Previous studies have indicated that children of low birth weight less than 2, g are at risk for a wide variety of health and developmental problems 8 — 13 , 16 , No previous studies have, however, described a differential effect of birth weight on RD among male and female children. It is unclear why low birth weight would more strongly predispose female children than male children toward RD. Overall, while low birth weight increased the risk for RD in girls, it increased the risk only to about the level typically experienced by male children of normal birth weight. Therefore, the effect of low birth weight may not be as noticeable in boys because boys already have a higher baseline rate of RD.
We examined this group by sex to determine whether boys of low birth weight were more likely to experience other learning problems that might exclude them from the pure RD classification by using the Fisher's exact test. We found that boys of low birth weight were more likely to have attention deficit hyperactivity disorder compared with girls In addition, our results remained the same regardless of whether or not these children were included in our analyses data not shown. Therefore, the observed sex differences do not appear to be due to differential exclusion of boys from the pure RD classification.
Our data also suggest that sociodemographic factors predispose girls and boys to RD.
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For example, we found that low parental education level was associated with an overall increased risk of LD for both boys and girls. Parental education is frequently used as a marker for SES 29 , and low SES has frequently been demonstrated to be an important risk factor for later school difficulties 11 , 13 , 30 , Low SES may be a marker for parental educational difficulties i.
Overall, while low maternal and paternal education increased the risk for RD in both boys and girls, our data suggest that low parental education affected male and female children differentially. In multivariable models, low maternal education level was a significant risk factor for RD in girls, but not in boys, while low paternal education was a significant risk factor for RD in boys, but not in girls. A significant interaction was observed only between sex and maternal education.
Previous studies have suggested that maternal education tends to predict a daughter's educational attainment 32 , In addition, having female teachers as role models also predicts increased educational attainment in girls, but not in boys These studies suggest that socialization patterns for girls differ from those of boys and that appropriate female role models may improve girls' academic achievement.
By analogy, appropriate parental male role models may improve boys' academic achievement. These factors may also be important in our study population and may explain why, in our birth cohort, low maternal education is a risk factor for RD in girls, while low paternal education is a risk factor for RD in boys.
Higher paternal age 35 years or older was associated with decreased RD in girls but not in boys. It is possible that older, more educated fathers may make more of an effort to participate in their daughters' education compared with younger, less educated fathers. We thoroughly reviewed all medical and school records and independently determined whether or not a child had RD. This process allowed us to minimize some of the referral bias that may be present in studies in which the samples were derived from teacher or parent referral.
In addition, our study had a substantially larger sample size than did most previous studies of LD, allowing us to consider interactions of potential risk factors with child's sex. A potential limitation of our study is that 33 percent of the original birth cohort migrated from Olmsted County by age 5 years. Of the observed differences, none is likely to be of concern for evaluating potential RD risk factors. Because we examined 20 potential RD risk factors, it is also possible that an alpha level of 0.
Thus, to protect against type I error, a p value of 0. However, most of our reported associations low paternal education in boys and low maternal education and low birth weight in girls achieved this level of significance in univariate models table 2 , so we believe it is unlikely that our results were due to type I error. We used birth certificate data as our source for potential risk factor information. Previous studies have demonstrated that much of the information captured on birth certificates is valid and reliable, particularly that on birth weight and maternal and paternal demographic characteristics 37 — Other data, such as pregnancy, labor, and delivery complications, tend to be underreported on birth certificates 37 — Therefore, it is possible that some complications among our study population were missed.
If the children who were reading disabled had more complications of pregnancy, labor, and delivery than did children who were not reading disabled, we will underestimate the association between these complications and RD. If the children who were reading disabled had fewer pregnancy, labor, and delivery complications than children who were not reading disabled, we will overestimate the association between these complications and RD. However, we have no reason to believe that the quality of the birth certificate data varied by outcome or by sex. Further studies are needed to examine the association of other potential risk factors not included on birth certificates with RD.
These include maternal smoking, use of drugs or alcohol, hypertension, other maternal health conditions, use of medications, pre- and perinatal child illnesses, and intrauterine growth retardation. Because we did not test every child for RD, it is possible for our study results to be biased if boys and girls were differentially referred for testing.
However, our data suggest that boys were not differentially referred for testing at a higher rate than girls in our study population. Thus, in our study population, boys seemed to be slightly but not significantly more likely to be referred for further testing, and these increases were probably not sufficient to appreciably affect our study findings. Finally, because we did not test every child in our cohort for RD, it is also possible that we may have failed to identify some cases of RD.
If we failed to identify approximately equal numbers of girls and boys, our results would under-estimate any associations that might truly exist and would be a conservative estimate of associations between risk factors and RD. It is also possible that we may have failed to identify more girls than boys as having RD.
However, sensitivity analyses suggest that our observed male-female differences were not due to unidentified RD cases among girls. By applying our observed incidence rate among boys 2. Because we identified 26 cases among the girls by the Minnesota regression formula , we would have needed to miss at least 59 69 percent RD children among the remaining girls in the cohort without missing any additional cases among the remaining boys.
We believe this is highly unlikely, given our efforts at complete ascertainment. In conclusion, this study examines the interaction between sex and potential risk factors for RD.
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Our results suggest that boys and girls are significantly and differentially susceptible to potential risk factors for RD. Therefore, the biologic processes that lead to RD may be different for boys and girls. While further studies are needed to define how genetic, social, and other biologic factors may interact to contribute to the increased level of RD observed in male children compared with female children, our results suggest that boys and girls with RD may need to be considered separately in future RD studies. Oxford University Press is a department of the University of Oxford.
It furthers the University's objective of excellence in research, scholarship, and education by publishing worldwide. Sign In or Create an Account. Close mobile search navigation Article navigation. Abstract The authors conducted a case-control study to determine whether risk factors for reading disability RD differentially affect boys and girls. Reprint requests to Dr. Learning disorders with a special emphasis on reading disorders: Research initiatives in learning disabilities: J Child Psychol Psychiatry.
Male prevalence for reading disability is found in a large sample of black and white children free from ascertainment bias. J Int Neuropsychol Soc. Galaburda AM, Geschwind N. Cerebral lateralization, biological mechanisms, associations, and pathology. Prevalence of reading disability in boys and girls. Results of the Connecticut Longitudinal Study. Very low birth weight children: Cognitive abilities and school performance of extremely low birth weight children and matched term control children at age 8 years: Learning disabilities and school problems in a regional cohort of extremely low birth weight less than g children: J Dev Behav Pediatr.
Predicting school failure from information available at birth. Am J Ment Defic. Which newborns in New York City are at risk for special education placement?
Am J Public Health. Prediction of special education placement from birth certificate data. Am J Prev Med. Relationship between pregnancy and birth complications and the later development of learning disabilities.
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Can learning disabilities in children who were extremely low birth weight be identified at school entry? School performance of survivors of neonatal encephalopathy associated with birth asphyxia at term. Sex differences in the functional organization of the brain for language. Gender differences in brain and behavior: Dyslexia, gender, and brain imaging. History of the Rochester Epidemiology Project. Minnesota Department of Education. Rules of the State Board of Education.
Discrepancy compared to low achievement definitions of reading disability: Cognitive profile of reading disability: Phenotypic performance profile of children with reading disabilities. A regression-based test of the phonological-core-variable-difference model. Senate Committee on Labor and Human Resources. Epidemiology of severe mental retardation in children: Gualtieri T, Hicks RE.
An immunoreactive theory of selective male affliction. Grace and wit were prized in social interactions. A new intellectual curiosity gave rise to a healthy skepticism toward well-worn truths. The painting features an unidentified girl wearing a lemon yellow dress with white ruff collar and cuffs and purple ribbons.
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The subject is depicted in profile, reading from a small book held in her right hand, sitting with her left arm on a wooden rail and her back supported by a large lilac cushion resting against a wall. Her hair is tied in a chignon with a purple ribbon, and her face and dress are lit from the front, casting a shadow in the wall behind her. Fragonard pays close attention to the face, but uses looser brushwork on the dress and cushion, and the ruff was scratched into the paint with the end of a brush.
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The horizontal line of the armrest and a vertical line between two unadorned walls provide a sense of space and structure. The female figure in Young Girl Reading was meant to represent the natural essence of femininity. Fragonard pulls the figures hair up in a ribbon and to expose more of her neck, and also places a collar around the bottom of her neck, which both help elongate the female form.
Fragonard makes the female subjects face have a rosy-tint to it, which adds a daintier and more delicate feel to the painting. When looking closely at the book the female subject is reading in Young Girl Reading , one will notice that there is no legible writing. In Young Girl Reading, color helps convey emotion and mood. Fragonard used a typical Rococo color scheme, which consisted of soft, delicate colors and hues of gold.
The formal element of form, especially in this piece of work, help the viewers eye track the painting. The relationship between the dark background the wall and light foreground the female , or the heavy contrast, help the viewer home in on the curves and contours of the female form. Texture also helps create depth and differ between the different layers of the painting. For example, the walls, the dress, and armrest all have different textures created through different styles of brushstrokes.
The work is more a genre painting of an everyday scene than a portrait, and the name of the sitter is not known. X-ray photography has revealed that the canvas originally featured a different head looking towards the viewer, which Fragonard painted over.