Presents a case report of a 7-year-old boy who was born extremely preterm at 25 weeks’ gestational age weighing 846 gm. Michael lives with his biological parents and two sisters aged 5 and 15 years. His father is a self-employed carpenter while his mother is a registered nurse. Michael was considered at high risk for developmental problems because of his extreme prematurity at birth and was enrolled into a follow-up surveillance program that included assessments at 2, 5, and 7 years of age. His most recent pediatric assessment at age 7 years indicated that he was in good health. He experienced occasional episodes of iron deficiency due to poor dietary intake of iron and this was being monitored and treated by his doctor. His height, weight, head circumference and blood pressure were all within the normal range. His hearing and vision were also reported to be normal, and his motor and neurological assessment revealed no signs of cerebral palsy. Basic literacy skills according to a screening assessment of single-word decoding and spelling were at, or close to, his grade level. Although his phonological awareness and processing were assessed to be age appropriate, his phonetic reading was poor. This would suggest that his early reading has been dominated by the ‘Sight Word’ approach, which may be appropriate given his working memory difficulties. On testing, his visual-spatial memory and learning was also a concern, although the measures administered were predominantly assessing memory of spatial locations rather than visual details. His math was well below grade level, and his limited acquisition of basic mathematical principles is likely to be due to a combination of factors including his poor attention, reduced working memory and visual-spatial processing deficits.