulties. METHODS: Ten very preterm children (PT; gestational age ≤32 weeks; 6 boys; 8 years 6 months, SD 4 months) were compared to seven healthy term peers (4 boys; 8 years 4 months, SD 4 months). Clinical assessment comprised two standardized tests for motor skills and visuomotor coordination. Transcranial magnetic stimulation (TMS) was applied over M1 area of the preactivated first dorsal interosseous muscle to measure the corticomotor excitability and the short intracortical inhibition (SICI). RESULTS: PT scores were significantly lower on the Developmental Test of Visual-Motor Integration (p=0.0018) and on the Movement Assessment Battery for Children (p=0.038). In parallel, the dominant hemisphere worked differently with no SICI in PT (p=0.009) and more variability of corticomotor excitability (p=0.001). CONCLUSIONS: These intertwined neurophysiological findings suggest that a faulty motor programming in the dominant M1 of PT could explain visuomotor coordination deficits. SIGNIFICANCE: Our study contributes to the understanding of possible mechanisms that underlie motor difficulties commonly observed in children who were born premature. In addition, the effectiveness of rehabilitation interventions may be better understood by applying TMS as an outcome measure in the future.

Self-concept in children with cerebral palsy: is there something in the wind?

PURPOSE: The aim of this study was to compare self-concept in four groups of children distinguished by the presence/absence of either a motor impairment (with and without cerebral palsy, CP) or social adjustment problems (victimisation). METHOD: Four groups were formed: a victimised CP group (n=17), a non-victimised CP group (n=41), a victimised comparison group (n=10) and a non-victimised comparison group (n=46). Self-concept was measured using the Self-Perception Profile for Children (SPPC, Harter The Self-Perception Profile for Children. Unpublished manual. Denver, CO: University of Denver; 1985) during the school visit. Victimisation was obtained by conducting a classwide sociometric interview in the class of the target child. RESULTS: The results indicate that the groups differ depending on the domain measured. CONCLUSIONS: By identifying factors that may influence self-concept in children with CP, this study contributes new information to this subject.

Observed behaviours of pre-term children in a social play situation with classroom peers.

BACKGROUND: A number of studies have reported social adjustment problems in pre-term children. OBJECTIVES: To observe the pre-term's behaviour in an experimental situation and correlate these observed behaviours with the children's peer-rated social behaviours (withdrawal, aggression and sociability/leadership). METHODS: Of 56 pre-term children, 24 were classified as the sick pre-term (SPT) group and 32 children as the healthy pre-term (HPT) group. The comparison group comprised 56 healthy full-terms. The experimental situation used a game called Rush Hour, a labyrinth-type board game. The play situation was videotaped and behaviours (number of consecutive moves) were coded in real time. RESULTS: At 12 years of age, the sick pre-term (SPT) group exhibited fewer consecutive moves during the game than the other two groups, especially when the task became more complex (involving four consecutives moves). Moreover, the Complex Task Index was correlated with the social withdrawal score rated by peers. CONCLUSION: The at-birth sick pre-term gradually became less involved in a complex decision-making task and this was understood as a lesser ability to make a decision in a complex setting.

Social adjustment at school: Are children with cerebral palsy perceived more negatively by their peers than other at-risk children?

PURPOSE: To compare three dimensions of social adjustment (social status, friendship and victimization) across four groups of children between the ages of nine and 12 who differ by their birth status (premature vs. at term) and the presence or absence of a motor impairment (with and without cerebral palsy [CP]). METHOD: All premature (n = 72) and term children (n = 118) without CP and all children with CP (premature with CP: n = 49; term with CP: n = 29) are part of a follow-up study. Social adjustment measures were obtained by conducting a classwide sociometric interview in the class of the target child. RESULTS: Irrespective of their birth status, girls with CP have more social adjustment problems than those without a disability. With respect to victimization, the results show that, irrespective of gender, both CP children and premature children (without CP) differ from their term peers (without CP). CONCLUSIONS: By comparing the four groups, we are able to qualify the impact of a visible clinical impairment such as CP versus that of extreme prematurity on social adjustment.

Visuo-motor coordination in 8-year-old children born pre-term before and after 28 weeks of gestation.

PURPOSE: This study compared the visuo-motor abilities between pre-term and full-term children. METHODS: Twenty-three 8-year-old children participated, five being born under 28 weeks gestational age (wGA) referred to as Preterms1 (mean=8 years 5 months [SD 0.3]), nine Preterms2 of 28-35 wGA (mean=7 years 9 months [SD 0.7]) and nine typically developing full-term controls (mean=8 years 6 months [SD 0.7]). All children were studied in an interhemispheric transfer time and in a visuo-manual pointing-task to test motor programming time in three conditions: unimanual pointing (dominant, non-dominant hands), mirror bimanual pointing (same direction for both hands) and opposite bimanual pointing. RESULTS: Significant differences were detected between Preterms 1 and 2, the latter being similar to controls. Preterms1 presented increases in interhemispheric time, suggesting an alteration in the transcallosal pathways. Programming time was significantly lengthened (p50.01) for dominant hand unilateral pointing and opposite bilateral pointing and it was the shortest for mirror pointing. CONCLUSIONS: A faulty programming of visuo-manual tasks is suspected in Preterms1 with potential difficulty inhibiting the non-dominant limb mirror movement. This may result from an impaired interhemispheric inhibition owing to potential corpus callosum thinning. Such measures may be used to help follow-up subtle changes in fine motor control and detect pre-terms at risk of developing long-term deficits.

The performance profile on the Wisconsin Card Sorting Test of a group of children with cerebral palsy aged between 9 and 12.

PURPOSE: The aim of this study was to determine the performance profile of a group of children with cerebral palsy (CP) on the Wisconsin Card Sorting Test (WCST). METHODS: The sample consisted of 102 children aged between 9-12, divided into two groups: the clinical group consisted of 52 children with in mainstream class (37 with hemiplegia and 15 with diplegia), while the comparison group comprised 50 children matched for class, gender, age and socioeconomic status. RESULTS: The findings showed that children with CP make more non-perseverative errors, they completed fewer categories, required more trials to complete the first category and gave fewer conceptual responses than control children. Children with diplegia are distinguished more from comparison children than children with hemiplegia. CONCLUSION: The results suggest a difficulty in initial conceptualization that could be attributable to a slow rate of information processing. Delayed maturation of the nervous system is likely to be implied.

Measuring participation in children with disabilities using the Assessment of Life Habits.

The objectives of this study were: (1) to examine the psychometric properties of the Assessment of Life Habits (LIFE-H) for children; and (2) to draw a profile of the level of participation among children of 5 to 13 years of age with various impairments. The research team adapted the adult version of the LIFE-H in order to render it more appropriate for the daily life experiences of children. Content validity was verified by an expert panel of 29 people, made up of parents, paediatric clinicians, and researchers. Reliability and construct validity of the LIFE-H for children (interview-administered form) was tested during an experiment that comprised three sessions of interviews with a group of 94 parents of children with disabilities (36 males, 58 females; mean age 8y 10mo [SD 2y 6 mo]; diagnostic groups: cerebral palsy, myelomeningocoele, sensory-motor neuropathy, traumatic brain injury, and developmental delay). Overall, the LIFE-H showed high intrarater reliability with intraclass correlation coefficient values of 0.78 or higher for 10 out of 11 categories. The correlations between the LIFE-H and the tools used in pediatric rehabilitation varied, and categories with similar constructs generally led to higher correlations. The psychometric properties of the LIFE-H are appropriate and its content allows a complete description of participation among children with disabilities.

Social adjustment of children with cerebral palsy in mainstream classes: peer perception.

The aim of this study was to describe the social experience of children with cerebral palsy (CP) in mainstream classes in Canada and compare it with that of their classmates without disability. The CP group included 25 females and 35 males (mean age 10 y 5 mo [SD 0.95], range 10 y 4 mo-10 y 10 mo) diagnosed as having hemiplegia (n=44) or diplegia (n=16) and classified as Level I on the Gross Motor Function Classification System (GMFCS). Fifty-seven comparison children, born at term and without any motor and/or sensory impairment, were recruited from the classes of the children with CP during a school visit (mean age 10 y 3 mo, [SD 1.0], range 10 y-10 y 6 mo). They were matched to children with CP for sex, age, parents' education level, and family income. Social adjustment measures (social status, reciprocated friendships, social isolation, aggression, sociability/leadership, and verbal and/or physical victimization) were obtained by conducting a class-wide sociometric interview (n=943) in the classes of the children with CP. Findings showed that children with CP (specifically females with CP and irrespective of their type of disability) had fewer reciprocated friendships, exhibited fewer sociable/leadership behaviours, and were more isolated and victimized by their peers than their classmates without a disability. This seems to suggest that females and males with CP are perceived differently from their peers in a mainstreaming context. The discussion addresses the issue of age- and sex-related differences and provides avenues of intervention relating to personal and environmental factors that could facilitate or interfere with the social experience of children with CP in a mainstream environment.

Victimization: a newly recognized outcome of prematurity.

Victimization by peers affects 10 to 20% of school children under the age of 12 years. Physical, verbal, and psychological victimization (being pushed, hit, called names, teased, being the target of rumours, theft, extortion) is associated with short- and long-term adjustment problems, such as peer rejection, social withdrawal, low self-esteem, anxiety, loneliness, and depression, as well as academic problems and school drop-out. Research on populations of school children (primary and secondary) has associated victimization with personal risk factors (the victim's characteristics and behaviour) and interpersonal risk factors (social relationships between peers). Studies on the social adjustment of preterm children at school age show that, even in the absence of a major motor or cognitive disability, this population has several personal risk factors associated with victimization. The objective of this study was to compare the level of victimization experienced by a group of 96 seven-year-old children born extremely preterm (EP, < 29 weeks of gestation; 49 females) against that experienced by a group of 63 term children (34 females) matched for age and sex, maternal level of education, and family socioeconomic status. The children born EP had a mean gestational age of 27.3 weeks (SD 1.2) and a mean birthweight of 1001.1g (SD 223) and normal birthweight children had a mean gestational age of 39.5 weeks (SD 1.5) and a mean birthweight of 3468.7g (SD 431). Physical and verbal victimization were assessed in a school setting by peers with individual sociometric interviews (Modified Peer Nomination Inventory). After controlling for physical growth (height and weight) at the age of 7 years, the data indicate two independent effects: males were more victimized than females, and children born preterm experienced more verbal victimization by their peers than their term classmates, even when participants with a visible motor, intellectual, or sensory disability were excluded. Several hypotheses are presented to account for the higher incidence of verbal victimization of preterm children.