The prevalence and pattern of specific learning disabilities (LD) in neurologically normal children with extremely low birth weight (ELBW) (<800 g) and average intelligence were compared with full-term children with normal birth weight in a study at the British Columbia Research Institute for Children’s and Women’s Health, University of British Columbia, Vancouver, BC. Tests included were WISC-R, Gray Oral Reading Test-R, Written Language-R, WRAT-R, and Developmental Test of Visual-Motor Integration. Of 114 children with ELBW born between 1982 and 1987 and seen at ages 8 to 9 years, 74 had IQs greater than or equal to 85 and formed the study group. Thirty full-term children with normal birth weight were the comparison group. Children in the ELBW group scored significantly lower than the comparison group on all measures. Forty-eight in the ELBW group (65%) met criteria for LD in 1 or more areas compared with 4 in the control group (13%), (P<.001). Rates of LD in written output, arithmetic, and reading were significantly higher in the ELBW group. Written output was most frequently affected (83% of children), followed by arithmetic (46%), and reading (35%). Reading achievement was significantly associated with Verbal IQ and short-term visual memory, while arithmetic achievement was significantly associated with Visual-Motor Integration and Verbal IQ Written output was correlated with Performance IQ Academic difficulties in children with ELBW reflect a complex mixture of multiple weaknesses in visuospatial, visual-motor, and verbal abilities. 
COMMENT. Multiple academic weaknesses are common in neurologically normal children with ELBW compared with control peers. Visuospatial, visual-motor, and verbal functioning correlated with performance in arithmetic and reading in ELBW children, while verbal functioning only explained performance of control children.