Education		ELBWs who escape severe disability are nevertheless at significant risk of a major disadvantage educationally. When evaluated at age 5-8 years, they fared worse than FT babies in every area required for successful functioning in a school system. And this gap between ELBWs and their NBW counterparts is likely to widen even more in high school. Here are some sobering figures: 15-20% of ELBWs require special education 20% have repeated a grade level at school by age 8 29% are involved in an individualized education plan (IEP) at school Studies consistently show ELBW's IQ is 10-20 points lower than FT babies'. A full 40% require some special assistance at school: modified schedule classroom made accessible special lunch tutoring transportation Remember this is all after excluding those with a major handicap. Teachers have characterized ELBWs as more active and anxious, distractible with difficulty staying on task, insecure and doubtful of their own abilities, giving up easily and requiring constant praise and encouragement to complete tasks, uncomfortable with adults, having poor social skills and having a problem working independently. All of these behavioral traits are negatives in the educational environment. The role of the pediatrician, mandated by the Individuals with Disabilities Education Act, includes diagnosis and evaluation of the child's disability. However, in keeping with the concept of the "medical home", as espoused by the AAP in 1992, more active involvement by the pediatrician is required. Identification of the need for subspecialty referrals, interaction with schools and community agencies, being an advocate for the child within the school and community and the coordination of medical care and health-related services are all within the domain of the pediatrician. Return to top of page