The cognitive and motor abilities of 43 very low birth weight children (VLBW) and classroom controls are reported from the Greenwood Children's Centre, City Hospital, Nottingham, England. Children born in 1981 and weighing less than 1501 grams who had received treatment in the neonatal intensive care unit were followed up on entry to primary school at the age of 5 years. Those included in the study were apparently normal with no observed handicap or need for special educational services. The results on the McCarthy Scales of Children's Abilities were compared with those of matched classmates. Significant differences were found between the two groups on all six scales and were most marked on the general cognitive index. The mean IQ score for the study children was 88 compared with 101 for the controls. No child in the control group scored below 74, whereas 8 of the study children scored below 70 and were in need of special education. 
COMMENT In addition to the immediate morbidity and mortality, the cognitive deficits of very low birth weight children are a concern. One third of the VLBW infants born in the Nottingham Centre died in the neonatal period, but two-thirds appeared to be developing normally on the basis of early follow-up studies. Learning difficulties among the study group became increasingly apparent at higher educational levels, although in their first year of school none had been uncovered.