The objectives of the study were:  (1) To make required modifications in the portage early education program checklist after doing a pilot study. (2) To screen study group and control group children on language, cognitive and motor development using the modified portage checklist. (3) To find the relationship in the above three areas assessed on the modified portage checklist for the entire sample. (4) To compare performance on language, cognitive and motor between study group and control group on the modified portage checklist. (5) To find the critical item for detecting learning problems in high-risk children. (6) To make required modifications in the Brigance Diagnostic Inventory of Early Development after doing a pilot study. (7) To assess and find the prevalence of learning difficulties in reading, writing, mathematics, speech and language, general knowledge and comprehension in the group of children who were identified as not having attained developmental norms (below average group) as assessed on the modified Brigance. (8) To find the relationship between the assessment on the modified portage and Brigance. (9) To analyze the behavioral patterns of children below average group and control group as perceived by their parents and teachers using the Conners’ Parent Rating Scale and Conners’ Teacher Rating Scale. (6) To find the impact of variables, like, socio-economic status, education of mother, education of father, low birth weight, prematurely, birth asphyxia, hyperbilirubinemia, septicemia/meningitis, convulsions, type of school, medium of instruction in school, spaciousness of house, stimulation received through books, games and toys on the performance of high-risk children as assessed on the modified portage checklist.

The hypotheses of the study were: (1) There is no significant difference between performance of control group and study group on the modified portage checklist. (2) There is no significant difference between performance on the modified portage checklist in language, cognitive and motor development of the entire sample. (3) There is no significant difference between assessment on the modified portage checklist and Brigance Diagnostic Inventory of early development for below average group. (4) There is no significant difference between control group and study group on behavior rated by parents using Conners’ Parent Rating Scale. (5) There is no significant difference between control group and study group on behavior rated by teachers using Conners’ Teacher Rating Scale. (6) There is no significant agreement in perception of parents and teachers regarding behavioral problems and normal behavior of children as rated on the Conners’ Parent and Teacher Rating Scale in the study group. (7) There is no significant agreement in perception of parents and teachers in behavioral problems and normal behavior of children as rated on the Conners’ Parent and Teacher Rating Scale in the control group. (8) There is no significant effect of extraneous factors and risk factors at birth on the performance of high-risk children on the modified portage checklist.

The study consisted of 149 high-risk children from high, low and middle socio-economic strata from urban and rural areas of Pune who had been admitted in the Neonatal Intensive Care Unit (NICU) of K.E.M. Hospital, Pune. 50 children with a documented normal birth history between the ages of 4-6 years living in the same localities were identified as the control group.

Tools used were: Portage Early Education Program Checklist (birth to six years); Brigance Diagnostic Inventory of Early Development (birth to seven years), Conners’ Parent and Teaching Rating Scale, and Kuppuswamy Socio-Economic Status Scale.

For data collection, 149 study group children were assessed in their home and about 1 hours and 30 minutes were spent in each child’s home. ANOVA and t-test were used for data analysis.

The findings of the study were: (1) There was significant difference between performance of control group and study group on the modified portage checklist. (2) There was  significant difference between performance on the modified portage checklist in language, cognitive and motor development of the entire sample. (3) There was significant difference between assessment on the modified portage checklist and Brigance Diagnostic Inventory of early development for below average group. (4) There was significant difference between control group and study group on behavior rated by parents using Conners’ Parent Rating Scale. (5) There was significant difference between control group and study group on behavior rated by teachers using Conners’ Teacher Rating Scale. (6) There was significant agreement in perception of parents and teachers regarding behavioral problems and normal behavior of children as rated on the Conners’ Parent and Teacher Rating Scale in the study group. (7) There was significant agreement in perception of parents and teachers in behavioral problems and normal behavior of children as rated on the Conners’ Parent and Teacher Rating Scale in the control group. (8) There was significant effect of extraneous factors and risk factors at birth on the performance of high-risk children on the modified portage checklist. (9) The incidence of learning problems in the high-risk population was 11.2%. The incidence of similar problems in the control children was 10%. (10) The Portage Early Education Program was found to be an easy and simple test to administer. (11) All the children who were detected as below average on the portage were confirmed as below average on the Brigance. (12) A significant larger number of children from the low socio-economic strata were below average as compared to the middle and high groups. (13) A significant larger number of children from private aided schools were average and above average as compared to municipal schools. (14) A significant larger number of children from municipal schools as compared to private ‘aided’ schools were from the lower socio-economic strata. (15) A significant larger number of children from municipal schools as compared to private ‘unaided’ schools were from the low socio-economic strata. (16) Occurrence of conclusions in the neonatal period was identified as one of the important factors that affect learning ability. (17) Low SES was identified as another important factor that affects learning ability.