When not all is well : outcomes of Singaporean Chinese very low birth weight children in mainstream primary schools

Advances in perinatal care in the past decade have resulted in the increased survival of very low birth weight (VLBW) infants. These are children born with a birth weight of less than 1500 grams. The mortality and immediate morbidity, that is clear neurodevelopmental deficits such as cerebral palsy, of these infants are well documented. However, less is reported about the VLBW children who may not be obviously neurologically or intellectually deficient but experience various problems in mainstream primary schools nonetheless. Underlying this study is the concern that some of the difficulties faced by local VLBW children were obscured during the period of follow-up and that they were viewed as progressing "well' based primarily on apparently normal outcomes such as average test scores. In her capacity as a psychologist involved in the multi-disciplinary follow-up of VLBW children from two to eight years old, the author has gathered information on a sample of 107 Singaporean VLBW children of ethnic Chinese origin. Using methodological as well as investigator triangulation, quantitative and qualitative results are reported. The survey method was used to obtain the former while the latter were elicited by the case study approach. In addition, the case studies of seven VLBW children with different experiences were included. Whilst the findings are in general agreement with the published literature, the limitations of the study coupled with Singaporean factors at play meant that they may not be entirely representative of the local VLBW population at large. It is anticipated, however, that the findings will provide the reader with a deeper understanding of how Singaporean Chinese VLBW children in mainstream schools are functioning on the whole. It is also hoped that this study will serve as a signpost for future VLBW follow- up work in Singapore.