• 50,000 children are born each year weighing less than 3 1/3 pounds; 85% now survive to school age. Thus, 1/100 school-age children are former premature infants, grown up.
• 15% of these children have mental retardation and major motor deficits; 85% of these have medical issues relevant to the school day.
• 50% of former premature infants have substantial developmental issues outside the range of mental retardation; _ of these have medical issues relevant to the school day.
• The likelihood of prematurity and its consequences are not evenly or equally distributed across the Commonwealth; the burden is therefore not equally shared by communities.

• 2/1000 infants born at full-term are born asphyxiated; nearly all survive.
• Nearly all have significant motor and cognitive deficits.

• These issues will persist for at least the first decade of this century; more pessimistic projections suggest this will persist for the first two decades of this century.

• 1% of the school-age population has epilepsy. 85% of these children have cognitive difficulties that have significant impact upon their schooling.
• The incidence of this problem is not declining.

• Autism disorders appear to be on the increase. Conservative estimates suggest current incidence is between 2 and 4/1000.

• Attention disorders constitute between 4 and 6 % of the school-age population. Even with effective medical treatment, these children have significant academic problems.

Thus, conservative estimates suggest that 7.5% of the school-age population has a medical diagnosis that has such impact that these children cannot be expected to prosper without appropriate assistance in school. This assistance is both medical and academic. The burden of these problems is disproportionately place on poor urban population.

David K. Urion, M.D.

Director, Learning Disabilities/Behavioral Neurology Program

Department of Neurology, Children’s Hospital and Harvard Medical School

Member of the Faculty, Harvard Graduate School of Education