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Geva S, Hoskote A, Saini M, Clark CA, Banks T, Chong WKK, Baldeweg T, de Haan M, Vargha-Khadem F. Cognitive outcome and its neural correlates after cardiorespiratory arrest in childhood. Dev Sci 2024:e13501. [PMID: 38558493 DOI: 10.1111/desc.13501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 02/19/2024] [Accepted: 02/21/2024] [Indexed: 04/04/2024]
Abstract
Hypoxia-ischaemia (HI) can result in structural brain abnormalities, which in turn can lead to behavioural deficits in various cognitive and motor domains, in both adult and paediatric populations. Cardiorespiratory arrest (CA) is a major cause of hypoxia-ischaemia in adults, but it is relatively rare in infants and children. While the effects of adult CA on brain and cognition have been widely studied, to date, there are no studies examining the neurodevelopmental outcome of children who suffered CA early in life. Here, we studied the long-term outcome of 28 children who suffered early CA (i.e., before age 16). They were compared to a group of control participants (n = 28) matched for age, sex and socio-economic status. The patient group had impairments in the domains of memory, language and academic attainment (measured using standardised tests). Individual scores within the impaired range were most commonly found within the memory domain (79%), followed by academic attainment (50%), and language (36%). The patient group also had reduced whole brain grey matter volume, and reduced volume and fractional anisotropy of the white matter. In addition, lower performance on memory tests was correlated with bilaterally reduced volume of the hippocampi, thalami, and striatum, while lower attainment scores were correlated with bilateral reduction of fractional anisotropy in the superior cerebellar peduncle, the main output tract of the cerebellum. We conclude that patients who suffered early CA are at risk of developing specific cognitive deficits associated with structural brain abnormalities. RESEARCH HIGHLIGHTS: Our data shed light on the long-term outcome and associated neural mechanisms after paediatric hypoxia-ischaemia as a result of cardiorespiratory arrest. Patients had impaired scores on memory, language and academic attainment. Memory impairments were associated with smaller hippocampi, thalami, and striatum. Lower academic attainment correlated with reduced fractional anisotropy of the superior cerebellar peduncle.
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Affiliation(s)
- Sharon Geva
- Department of Developmental Neurosciences, University College London Great Ormond Street Institute of Child Health, London, United Kingdom of Great Britain and Northern Ireland
| | - Aparna Hoskote
- Heart and Lung Division, Institute of Cardiovascular Science, Great Ormond Street Hospital, London, United Kingdom of Great Britain and Northern Ireland
| | - Maneet Saini
- Department of Developmental Neurosciences, University College London Great Ormond Street Institute of Child Health, London, United Kingdom of Great Britain and Northern Ireland
| | - Christopher A Clark
- Department of Developmental Neurosciences, University College London Great Ormond Street Institute of Child Health, London, United Kingdom of Great Britain and Northern Ireland
| | - Tina Banks
- Department of Radiology, Great Ormond Street Hospital, London, United Kingdom of Great Britain and Northern Ireland
| | - W K Kling Chong
- Department of Developmental Neurosciences, University College London Great Ormond Street Institute of Child Health, London, United Kingdom of Great Britain and Northern Ireland
| | - Torsten Baldeweg
- Department of Developmental Neurosciences, University College London Great Ormond Street Institute of Child Health, London, United Kingdom of Great Britain and Northern Ireland
| | - Michelle de Haan
- Department of Developmental Neurosciences, University College London Great Ormond Street Institute of Child Health, London, United Kingdom of Great Britain and Northern Ireland
| | - Faraneh Vargha-Khadem
- Department of Developmental Neurosciences, University College London Great Ormond Street Institute of Child Health, London, United Kingdom of Great Britain and Northern Ireland
- Neuropsychology Service, Great Ormond Street Hospital, London, United Kingdom of Great Britain and Northern Ireland
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Kim SW, Andronis L, Seppänen AV, Aubert AM, Barros H, Draper ES, Sentenac M, Zeitlin J, Petrou S. Health-related quality of life of children born very preterm: a multinational European cohort study. Qual Life Res 2023; 32:47-58. [PMID: 35976599 PMCID: PMC9829588 DOI: 10.1007/s11136-022-03217-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/24/2022] [Indexed: 01/13/2023]
Abstract
PURPOSE This study aims to (1) describe the health-related quality of life (HRQoL) outcomes experienced by children born very preterm (28-31 weeks' gestation) and extremely preterm (< 28 weeks' gestation) at five years of age and (2) explore the mediation effects of bronchopulmonary dysplasia (BPD) and severe non-respiratory neonatal morbidity on those outcomes. METHODS This investigation was based on data for 3687 children born at < 32 weeks' gestation that contributed to the EPICE and SHIPS studies conducted in 19 regions across 11 European countries. Descriptive statistics and multi-level ordinary linear squares (OLS) regression were used to explore the association between perinatal and sociodemographic characteristics and PedsQL™ GCS scores. A mediation analysis that applied generalised structural equation modelling explored the association between potential mediators and PedsQL™ GCS scores. RESULTS The multi-level OLS regression (fully adjusted model) revealed that birth at < 26 weeks' gestation, BPD status and experience of severe non-respiratory morbidity were associated with mean decrements in the total PedsQL™ GCS score of 0.35, 3.71 and 5.87, respectively. The mediation analysis revealed that the indirect effects of BPD and severe non-respiratory morbidity on the total PedsQL™ GCS score translated into decrements of 1.73 and 17.56, respectively, at < 26 weeks' gestation; 0.99 and 10.95, respectively, at 26-27 weeks' gestation; and 0.34 and 4.80, respectively, at 28-29 weeks' gestation (referent: birth at 30-31 weeks' gestation). CONCLUSION The findings suggest that HRQoL is particularly impaired by extremely preterm birth and the concomitant complications of preterm birth such as BPD and severe non-respiratory morbidity.
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Affiliation(s)
- Sung Wook Kim
- grid.4991.50000 0004 1936 8948Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Woodstock Road, Oxford, OX2 6GG UK
| | - Lazaros Andronis
- grid.7372.10000 0000 8809 1613Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK
| | - Anna-Veera Seppänen
- grid.513249.80000 0004 8513 0030Université Paris Cité, Inserm, INRAE, Centre for Research in Epidemiology and StatisticS (CRESS), Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPé, 75004 Paris, France
| | - Adrien M. Aubert
- grid.513249.80000 0004 8513 0030Université Paris Cité, Inserm, INRAE, Centre for Research in Epidemiology and StatisticS (CRESS), Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPé, 75004 Paris, France
| | - Henrique Barros
- grid.5808.50000 0001 1503 7226EPIUnit-Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal
| | - Elizabeth S. Draper
- grid.9918.90000 0004 1936 8411Department of Health Sciences, University of Leicester, Leicester, UK
| | - Mariane Sentenac
- grid.513249.80000 0004 8513 0030Université Paris Cité, Inserm, INRAE, Centre for Research in Epidemiology and StatisticS (CRESS), Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPé, 75004 Paris, France
| | - Jennifer Zeitlin
- grid.513249.80000 0004 8513 0030Université Paris Cité, Inserm, INRAE, Centre for Research in Epidemiology and StatisticS (CRESS), Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPé, 75004 Paris, France
| | - Stavros Petrou
- grid.4991.50000 0004 1936 8948Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Woodstock Road, Oxford, OX2 6GG UK
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Associations between early efficiency in language processing and language and cognitive outcomes in children born full term and preterm: similarities and differences. Child Neuropsychol 2022:1-20. [PMID: 36324057 PMCID: PMC10151433 DOI: 10.1080/09297049.2022.2138304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Associations between children's early language processing efficiency and later verbal and non-verbal outcomes shed light on the extent to which early information processing skills support later learning across different domains of function. Examining whether the strengths of associations are similar in typically developing and at-risk populations provides an additional lens into the varying routes to learning that children may take across development. In this follow-up study, children born full-term (FT, n = 49) and preterm (PT, n = 45, ≤32 weeks gestational age, birth weight <1800 g) were assessed in the Looking While Listening (LWL) task at 18 months (corrected for degree of prematurity in PT group). This eye-tracking task assesses efficiency of real-time spoken language comprehension as accuracy and speed (RT) of processing. At 4 ½ years, children were assessed on standardized tests of receptive vocabulary, expressive language, and non-verbal IQ. Language processing efficiency was associated with both language outcomes (r2-change: 7.0-19.7%, p < 0.01), after covariates. Birth group did not moderate these effects, suggesting similar mechanisms of learning in these domains for PT and FT children. However, birth group moderated the association between speed and non-verbal IQ (r2-change: 4.5%, p < 0.05), such that an association was found in the PT but not the FT group. This finding suggests that information processing skills reflected in efficiency of real-time language processing may be recruited to support learning in a broader range of verbal and non-verbal domains in the PT compared to the FT group.
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Neurodevelopmental Outcomes in Preterm Children with Sickle Cell Disease. J Int Neuropsychol Soc 2022; 28:1039-1049. [PMID: 34839840 PMCID: PMC9148381 DOI: 10.1017/s1355617721001338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVES To explore the combined effect of pediatric sickle cell disease (SCD) and preterm birth on cognitive functioning. METHODS Cognitive functioning was examined in children ages 6-8 with high risk SCD genotypes born preterm (n = 20) and full-term (n = 59) and lower risk SCD genotypes/no SCD born preterm (n = 11) and full-term (n = 99) using tests previously shown to be sensitive to SCD-related neurocognitive deficits. Factorial ANOVAs and log linear analyses were conducted to examine the relationship between SCD risk, preterm birth status, and cognitive outcomes. Continuous scores were examined for specific tests. Children were categorized as having an abnormal screening outcome if at least one cognitive score was ≥1.5 standard deviations below the population mean. RESULTS Children with elevated risk due to high risk SCD and preterm birth performed worse than other groups on a test of expressive language but not on tests that emphasize processing speed and working memory. There was a three-way interaction between preterm status, SCD risk, and abnormal screening outcome, which was largely driven by the increased likelihood of abnormal cognitive scores for children with high risk SCD born preterm. CONCLUSIONS The combination of SCD and preterm birth may confer increased risk for language deficits and elevated rates of abnormal cognitive screenings. This suggests that neurodevelopmental risk imparted by comorbid SCD and preterm birth may manifest as heterogenous, rather than specific, patterns of cognitive deficits. Future studies are needed to clarify the domains of cognitive functioning most susceptible to disease-related effects of comorbid SCD and preterm birth.
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Quiroga Bernardos C, López Gómez S, Iglesias Souto PM, Rivas Torres RM, Taboada Ares EM. The Detection of Early Reading Performance and Its Relationship with Biopsychosocial Risk Factors in the Study of Learning Difficulties. Eur J Investig Health Psychol Educ 2022; 12:1205-1219. [PMID: 36005233 PMCID: PMC9407524 DOI: 10.3390/ejihpe12080084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 08/16/2022] [Accepted: 08/17/2022] [Indexed: 11/16/2022] Open
Abstract
The study of the multiple processes involved in learning how to read can contribute towards the early detection of good and bad readers. However, it is necessary to take into consideration different biopsychosocial risk factors (pre- and perigestational, neonatal, medical, developmental and family-related) that may have a significant impact on neurodevelopment, producing atypical cognitive development that could lead to the presence of reading difficulties. The objective of this study was to identify the main psycholinguistic abilities involved in the early reading performance and analyse their relationship to biopsychosocial risk factors. A total of 110 subjects between the ages of 4 and 7 years old and enrolled in state-run schools in Spain participated in the study. Significant correlations were found between different psycholinguistic abilities and certain biopsychosocial risk factors (having had hyperbilirubinemia, having obtained a score lower than 9 on the Apgar test, having had language problems or a sibling with dyslexia). This relationship should be taken into account in the study of learning difficulties as a potential indicator to predict later reading development and even the presence of developmental dyslexia.
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Affiliation(s)
| | | | - Patricia María Iglesias Souto
- Department of Developmental and Educational Psychology, Faculty of Psychology, University of Santiago de Compostela, 15782 Santiago, Spain
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Taylor HG, Vrantsidis DM, Neel ML, Benkart R, Busch TA, de Silva A, Udaipuria S, Maitre NL. School Readiness in 4-Year-Old Very Preterm Children. CHILDREN 2022; 9:children9030323. [PMID: 35327695 PMCID: PMC8947581 DOI: 10.3390/children9030323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 02/10/2022] [Accepted: 02/21/2022] [Indexed: 11/22/2022]
Abstract
The aims of this study were to identify the aspects of school readiness that best distinguish very preterm (VPT) preschoolers from full-term (FT) controls, determine the extent to which readiness problems in the VPT group reflected global cognitive weaknesses or more specific deficits, and identify distinct profiles of readiness problems. Fifty-three VPT (gestational age ≤ 30 weeks) 4-year-olds were compared to 38 FT (gestational age ≥ 37 weeks) controls on measures of global cognitive ability, executive function, motor skills, early literacy and numeracy, and psychosocial functioning. Latent class analysis (LCA) was also conducted to identify individual readiness profiles. The VPT group had the most pronounced difficulties on tests of spatial and nonverbal cognitive abilities, executive function, motor skills, phonological processing, and numeracy. The VPT group also had sex-related difficulties in processing speed, social functioning, and emotion regulation. These differences were evident in analyses of both continuous scores and rates of deficits. The VPT group’s difficulties in motor skills, and VPT females’ difficulties in social functioning and emotion regulation, were evident even when controlling for global cognitive ability. LCA suggested four profiles of readiness, with the majority of the VPT group assigned to profiles characterized by relative weaknesses in either cognitive abilities or psychosocial functioning or by more global readiness problems. The findings support the need to evaluate multiple aspects of school readiness in VPT preschoolers and inform efforts to design more targeted early educational interventions.
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Affiliation(s)
- H. Gerry Taylor
- Abigail Wexner Research Institute, Nationwide Children’s Hospital, Columbus, OH 43215, USA; (D.M.V.); (M.L.N.); (R.B.); (T.A.B.); (A.d.S.)
- Department of Pediatrics, The Ohio State University, Columbus, OH 43210, USA
- Correspondence: ; Tel.: +1-614-722-3184
| | - Daphne M. Vrantsidis
- Abigail Wexner Research Institute, Nationwide Children’s Hospital, Columbus, OH 43215, USA; (D.M.V.); (M.L.N.); (R.B.); (T.A.B.); (A.d.S.)
| | - Mary Lauren Neel
- Abigail Wexner Research Institute, Nationwide Children’s Hospital, Columbus, OH 43215, USA; (D.M.V.); (M.L.N.); (R.B.); (T.A.B.); (A.d.S.)
- Department of Pediatrics, The Ohio State University, Columbus, OH 43210, USA
| | - Rebekah Benkart
- Abigail Wexner Research Institute, Nationwide Children’s Hospital, Columbus, OH 43215, USA; (D.M.V.); (M.L.N.); (R.B.); (T.A.B.); (A.d.S.)
| | - Tyler A. Busch
- Abigail Wexner Research Institute, Nationwide Children’s Hospital, Columbus, OH 43215, USA; (D.M.V.); (M.L.N.); (R.B.); (T.A.B.); (A.d.S.)
| | - Aryanne de Silva
- Abigail Wexner Research Institute, Nationwide Children’s Hospital, Columbus, OH 43215, USA; (D.M.V.); (M.L.N.); (R.B.); (T.A.B.); (A.d.S.)
- Department of Pediatrics, The Ohio State University, Columbus, OH 43210, USA
| | - Shivika Udaipuria
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA;
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Walczak-Kozłowska T, Chrzan-Dętkoś M, Harciarek M. Heterogeneity of the attentional system's efficiency among very prematurely born pre-schoolers. Child Neuropsychol 2021; 28:120-142. [PMID: 34348594 DOI: 10.1080/09297049.2021.1961702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Very preterm birth increases the risk of ADHD as well as other neurodevelopmental disorders. Deficits within the attentional system were previously signaled in preterm children; however, studies lacked in consideration of an intragroup differentiation. Thus, this study aimed to verify whether deficits in the attentional mechanisms are inter-individually differentiated among very prematurely born children and if so, which biomedical and non-biomedical factors are associated with the profile of deficits within the attentional system. We tested the efficiency of attentional processes among 5-year-old children with the Attention Network Task - Child Version. The results have indicated that 26% of very preterm children presented with the suboptimal functioning of the attentional system (more than 1 SD below mean score of full-term children in attentional alerting and orienting), whereas 74% were characterized by the normal efficiency of attention. The profile of attentional deficits observed among very preterm preschoolers was associated with significantly lower birth weight and decreased family living standard. Very prematurely born children are thus a relatively heterogeneous group in terms of the efficiency of attentional system and deficits apply to only some of those children. Early developmental support aimed at enhancing attentional functioning should be addressed to children with lower birth weight in the first place.
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Affiliation(s)
- Tamara Walczak-Kozłowska
- Division of Neuropsychology, Institute of Psychology, Department of the Social Sciences, University of Gdańsk, Gdańsk, Poland
| | - Magdalena Chrzan-Dętkoś
- Division of Developmental Psychology and Psychopathology, Institute of Psychology, Department of the Social Sciences, University of Gdańsk, Gdańsk, Poland
| | - Michał Harciarek
- Division of Neuropsychology, Institute of Psychology, Department of the Social Sciences, University of Gdańsk, Gdańsk, Poland
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Townley Flores C, Gerstein A, Phibbs CS, Sanders LM. Short-Term and Long-Term Educational Outcomes of Infants Born Moderately and Late Preterm. J Pediatr 2021; 232:31-37.e2. [PMID: 33412166 DOI: 10.1016/j.jpeds.2020.12.070] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 12/23/2020] [Accepted: 12/29/2020] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To assess the relationship of moderate and late preterm birth (320/7-366/7 weeks) to long-term educational outcomes. STUDY DESIGN We hypothesized that moderate and late preterm birth would be associated with adverse outcomes in elementary school. To test this, we linked vital statistics patient discharge data from the Office of Statewide Health Planning and Development including birth outcomes, to the 2015-2016 school year administrative data of a large, urban school district (n = 72 316). We compared the relative risk of moderate and late preterm and term infants for later adverse neurocognitive and behavioral outcomes in kindergarten through the 12th grade. RESULTS After adjusting for socioeconomic status, compared with term birth, moderate and late preterm birth was associated with an increased risk of low performance in mathematics and English language arts, chronic absenteeism, and suspension. These risks emerged in kindergarten through grade 2 and remained in grades 3-5, but seemed to wash out in later grades, with the exception of suspension, which remained through grades 9-12. CONCLUSIONS Confirming our hypothesis, moderate and late preterm birth was associated with adverse educational outcomes in late elementary school, indicating that it is a significant risk factor that school districts could leverage when targeting early intervention. Future studies will need to test these relations in geographically and socioeconomically diverse school districts, include a wider variety of outcomes, and consider how early interventions moderate associations between birth outcomes and educational outcomes.
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Affiliation(s)
- Carrie Townley Flores
- Institute of Education Sciences Fellow, Center for Education Policy Analysis, Stanford University, Stanford, CA.
| | - Amy Gerstein
- John W. Gardner Center for Youth and Their Communities, Stanford University, Stanford, CA
| | - Ciaran S Phibbs
- Health Economics Resource Center, Palo Alto VA Health Care System, Department of Pediatrics, Stanford University, Stanford, CA
| | - Lee M Sanders
- Division of General Pediatrics, Center for Policy, Outcomes and Prevention, Stanford University, Stanford, CA
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Gráf R, Kalmár M, Harnos A, Boross G, Nagy A. Reading and spelling skills of prematurely born children in light of the underlying cognitive factors. Cogn Process 2021; 22:311-319. [PMID: 33108549 PMCID: PMC8179904 DOI: 10.1007/s10339-020-01001-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2019] [Accepted: 10/10/2020] [Indexed: 11/25/2022]
Abstract
Prematurity is a serious risk factor for learning difficulties. Within the academic skills reading has the greatest impact on the prospects of the students; therefore, studying the reading skills in the risk populations is very important. The aim of our study was to investigate reading and spelling skills of prematurely born children. Our target group consisted of 8-11-year-old children (n = 23) who were born preterm with very low birthweights (VLBW). For comparison 57 full-term children (27 good readers and 30 dyslexics) were included in the study sample. To assess the reading and spelling abilities the Hungarian version of the 3DM (Dyslexia Differential Diagnosis) was used. Cognitive abilities were tested using the Hungarian adaptation of the WISC-IV and the Rey Complex Figure Test. The data were analyzed with a novel statistical approach using the R program. In the cognitive measures the mean performances of all three groups fell within the normal range. In the WISC-IV Full-scale IQ as well as in some other cognitive measures the good readers significantly outperformed both the dyslexics and the preterms. The findings of the study did not confirm our expectation that VLBW prematurity should lead to developmental disadvantages in the acquisition of reading and spelling skills since in the reading and spelling performances of the good readers and the preterms did not differ, while both the good readers and the preterms scored higher than the dyslexics. The results suggest that the cognitive assets of the preterm children contributing to their reading and spelling performances were their good spatial-visual memory, working memory, and processing speed. The identification of the cognitive mechanisms underlying reading and spelling abilities is of crucial importance for designing intervention for children with deficits in these academic skills.
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Affiliation(s)
- Rózsa Gráf
- Institute of Teacher Trainig, Section of Special Education, University of Miskolc, Miskolc, Hungary.
- Department of Neonatology and Neonatal Intensive Care Unit, Péterfy Sándor Hospital, Budapest, Budapest, Hungary.
| | - Magda Kalmár
- Institute of Psychology, Eötvös Loránd University of Budapest, Budapest, Hungary
| | - Andrea Harnos
- Department of Biomathematics and Informatics, University of Veterinary Medicine, Budapest, Budapest, Hungary
| | - Gábor Boross
- Department of Neonatology and Neonatal Intensive Care Unit, Péterfy Sándor Hospital, Budapest, Budapest, Hungary
| | - Anett Nagy
- Faculty of Special Education, Eötvös Loránd University of Budapest, Budapest, Hungary
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Abstract
The societal cost of preterm birth indicates potential economic gains from interventions that reduce the incidence of preterm birth. Changes in the epidemiology of preterm birth and healthcare costs require periodic updates to cost estimates. Previously reported incremental cost estimates for the United States in 2004 were updated. The discounted present value of the excess cost associated with prematurity for the 2016 US birth cohort was estimated to be $25.2 billion: $17.1 billion for medical care of persons born preterm, $2.0 billion for delivery care, $1.3 billion for early intervention and special education, and $4.8 billion in lost productivity due to associated disabilities in adults. The nominal and inflation-adjusted incremental costs per preterm birth increased by 26% and 4%, respectively, during 2004-2016. The aggregate cost decreased by 4%, associated with declines in overall births and the preterm birth rate and changes in the distribution by gestational age.
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Affiliation(s)
- Norman J Waitzman
- Department of Economics, University of Utah, 260 Central Campus Dr., Salt Lake City, UT, USA.
| | - Ali Jalali
- Department of Population Health Sciences, Weill Cornell Medical College, New York, NY, USA
| | - Scott D Grosse
- Centers for Disease Control and Prevention, National Center on Birth Defects and Developmental Disabilities, Atlanta, GA, USA
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Heikkinen M, Kallankari H, Partanen L, Korkalainen N, Kaukola T, Yliherva A. Children born before 32 weeks of gestation displayed impaired reading fluency, comprehension and spelling skills at 9 years of age. Acta Paediatr 2021; 110:521-527. [PMID: 32609898 DOI: 10.1111/apa.15456] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Revised: 06/16/2020] [Accepted: 06/25/2020] [Indexed: 12/01/2022]
Abstract
AIM Our aim was to study whether prematurity, associated with prenatal and neonatal risk factors, affects specific literacy skills among school children born at a very low gestational age (VLGA) of <32 weeks. METHODS The study group comprised 76 prospectively followed VLGA children born between November 1998 and November 2002 at Oulu University Hospital, Finland, and 51 term controls. The median gestational age of the VLGA children was 29.0 (24.1-31.9) weeks. All children were examined at a median age of 8.9 (8.0-9.9) years in Oulu between November 2007 and November 2011. Reading fluency, comprehension and spelling skills were evaluated using standardised tests for Finnish-speaking children. RESULTS Very low gestational age children had significantly poorer test results in reading comprehension (median 6.9 vs 8.3, P = .014) and spelling (median 35.7 vs 38.0, P = .013) than term children. Furthermore, VLGA children more often performed below the 10th percentile normal values in spelling (P = .012) compared with term controls. Foetal growth restriction was associated with lower scoring in reading fluency (P = .023) and spelling (P = .004) among VLGA children. CONCLUSION Very low gestational age school children performed poorer in reading comprehension and spelling than term children. In addition, poor foetal growth in VLGA children was associated with literacy problems.
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Affiliation(s)
- Minna Heikkinen
- Faculty of Humanities Child Language Research Center University of Oulu Oulu Finland
| | - Hanna Kallankari
- PEDEGO Research Unit and Medical Research Center Oulu University of Oulu Oulu Finland
- Department of Child Neurology Oulu University Hospital Oulu Finland
| | - Lea Partanen
- Faculty of Humanities Child Language Research Center University of Oulu Oulu Finland
| | - Noora Korkalainen
- PEDEGO Research Unit and Medical Research Center Oulu University of Oulu Oulu Finland
| | - Tuula Kaukola
- PEDEGO Research Unit and Medical Research Center Oulu University of Oulu Oulu Finland
- Department of Neonatology Oulu University Hospital Oulu Finland
| | - Anneli Yliherva
- Faculty of Humanities Child Language Research Center University of Oulu Oulu Finland
- Logopedics, Faculty of Social Sciences University of Tampere Tampere Finland
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de Silva A, Neel ML, Maitre N, Busch T, Taylor HG. Resilience and vulnerability in very preterm 4-year-olds. Clin Neuropsychol 2020; 35:904-924. [DOI: 10.1080/13854046.2020.1817565] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Aryanne de Silva
- Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, OH, USA
- Department of Pediatrics, The Ohio State University, Columbus, OH, USA
| | - Mary Lauren Neel
- Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, OH, USA
- Department of Pediatrics, The Ohio State University, Columbus, OH, USA
| | - Nathalie Maitre
- Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, OH, USA
- Department of Pediatrics, The Ohio State University, Columbus, OH, USA
| | - Tyler Busch
- Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, OH, USA
| | - H. Gerry Taylor
- Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, OH, USA
- Department of Pediatrics, The Ohio State University, Columbus, OH, USA
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Barnes-Davis ME, Williamson BJ, Merhar SL, Holland SK, Kadis DS. Extremely preterm children exhibit altered cortical thickness in language areas. Sci Rep 2020; 10:10824. [PMID: 32616747 PMCID: PMC7331674 DOI: 10.1038/s41598-020-67662-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Accepted: 06/11/2020] [Indexed: 11/30/2022] Open
Abstract
Children born extremely preterm (< 28 weeks gestation, EPT) are at increased risk for language and other neurocognitive deficits compared to term controls (TC). Prior studies have reported both increases and decreases in cortical thickness in EPT across the cerebrum. These studies have not formally normalized for intracranial volume (ICV), which is especially important as EPT children often have smaller stature, head size, and ICV. We previously reported increased interhemispheric functional and structural connectivity in a well-controlled group of school-aged EPT children with no known brain injury or neurological deficits. Functional and structural hyperconnectivity between left and right temporoparietal regions was positively related with language scores in EPT, which may be reflected in measures of cortical thickness. To characterize possible language network cortical thickness effects, 15 EPT children and 15 TC underwent standardized assessments of language and structural magnetic resonance imaging at 4 to 6 years of age. Images were subjected to volumetric and cortical thickness analyses using FreeSurfer. Whole-brain analyses of cortical thickness were conducted both with and without normalization by ICV. Non-normalized results showed thinner temporal cortex for EPT, while ICV-normalized results showed thicker cortical regions in the right temporal lobe (FDRq = 0.05). Only ICV-normalized results were significantly related to language scores, with right temporal cortical thickness being positively correlated with performance.
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Affiliation(s)
- Maria E Barnes-Davis
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, USA. .,Perinatal Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, USA.
| | | | - Stephanie L Merhar
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, USA.,Perinatal Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, USA
| | - Scott K Holland
- Medpace Imaging Core Laboratory, Medpace Inc, Cincinnati, USA.,Department of Physics, University of Cincinnati, Cincinnati, USA
| | - Darren S Kadis
- Neurosciences and Mental Health, Hospital for Sick Children, Toronto, Canada.,Department of Physiology, University of Toronto, Toronto, Canada
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Pineda R, Liszka L, Inder T. Early neurobehavior at 30 weeks postmenstrual age is related to outcome at term equivalent age. Early Hum Dev 2020; 146:105057. [PMID: 32470768 PMCID: PMC7377927 DOI: 10.1016/j.earlhumdev.2020.105057] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 03/03/2020] [Accepted: 05/04/2020] [Indexed: 10/24/2022]
Abstract
AIMS To determine 1) the relationship between infant medical factors and early neurobehavior, and 2) the relationship between early neurobehavior at 30 weeks postmenstrual age (PMA) and neurobehavior at term equivalent age. STUDY DESIGN In this prospective longitudinal study, 88 very preterm infants born ≤30 weeks estimated gestational age (EGA) had neurobehavioral assessments at 30 weeks PMA using the Premie-Neuro and at term equivalent age using the NICU Network Neurobehavioral Scale (NNNS) and Hammersmith Neonatal Neurological Evaluation (HNNE). RESULTS Lower Premie-Neuro scores at 30 weeks PMA were related to being more immature at birth (p = 0.01; β = 3.87); the presence of patent ductus arteriosus (PDA; p < 0.01; β = -16.50) and cerebral injury (p < 0.01; β = -20.46); and prolonged exposure to oxygen therapy (p < 0.01; β = -0.01), endotracheal intubation (p < 0.01; β = -0.23), and total parenteral nutrition (p < 0.01; β = -0.35). After controlling for EGA, PDA, and number of days of endotracheal intubation, lower Premie-Neuro scores at 30 weeks PMA were independently related to lower total HNNE scores at term (p < 0.01; β = 0.12) and worse outcome on the NNNS with poorer quality of movement (p < 0.01; β = 0.02) and more stress (p < 0.01; ß = -0.004), asymmetry (p = 0.01; β = -0.04), excitability (p < 0.01; β = -0.05) and suboptimal reflexes (p < 0.01; ß = -0.06). CONCLUSION Medical factors were associated with early neurobehavioral performance at 30 weeks PMA. Early neurobehavior at 30 weeks PMA was a good marker of adverse neurobehavior at NICU discharge.
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Affiliation(s)
- Roberta Pineda
- University of Southern California, Chan Division of Occupational Science and Occupational Therapy, Los Angeles, CA, United States of America; Keck School of Medicine, Department of Pediatrics, Los Angeles, CA, United States of America; Washington University School of Medicine, Program in Occupational Therapy, St. Louis, MO, United States of America.
| | - Lara Liszka
- Washington University School of Medicine, Program in Occupational Therapy, St. Louis, MO, United States of America; Seattle Children's Hospital, Seattle, WA, United States of America
| | - Terrie Inder
- Brigham and Women's Hospital, Department of Pediatric Newborn Medicine, Boston, MA, United States of America; Harvard University, Harvard Medical School, Boston, MA, United States of America
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15
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McBryde M, Fitzallen GC, Liley HG, Taylor HG, Bora S. Academic Outcomes of School-Aged Children Born Preterm: A Systematic Review and Meta-analysis. JAMA Netw Open 2020; 3:e202027. [PMID: 32242904 PMCID: PMC7125435 DOI: 10.1001/jamanetworkopen.2020.2027] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
IMPORTANCE Children born preterm are at an elevated risk of academic underachievement. However, the extent to which performance across domain-specific subskills in reading and mathematics is associated with preterm birth remains unclear. OBJECTIVE To conduct a systematic review and meta-analysis of academic outcomes of school-aged children born preterm, compared with children born at term, appraising evidence for higher- and lower-order subskills in reading and mathematics. DATA SOURCES PubMed/MEDLINE, PsycINFO, and the Cumulative Index of Nursing and Allied Health Literature electronic databases from January 1, 1980, to July 30, 2018, were searched for population, exposure, and outcome terms such as child (population), preterm birth (exposure), and education* (outcome). STUDY SELECTION Peer-reviewed English-language publications that included preterm-born children and a comparison group of term-born children aged 5 to 18 years and born during or after 1980 and that reported outcomes on standardized assessments from cohort or cross-sectional studies were screened. Of the 9833 articles screened, 33 unique studies met the inclusion criteria. DATA EXTRACTION AND SYNTHESIS Data were analyzed from August 1 to September 29, 2018. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines were followed. Two reviewers independently screened the databases and extracted sample characteristics and outcomes scores. Pooled mean differences (MDs) were analyzed using random-effects models. MAIN OUTCOMES AND MEASURES Performance on standardized assessment of higher-order subskills of reading comprehension and applied mathematics problems; lower-order reading subskills of decoding, pseudoword decoding, and word identification; and lower-order mathematics subskills of knowledge, calculation, and fluency. RESULTS Outcomes data were extracted for 4006 preterm and 3317 term-born children, totaling 7323 participants from 33 unique studies. Relative to children born at term, children born preterm scored significantly lower in reading comprehension (mean difference [MD], -7.96; 95% CI, -12.15 to -3.76; I2 = 81%) and applied mathematical problems (MD, -11.41; 95% CI, -17.57 to -5.26; I2 = 91%) assessments. Across the assessments of lower-order skills, children born preterm scored significantly lower than their term-born peers in calculation (MD, -10.57; 95% CI, -15.62 to -5.52; I2 = 92%), decoding (MD, -10.18; 95% CI, -16.83 to -3.53; I2 = 71%), mathematical knowledge (MD, -9.88; 95% CI, -11.68 to -8.08; I2 = 62%), word identification (MD, -7.44; 95% CI, -9.08 to -5.80; I2 = 69%), and mathematical fluency (MD, -6.89; 95% CI, -13.54 to -0.23; I2 = 72%). The associations remained unchanged after sensitivity analyses for reducing heterogeneity. CONCLUSIONS AND RELEVANCE These findings provide evidence that preterm birth is associated with academic underperformance in aggregate measures of reading and mathematics, as well as a variety of related subskills.
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Affiliation(s)
- Melinda McBryde
- Currently graduate students at School of Psychology, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, Australia
- Mothers, Babies and Women’s Health Program, Mater Research Institute, Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - Grace C. Fitzallen
- Currently graduate students at School of Psychology, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, Australia
- Mothers, Babies and Women’s Health Program, Mater Research Institute, Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - Helen G. Liley
- Mothers, Babies and Women’s Health Program, Mater Research Institute, Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - H. Gerry Taylor
- Abigail Wexner Research Institute, Biobehavioral Health Centre, Nationwide Children’s Hospital, Columbus, Ohio
- Department of Pediatrics, The Ohio State University, Columbus
| | - Samudragupta Bora
- Mothers, Babies and Women’s Health Program, Mater Research Institute, Faculty of Medicine, The University of Queensland, Brisbane, Australia
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16
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O'Reilly H, Johnson S, Ni Y, Wolke D, Marlow N. Neuropsychological Outcomes at 19 Years of Age Following Extremely Preterm Birth. Pediatrics 2020; 145:peds.2019-2087. [PMID: 31924688 DOI: 10.1542/peds.2019-2087] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/24/2019] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Children born extremely preterm (EP) (<26 weeks' gestation) have lower cognitive scores and an increased rate of cognitive impairment compared with their term-born peers. However, the neuropsychological presentation of these EP individuals in adulthood has not been described. The aim of this study was to examine neuropsychological outcomes in early adulthood after EP birth in the 1995 EPICure cohort and to investigate if the rate of intellectual impairment changed longitudinally. METHODS A total of 127 young adults born EP and 64 term-born controls had a neuropsychological assessment at 19 years of age examining general cognitive abilities (IQ), visuomotor abilities, prospective memory, and aspects of executive functions and language. RESULTS Adults born EP scored significantly lower than term-born controls across all neuropsychological tests with effect sizes (Cohen's d) of 0.7 to 1.2. Sixty percent of adults born EP had impairment in at least 1 neuropsychological domain; deficits in general cognitive functioning and visuomotor abilities were most frequent. The proportion of EP participants with an intellectual impairment (IQ <70) increased by 6.7% between 11 and 19 years of age (P = .02). Visuospatial functioning in childhood predicted visuomotor functioning at 19 years. CONCLUSIONS Adults born EP continue to perform lower than their term-born peers in general cognitive abilities as well as across a range of neuropsychological functions, indicating that these young adults do not show improvement overtime. The prevalence of intellectual impairment increased from 11 years into adulthood.
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Affiliation(s)
- Helen O'Reilly
- Institute for Women's Health, University College London, London, United Kingdom; h.o'.,Department of Psychology, University College Dublin, Dublin, Ireland
| | - Samantha Johnson
- Department of Health Sciences, George Davies Centre, University of Leicester, Leicester, United Kingdom; and
| | - Yanyan Ni
- Institute for Women's Health, University College London, London, United Kingdom
| | - Dieter Wolke
- Division of Mental Health and Wellbeing, Department of Psychology, Warwick Medical School, University of Warwick, Coventry, United Kingdom
| | - Neil Marlow
- Institute for Women's Health, University College London, London, United Kingdom
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17
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Barnes-Davis ME, Williamson BJ, Merhar SL, Holland SK, Kadis DS. Rewiring the extremely preterm brain: Altered structural connectivity relates to language function. Neuroimage Clin 2020; 25:102194. [PMID: 32032818 PMCID: PMC7005506 DOI: 10.1016/j.nicl.2020.102194] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 01/20/2020] [Accepted: 01/21/2020] [Indexed: 11/26/2022]
Abstract
Children born preterm are at increased risk for cognitive impairment, with higher-order functions such as language being especially vulnerable. Previously, we and others have reported increased interhemispheric functional connectivity in children born extremely preterm; the finding appears at odds with literature showing decreased integrity of the corpus callosum, the primary commissural bundle, in preterm children. We address the apparent discrepancy by obtaining advanced measures of structural connectivity in twelve school-aged children born extremely preterm (<28 weeks) and ten term controls. We hypothesize increased extracallosal structural connectivity might support the functional hyperconnectivity we had previously observed. Participants were aged four to six years at time of study and groups did not differ in age, sex, race, ethnicity, or socioeconomic status. Whole-brain and language-network-specific (functionally-constrained) connectometry analyses were performed. At the whole-brain level, preterm children had decreased connectivity in the corpus callosum and increased connectivity in the cerebellum versus controls. Functionally-constrained analyses revealed significantly increased extracallosal connectivity between bilateral temporal regions in preterm children (FDRq <0.05). Connectivity within these extracallosal pathways was positively correlated with performance on standardized language assessments in children born preterm (FDRq <0.001), but unrelated to performance in controls. This is the first study to identify anatomical substrates for increased interhemispheric functional connectivity in children born preterm; increased reliance on an extracallosal pathway may represent a biomarker for resiliency following extremely preterm birth.
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Affiliation(s)
- Maria E Barnes-Davis
- Perinatal Institute, Cincinnati Children's Hospital Medical Center, United States; Department of Pediatrics, University of Cincinnati College of Medicine, United States.
| | - Brady J Williamson
- Department of Psychology, University of Cincinnati, United States; Pediatric Neuroimaging Research Consortium, Cincinnati Children's Hospital Medical Center, United States
| | - Stephanie L Merhar
- Perinatal Institute, Cincinnati Children's Hospital Medical Center, United States; Department of Pediatrics, University of Cincinnati College of Medicine, United States
| | - Scott K Holland
- Department of Physics, University of Cincinnati, United States; Medpace Imaging Core Laboratory, Medpace Inc., United States
| | - Darren S Kadis
- Neurosciences and Mental Health Research Institute, Hospital for Sick Children, Canada; Department of Physiology, Faculty of Medicine, University of Toronto, Canada
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18
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Babik I, Cunha AB, Moeyaert M, Hall ML, Paul DA, Mackley A, Lobo MA. Feasibility and Effectiveness of Intervention With the Playskin Lift Exoskeletal Garment for Infants at Risk. Phys Ther 2019; 99:666-676. [PMID: 31155661 PMCID: PMC6545275 DOI: 10.1093/ptj/pzz035] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Accepted: 01/01/2019] [Indexed: 11/14/2022]
Abstract
BACKGROUND Infants born preterm and/or with brain injury often exhibit delays in the development of reaching and object exploration, increasing their risk of associated delays in cognitive development. OBJECTIVE The objective of this study was to longitudinally evaluate feasibility of use of the novel Playskin Lift exoskeletal garment (Playskin; developed and trademarked by Dr. Lobo's Super Suits FUNctional Fashion and Wearable Technology Program at the University of Delaware, Newark, DE, USA), the assistive and rehabilitative effects of intervention with the garment on reaching and object exploration ability, and to relate changes in reaching and object exploration to changes in cognition during intervention for infants at risk for developmental delays. DESIGN A multiple baseline single-case design with 1- to 2-month Baseline, 4-month Intervention, and 1-month Postintervention phases was implemented. METHODS Ten infants born preterm and/or with brain injury, mean [SD] age 2.2 [1.3] months at the beginning of the study, were assessed biweekly throughout the study both with and without the Playskin Lift. Assessments included a Reaching Assessment and the cognitive subscale of the Bayley Scales of Infant and Toddler Development. Reaching and object exploration behaviors were coded from videos of the Reaching Assessment. Results were analyzed using multilevel modeling in SAS. RESULTS The Playskin Lift improved infants' reaching ability, hand orientation for grasp and object exploration, and multimodal object exploration when worn within sessions, especially during the Intervention phase. The garment also improved independent reaching and object exploration across time during the Intervention phase, with retention of gains in the Postintervention phase. Improvement in reaching ability was positively related to changes in cognitive outcomes during the Intervention phase. LIMITATIONS Limitations included modest sample size and the potential confounds of development and experience with time. CONCLUSIONS The Playskin Lift can serve as a feasible, effective, and accessible assistive and rehabilitative device to advance reaching, object exploration, and cognition for infants at risk for future delays.
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Affiliation(s)
- Iryna Babik
- Biomechanics & Movement Science Program, Department of Physical Therapy, University of Delaware, Newark, Delaware
| | - Andrea B Cunha
- Biomechanics & Movement Science Program, Department of Physical Therapy, University of Delaware
| | - Mariola Moeyaert
- Division of Educational Psychology & Methodology, State University of New York at Albany, Albany, New York
| | - Martha L Hall
- Biomechanics & Movement Science Program, Department of Physical Therapy, University of Delaware
| | - David A Paul
- Departments of Pediatrics and Neonatology, Christiana Care Health System, Newark, Delaware
| | - Amy Mackley
- Departments of Pediatrics and Neonatology, Christiana Care Health System
| | - Michele A Lobo
- Biomechanics & Movement Science Program, 210K CHS Building, 540 S. College Avenue, University of Delaware, Newark, DE 19713 (USA),Address all correspondence to Dr Lobo at:
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19
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Abstract
OBJECTIVES Research on developmental outcomes of preterm birth has traditionally focused on adverse effects. This study investigated the prevalence and correlates of resilience in 146 extremely preterm/extremely low birth weight (EPT/ELBW) children (gestational age <28 weeks and/or birth weight <1000 g) attending kindergarten and 111 term-born normal birth weight (NBW) controls. METHODS Adaptive competence (i.e., "resilience" in the EPT/ELBW group) was defined by scores within grade expectations on achievement tests and the absence of clinically elevated parent ratings of child behavior problems. The "adaptive" children who met these criteria were compared to the "maladaptive" children who did not on child and family characteristics. Additional analyses were conducted to assess the conjoint effects of group (ELBW vs. NBW) and family factors on adaptive competence. RESULTS A substantial minority of the EPT/ELBW group (45%) were competent compared to a majority of NBW controls (73%), odds ratio (95% confidence interval)=0.26 (0.15, 0.45), p<.001. Adaptive competence was associated with higher cognitive skills, more favorable ratings of behavior and learning not used to define adaptive competence, and more advantaged family environments in both groups, as well as with a lower rate of earlier neurodevelopmental impairment in the EPT/ELBW group. Higher socioeconomic status and more favorable proximal home environments were associated with competence independent of group, and group differences in competence persisted across the next two school years. CONCLUSIONS The findings document resilience in kindergarten children with extreme prematurity and highlight the role of environmental factors as potential influences on outcome. (JINS, 2019, 25, 362-374).
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20
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Predicting text reading skills at age 8 years in children born preterm and at term. Early Hum Dev 2019; 130:80-86. [PMID: 30708270 PMCID: PMC6402954 DOI: 10.1016/j.earlhumdev.2019.01.012] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Revised: 01/08/2019] [Accepted: 01/15/2019] [Indexed: 12/20/2022]
Abstract
BACKGROUND Children born preterm are at risk for developing reading difficulties and for decrements in other cognitive skills compared to children born at term. AIMS To assess how domains of function, often negatively impacted by preterm birth, predict reading development in children born preterm and at term. STUDY DESIGN Longitudinal descriptive cohort study. SUBJECTS Preterm (n = 48; gestational age 22-32 weeks, 30 males) and term (n = 41, 18 males) participants were assessed at age 6 years on a battery of verbal and non-verbal cognitive skills and reassessed at age 8 using the Gray Oral Reading Tests-5. Linear regressions assessed the contributions of phonological awareness, language, executive function, and non-verbal IQ at age 6 to reading outcome at age 8. RESULTS Children born preterm had lower scores than children born at term on all measures (Cohen's d from 0.46 to 1.08, all p < .05). Phonological awareness and language abilities predicted reading in both groups (accounting for 19.9% and 25.0% of variance, respectively, p < .001). Birth group did not moderate the association. By contrast, the association between executive function and non-verbal intelligence and reading outcome was moderated by birth group (interaction accounted for 3.9-6.7% of variance, respectively, p < .05). Positive predictions to reading from executive function and non-verbal IQ were found only in children born preterm. CONCLUSIONS Non-verbal cognitive skills improved the prediction of reading outcome only in the preterm group, suggesting that reading decrements represent a component of global deficits. These findings have implications for evaluation of children born preterm at school entry and treatment of reading difficulties.
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21
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Lowe JR, Fuller JF, Do BT, Vohr BR, Das A, Hintz SR, Watterberg KL, Higgins RD. Behavioral problems are associated with cognitive and language scores in toddlers born extremely preterm. Early Hum Dev 2019; 128:48-54. [PMID: 30522091 PMCID: PMC6425758 DOI: 10.1016/j.earlhumdev.2018.11.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Revised: 11/16/2018] [Accepted: 11/17/2018] [Indexed: 12/29/2022]
Abstract
OBJECTIVE To evaluate the relationship of parent-reported child behaviors on the Child Behavior Checklist (CBCL) to cognition, language, and motor skills on the Bayley Scales of Infant and Toddler Development - III (Bayley-III) in toddlers born extremely preterm. STUDY DESIGN Toddlers born extremely preterm (gestational ages 22 0/7 to 26 6/7 weeks) were tested at 22-26 months corrected age with Bayley-III while parents completed the CBCL. Socio-demographic variables and medical history were recorded. Linear regression models were used to assess the relationship of Bayley-III cognitive, motor, and language scores with CBCL scores, adjusting for medical and socio-demographic factors. RESULTS Internalizing, affective, and pervasive development problem behavior scores on the CBCL correlated significantly with lower Bayley-III cognitive, language, and motor scores on unadjusted and adjusted analyses. Although externalizing and anxiety problems were significantly associated with cognitive and language scores on unadjusted analysis, the relationships were not significant after adjusting for socio-economic factors. CBCL scores were similar for boys and girls, with the exception of the pervasive developmental problem scale; boys had significantly more problems than girls (p = 0.02). CONCLUSIONS This study showed that parent reported behavior problems were related to lower cognitive, language, and motor development in toddlers born extremely preterm. Early findings of behavioral problems in toddlers born extremely premature may help identify children at greater risk for later learning difficulties. Adding a measure of behavior to the evaluation of these children may help better understand factors that can contribute to delays, especially in cognition and language.
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Affiliation(s)
- Jean R Lowe
- Department of Pediatrics, University of New Mexico Health Sciences Center, Albuquerque, NM, USA
| | - Janell F Fuller
- Department of Pediatrics, University of New Mexico Health Sciences Center, Albuquerque, NM, USA.
| | - Barbara T Do
- Social, Statistical and Environmental Sciences Unit, RTI International, Research Triangle Park, NC, USA
| | - Betty R Vohr
- Department of Pediatrics, Women & Infants Hospital, Brown University, Providence, RI, USA
| | - Abhik Das
- Social, Statistical and Environmental Sciences Unit, RTI International, Rockville, MD, USA
| | - Susan R Hintz
- Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto, CA, USA
| | - Kristi L Watterberg
- Department of Pediatrics, University of New Mexico Health Sciences Center, Albuquerque, NM, USA
| | - Rosemary D Higgins
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA
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22
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Taylor HG, Orchinik L, Fristad MA, Minich N, Klein N, Espy KA, Schluchter M, Hack M. Associations of Attention Deficit Hyperactivity Disorder (ADHD) at School Entry with Early Academic Progress in Children Born Prematurely and Full-Term Controls. LEARNING AND INDIVIDUAL DIFFERENCES 2019; 69:1-10. [PMID: 31223221 PMCID: PMC6586420 DOI: 10.1016/j.lindif.2018.10.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- H Gerry Taylor
- Center for Biobehavioral Health, Nationwide Children's Hospital Research Institute and Department of Pediatrics, The Ohio State University, Columbus, OH
- Department of Pediatrics, Case Western Reserve University and Rainbow Babies & Children's Hospital, University Hospitals Cleveland Medical Center, Cleveland, OH
| | - Leah Orchinik
- Department of Pediatrics, Nemours/Alfred I. DuPont Hospital for Children, Wilmington, DE and Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA
| | - Mary A Fristad
- Department of Psychiatry and Behavioral Health, The Ohio State University, Columbus, OH
| | - Nori Minich
- Department of Pediatrics, Case Western Reserve University and Rainbow Babies & Children's Hospital, University Hospitals Cleveland Medical Center, Cleveland, OH
| | - Nancy Klein
- Department of Education, Cleveland State University, Cleveland, OH
| | | | - Mark Schluchter
- Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH
| | - Maureen Hack
- Department of Pediatrics, Case Western Reserve University and Rainbow Babies & Children's Hospital, University Hospitals Cleveland Medical Center, Cleveland, OH
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23
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Neurodevelopmental outcome and adaptive behaviour in extremely low birth weight infants at 2 years of corrected age. Early Hum Dev 2019; 128:81-85. [PMID: 30584982 DOI: 10.1016/j.earlhumdev.2018.12.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Revised: 12/18/2018] [Accepted: 12/18/2018] [Indexed: 11/23/2022]
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24
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Reid LD, Strobino DM. A Population-Based Study of School Readiness Determinants in a Large Urban Public School District. Matern Child Health J 2018; 23:325-334. [PMID: 30569300 DOI: 10.1007/s10995-018-2666-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Objectives We examined biologic and social determinants of school readiness in an urban population and whether childcare altered these associations. Methods A retrospective cohort study was conducted using school readiness data linked to birth certificates of first-time kindergarten students (n = 39,463) in a large, urban public-school district during 2002-2012. Multivariate linear regression models compared mean readiness scores (MRS) for students born low birthweight (LBW) or preterm (PTB) and by childcare type, adjusting for other student and parent risk factors. Results MRSs for moderately LBW (1000-2499 g), extremely LBW (< 1000 g), moderately PTB (28-36 weeks), early-term (37-38 weeks) and post-term (42 + weeks) students were significantly lower than scores for their normal weight or full-term peers, adjusting for childcare type and other student and parent characteristics. Childcare was an important predictor of MRSs. MRSs were highest for district prekindergarten (PK) students and for students of mothers with greater years of education. Conclusions for Practice Social and biologic differences in MRSs for children entering school in a large urban public-school district suggest the need for greater attention to family and child health backgrounds. Increased enrollment in formal childcare may improve school readiness in these settings.
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Affiliation(s)
- Lawrence D Reid
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe Street, Baltimore, MD, 21205, USA.
| | - Donna M Strobino
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe Street, Baltimore, MD, 21205, USA
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25
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Taylor HG, Klein N, Espy KA, Schluchter M, Minich N, Stilp R, Hack M. Effects of extreme prematurity and kindergarten neuropsychological skills on early academic progress. Neuropsychology 2018; 32:809-821. [PMID: 30124312 DOI: 10.1037/neu0000434] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVE The study was designed to investigate the effect of extreme prematurity on growth in academic achievement across the early school years and the validity of kindergarten neuropsychological skills as predictors of achievement. METHOD A 2001-2003 birth cohort of 145 extremely preterm/extremely low birth weight (EPT/ELBW) children from a single medical center, along with 111 normal birth weight (NBW) classmate controls, were recruited during their first year in kindergarten and followed annually across the next 2 years in school. Mixed model analysis was conducted to compare the groups on growth in achievement across years and examine kindergarten neuropsychological skills as predictors of growth. RESULTS The EPT/ELBW group scored significantly below NBW controls on all achievement tests across years and had higher rates of special education placement and grade repetition. Despite limited catch-up of the EPT/ELBW group to the NBW controls in spelling, group differences were generally stable. Differences in spelling and mathematics achievement remained significant when controlling for global intelligence or excluding children who had intellectual or neurosensory impairments or repeated a grade. Higher scores on kindergarten tests of multiple neuropsychological ability domains predicted higher achievement levels and steeper growth in achievement. CONCLUSIONS The findings document persistent academic weaknesses in EPT/ELBW children across the early school years. Results point to the need for preschool interventions to enhance academic readiness and suggest that neuropsychological skills assessed in kindergarten are useful in identifying individual differences in early learning progress. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
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Affiliation(s)
| | - Nancy Klein
- Department of Education, Cleveland State University
| | | | - Mark Schluchter
- Department of Population and Quantitative Health Sciences, Case Western Reserve University
| | - Nori Minich
- Department of Pediatrics, Case Western Reserve University
| | | | - Maureen Hack
- Department of Pediatrics, Case Western Reserve University
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Twilhaar ES, de Kieviet JF, Aarnoudse-Moens CSH, van Elburg RM, Oosterlaan J. Academic performance of children born preterm: a meta-analysis and meta-regression. Arch Dis Child Fetal Neonatal Ed 2018; 103:F322-F330. [PMID: 28847871 PMCID: PMC6047144 DOI: 10.1136/archdischild-2017-312916] [Citation(s) in RCA: 97] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Revised: 06/28/2017] [Accepted: 07/12/2017] [Indexed: 11/17/2022]
Abstract
BACKGROUND Advances in neonatal healthcare have resulted in decreased mortality after preterm birth but have not led to parallel decreases in morbidity. Academic performance provides insight in the outcomes and specific difficulties and needs of preterm children. OBJECTIVE To study academic performance in preterm children born in the antenatal steroids and surfactant era and possible moderating effects of perinatal and demographic factors. DESIGN PubMed, Web of Science and PsycINFO were searched for peer-reviewed articles. Cohort studies with a full-term control group reporting standardised academic performance scores of preterm children (<37 weeks of gestation) at age 5 years or older and born in the antenatal steroids and surfactant era were included. Academic test scores and special educational needs of preterm and full-term children were analysed using random effects meta-analysis. Random effects meta-regressions were performed to explore the predictive role of perinatal and demographic factors for between-study variance in effect sizes. RESULTS The 17 eligible studies included 2390 preterm children and 1549 controls. Preterm children scored 0.71 SD below full-term peers on arithmetic (p<0.001), 0.44 and 0.52 SD lower on reading and spelling (p<0.001) and were 2.85 times more likely to receive special educational assistance (95% CI 2.12 to 3.84, p<0.001). Bronchopulmonarydysplasia explained 44% of the variance in academic performance (p=0.006). CONCLUSION Preterm children born in the antenatal steroids and surfactant era show considerable academic difficulties. Preterm children with bronchopulmonarydysplasia are at particular risk for poor academic outcome.
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Affiliation(s)
- E Sabrina Twilhaar
- Clinical Neuropsychology Section, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Jorrit F de Kieviet
- Clinical Neuropsychology Section, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Cornelieke SH Aarnoudse-Moens
- Clinical Neuropsychology Section, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands,Emma Children’s Hospital AMC, Amsterdam, The Netherlands
| | - Ruurd M van Elburg
- Emma Children’s Hospital AMC, Amsterdam, The Netherlands,Nutricia Research, Utrecht, The Netherlands,Department of Paediatrics, Vrije Universiteit Medical Center, Amsterdam, The Netherlands
| | - Jaap Oosterlaan
- Clinical Neuropsychology Section, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands,Emma Children’s Hospital AMC, Amsterdam, The Netherlands,Department of Paediatrics, Vrije Universiteit Medical Center, Amsterdam, The Netherlands
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Lee M, Pascoe JM, McNicholas CI. Reading, Mathematics and Fine Motor Skills at 5 Years of Age in US Children who were Extremely Premature at Birth. Matern Child Health J 2018; 21:199-207. [PMID: 27423237 DOI: 10.1007/s10995-016-2109-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Objectives The prevalence of extreme prematurity at birth has increased, but little research has examined its impact on developmental outcomes in large representative samples within the United States. This study examined the association of extreme prematurity with kindergarteners' reading skills, mathematics skills and fine motor skills. Methods The early childhood longitudinal study-birth cohort, a representative sample of the US children born in 2001 was analyzed for this study. Early reading and mathematics skills and fine motor skills were compared among 200 extremely premature children (EPC) (gestational age <28 wks or birthweight <1000 g), 500 premature children (PC), and 4300 term children (TC) (≥37wks or ≥2500 g). Generalized linear regression analyses included sampling weights, children's age, race, sex, and general health status, and parental marital status and education among singleton children. Results At age 5 years, EPC were 2.6(95 % CI 1.7-3.8) times more likely to fail build a gate and were 3.1(95 % CI 1.6-5.8) times more likely to fail all four drawing tasks compared to TC (p values <0.001). Fine motor performance of PC (failed to build a gate, 1.3[95 % CI 1.0-1.7]; failed to draw all four shapes, 1.1[95 % CI 0.8-1.6]) was not significantly different from TC. Mean early reading scale score (36.8[SE:1.3]) of EPC was 4.0 points lower than TC (p value < 0.0001) while mean reading score (39.9[SE:1.4]) of PC was not significantly different from TC (40.8[SE:1.1]). Mean mathematics scale score were significantly lower for both EPC (35.5[SE:1.0], p value < 0.001) and PC (39.8[SE:0.8], p value = 0.023) compared to TC (41.0[SE:0.6]). Conclusions for Practice Extreme prematurity at birth was associated with cognitive and fine motor delays at age 5 years. This suggests that based on a nationally representative sample of infants, the biological risk of extreme prematurity persists after adjusting for other factors related to development.
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Affiliation(s)
- Miryoung Lee
- Department of Pediatrics, Boonshoft School of Medicine, Wright State University, Dayton, OH, USA. .,Department of Community Health, Lifespan Health Research Center, Boonshoft School of Medicine, Wright State University, 3171 Research Blvd, Dayton, OH, 45420, USA.
| | - John M Pascoe
- Department of Pediatrics, Boonshoft School of Medicine, Wright State University, Dayton, OH, USA
| | - Caroline I McNicholas
- Department of Pediatrics, Boonshoft School of Medicine, Wright State University, Dayton, OH, USA
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Hasler HM, Akshoomoff N. Mathematics ability and related skills in preschoolers born very preterm. Child Neuropsychol 2017; 25:162-178. [PMID: 29233080 DOI: 10.1080/09297049.2017.1412413] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Children born very preterm (VPT) are at risk for academic, behavioral, and/or emotional problems. Mathematics is a particular weakness and better understanding of the relationship between preterm birth and early mathematics ability is needed, particularly as early as possible to aid in early intervention. Preschoolers born VPT (n = 58) and those born full term (FT; n = 29) were administered a large battery of measures within 6 months of beginning kindergarten. A multiple-mediation model was utilized to characterize the difference in skills underlying mathematics ability between groups. Children born VPT performed significantly worse than FT-born children on a measure of mathematics ability as well as full-scale IQ, verbal skills, visual-motor integration, phonological awareness, phonological working memory, motor skills, and executive functioning. Mathematics was significantly correlated with verbal skills, visual-motor integration, phonological processing, and motor skills across both groups. When entered into the mediation model, verbal skills, visual-motor integration, and phonological awareness were significant mediators of the group differences. This analysis provides insights into the pre-academic skills that are weak in preschoolers born VPT and their relationship to mathematics. It is important to identify children who will have difficulties as early as possible, particularly for VPT children who are at higher risk for academic difficulties. Therefore, this model may be used in evaluating VPT children for emerging difficulties as well as an indicator that if other weaknesses are found, an assessment of mathematics should be conducted.
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Affiliation(s)
- Holly M Hasler
- a Department of Psychiatry and Center for Human Development , University of California , San Diego , CA , USA
| | - Natacha Akshoomoff
- a Department of Psychiatry and Center for Human Development , University of California , San Diego , CA , USA
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29
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Félix J, Santos ME, Benítez-Burraco A. Spontaneous language of preterm children aged 4 and 5 years. REVISTA CEFAC 2017. [DOI: 10.1590/1982-021620171968017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Purposes: to evaluate spontaneous language development through the Mean Length of Utterance in words (MLU-w) of children with gestational age between 28 and 36 weeks. This research also aims to study if the gestational age, birth weight, gender, and parents’ level of formal education can influence that measurement. Methods: nineteen premature children (9 males, 10 females), in the age range 4-5 years old, enrolled on Lisbon area kindergartens, and considered as having typical development, participated in this research. Spontaneous speech of each child was recorded for 30 minutes and transcribed afterwards. Results: mean values of MLU-w of Portuguese premature children were significantly lower than those with typical development. A positive and significant correlation between the gestational age and the birth weight with the MLU-w was also found. The gender of the children and the parents’ level of formal education showed no influence on the results. Conclusion: these results reinforce the need to identify, on these children, possible deficits, in order to prevent negative impacts in school education, and stimulate their psychosocial development.
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Daher I, Le Dieu-Lugon B, Dourmap N, Lecuyer M, Ramet L, Gomila C, Ausseil J, Marret S, Leroux P, Roy V, El Mestikawy S, Daumas S, Gonzalez B, Leroux-Nicollet I, Cleren C. Magnesium Sulfate Prevents Neurochemical and Long-Term Behavioral Consequences of Neonatal Excitotoxic Lesions: Comparison Between Male and Female Mice. J Neuropathol Exp Neurol 2017; 76:883-897. [PMID: 28922852 DOI: 10.1093/jnen/nlx073] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Magnesium sulfate (MgSO4) administration to mothers at risk of preterm delivery is proposed as a neuroprotective strategy against neurological alterations such as cerebral palsy in newborns. However, long-term beneficial or adverse effects of MgSO4 and sex-specific sensitivity remain to be investigated. We conducted behavioral and neurochemical studies of MgSO4 effects in males and females, from the perinatal period to adolescence in a mouse model of cerebral neonatal lesion. The lesion was produced in 5-day-old (P5) pups by ibotenate intracortical injection. MgSO4 (600 mg/kg, i.p.) prior to ibotenate prevented lesion-induced sensorimotor alterations in both sexes at P6 and P7. The lesion increased glutamate level at P10 in the prefrontal cortex, which was prevented by MgSO4 in males. In neonatally lesioned adolescent mice, males exhibited more sequelae than females in motor and cognitive functions. In the perirhinal cortex of adolescent mice, the neonatal lesion induced an increase in vesicular glutamate transporter 1 density in males only, which was negatively correlated with cognitive scores. Long-term sequelae were prevented by neonatal MgSO4 administration. MgSO4 never induced short- or long-term deleterious effect on its own. These results also strongly suggest that sex-specific neuroprotection should be foreseen in preterm infants.
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Affiliation(s)
- Ismaël Daher
- Department of Neonatal Pediatrics and Intensive Care - Neuropediatrics, Normandie Univ, UNIROUEN, INSERM U1245, and Rouen University Hospital, Rouen, France; Normal and Pathological Glutamatergic Systems, Neuroscience Paris Seine, IBPS, INSERM U1130, CNRS UMR 8246 Université Pierre et Marie Curie, Paris, France; INSERM U1088, Laboratoire de Biochimie, Centre de Biologie Humaine, Amiens-Picardie University Hospital, Amiens, France; Normandie Univ, UNIROUEN, PSY-NCA, Rouen, France
| | - Bérénice Le Dieu-Lugon
- Department of Neonatal Pediatrics and Intensive Care - Neuropediatrics, Normandie Univ, UNIROUEN, INSERM U1245, and Rouen University Hospital, Rouen, France; Normal and Pathological Glutamatergic Systems, Neuroscience Paris Seine, IBPS, INSERM U1130, CNRS UMR 8246 Université Pierre et Marie Curie, Paris, France; INSERM U1088, Laboratoire de Biochimie, Centre de Biologie Humaine, Amiens-Picardie University Hospital, Amiens, France; Normandie Univ, UNIROUEN, PSY-NCA, Rouen, France
| | - Nathalie Dourmap
- Department of Neonatal Pediatrics and Intensive Care - Neuropediatrics, Normandie Univ, UNIROUEN, INSERM U1245, and Rouen University Hospital, Rouen, France; Normal and Pathological Glutamatergic Systems, Neuroscience Paris Seine, IBPS, INSERM U1130, CNRS UMR 8246 Université Pierre et Marie Curie, Paris, France; INSERM U1088, Laboratoire de Biochimie, Centre de Biologie Humaine, Amiens-Picardie University Hospital, Amiens, France; Normandie Univ, UNIROUEN, PSY-NCA, Rouen, France
| | - Matthieu Lecuyer
- Department of Neonatal Pediatrics and Intensive Care - Neuropediatrics, Normandie Univ, UNIROUEN, INSERM U1245, and Rouen University Hospital, Rouen, France; Normal and Pathological Glutamatergic Systems, Neuroscience Paris Seine, IBPS, INSERM U1130, CNRS UMR 8246 Université Pierre et Marie Curie, Paris, France; INSERM U1088, Laboratoire de Biochimie, Centre de Biologie Humaine, Amiens-Picardie University Hospital, Amiens, France; Normandie Univ, UNIROUEN, PSY-NCA, Rouen, France
| | - Lauriane Ramet
- Department of Neonatal Pediatrics and Intensive Care - Neuropediatrics, Normandie Univ, UNIROUEN, INSERM U1245, and Rouen University Hospital, Rouen, France; Normal and Pathological Glutamatergic Systems, Neuroscience Paris Seine, IBPS, INSERM U1130, CNRS UMR 8246 Université Pierre et Marie Curie, Paris, France; INSERM U1088, Laboratoire de Biochimie, Centre de Biologie Humaine, Amiens-Picardie University Hospital, Amiens, France; Normandie Univ, UNIROUEN, PSY-NCA, Rouen, France
| | - Cathy Gomila
- Department of Neonatal Pediatrics and Intensive Care - Neuropediatrics, Normandie Univ, UNIROUEN, INSERM U1245, and Rouen University Hospital, Rouen, France; Normal and Pathological Glutamatergic Systems, Neuroscience Paris Seine, IBPS, INSERM U1130, CNRS UMR 8246 Université Pierre et Marie Curie, Paris, France; INSERM U1088, Laboratoire de Biochimie, Centre de Biologie Humaine, Amiens-Picardie University Hospital, Amiens, France; Normandie Univ, UNIROUEN, PSY-NCA, Rouen, France
| | - Jérôme Ausseil
- Department of Neonatal Pediatrics and Intensive Care - Neuropediatrics, Normandie Univ, UNIROUEN, INSERM U1245, and Rouen University Hospital, Rouen, France; Normal and Pathological Glutamatergic Systems, Neuroscience Paris Seine, IBPS, INSERM U1130, CNRS UMR 8246 Université Pierre et Marie Curie, Paris, France; INSERM U1088, Laboratoire de Biochimie, Centre de Biologie Humaine, Amiens-Picardie University Hospital, Amiens, France; Normandie Univ, UNIROUEN, PSY-NCA, Rouen, France
| | - Stéphane Marret
- Department of Neonatal Pediatrics and Intensive Care - Neuropediatrics, Normandie Univ, UNIROUEN, INSERM U1245, and Rouen University Hospital, Rouen, France; Normal and Pathological Glutamatergic Systems, Neuroscience Paris Seine, IBPS, INSERM U1130, CNRS UMR 8246 Université Pierre et Marie Curie, Paris, France; INSERM U1088, Laboratoire de Biochimie, Centre de Biologie Humaine, Amiens-Picardie University Hospital, Amiens, France; Normandie Univ, UNIROUEN, PSY-NCA, Rouen, France
| | - Philippe Leroux
- Department of Neonatal Pediatrics and Intensive Care - Neuropediatrics, Normandie Univ, UNIROUEN, INSERM U1245, and Rouen University Hospital, Rouen, France; Normal and Pathological Glutamatergic Systems, Neuroscience Paris Seine, IBPS, INSERM U1130, CNRS UMR 8246 Université Pierre et Marie Curie, Paris, France; INSERM U1088, Laboratoire de Biochimie, Centre de Biologie Humaine, Amiens-Picardie University Hospital, Amiens, France; Normandie Univ, UNIROUEN, PSY-NCA, Rouen, France
| | - Vincent Roy
- Department of Neonatal Pediatrics and Intensive Care - Neuropediatrics, Normandie Univ, UNIROUEN, INSERM U1245, and Rouen University Hospital, Rouen, France; Normal and Pathological Glutamatergic Systems, Neuroscience Paris Seine, IBPS, INSERM U1130, CNRS UMR 8246 Université Pierre et Marie Curie, Paris, France; INSERM U1088, Laboratoire de Biochimie, Centre de Biologie Humaine, Amiens-Picardie University Hospital, Amiens, France; Normandie Univ, UNIROUEN, PSY-NCA, Rouen, France
| | - Salah El Mestikawy
- Department of Neonatal Pediatrics and Intensive Care - Neuropediatrics, Normandie Univ, UNIROUEN, INSERM U1245, and Rouen University Hospital, Rouen, France; Normal and Pathological Glutamatergic Systems, Neuroscience Paris Seine, IBPS, INSERM U1130, CNRS UMR 8246 Université Pierre et Marie Curie, Paris, France; INSERM U1088, Laboratoire de Biochimie, Centre de Biologie Humaine, Amiens-Picardie University Hospital, Amiens, France; Normandie Univ, UNIROUEN, PSY-NCA, Rouen, France
| | - Stéphanie Daumas
- Department of Neonatal Pediatrics and Intensive Care - Neuropediatrics, Normandie Univ, UNIROUEN, INSERM U1245, and Rouen University Hospital, Rouen, France; Normal and Pathological Glutamatergic Systems, Neuroscience Paris Seine, IBPS, INSERM U1130, CNRS UMR 8246 Université Pierre et Marie Curie, Paris, France; INSERM U1088, Laboratoire de Biochimie, Centre de Biologie Humaine, Amiens-Picardie University Hospital, Amiens, France; Normandie Univ, UNIROUEN, PSY-NCA, Rouen, France
| | - Bruno Gonzalez
- Department of Neonatal Pediatrics and Intensive Care - Neuropediatrics, Normandie Univ, UNIROUEN, INSERM U1245, and Rouen University Hospital, Rouen, France; Normal and Pathological Glutamatergic Systems, Neuroscience Paris Seine, IBPS, INSERM U1130, CNRS UMR 8246 Université Pierre et Marie Curie, Paris, France; INSERM U1088, Laboratoire de Biochimie, Centre de Biologie Humaine, Amiens-Picardie University Hospital, Amiens, France; Normandie Univ, UNIROUEN, PSY-NCA, Rouen, France
| | - Isabelle Leroux-Nicollet
- Department of Neonatal Pediatrics and Intensive Care - Neuropediatrics, Normandie Univ, UNIROUEN, INSERM U1245, and Rouen University Hospital, Rouen, France; Normal and Pathological Glutamatergic Systems, Neuroscience Paris Seine, IBPS, INSERM U1130, CNRS UMR 8246 Université Pierre et Marie Curie, Paris, France; INSERM U1088, Laboratoire de Biochimie, Centre de Biologie Humaine, Amiens-Picardie University Hospital, Amiens, France; Normandie Univ, UNIROUEN, PSY-NCA, Rouen, France
| | - Carine Cleren
- Department of Neonatal Pediatrics and Intensive Care - Neuropediatrics, Normandie Univ, UNIROUEN, INSERM U1245, and Rouen University Hospital, Rouen, France; Normal and Pathological Glutamatergic Systems, Neuroscience Paris Seine, IBPS, INSERM U1130, CNRS UMR 8246 Université Pierre et Marie Curie, Paris, France; INSERM U1088, Laboratoire de Biochimie, Centre de Biologie Humaine, Amiens-Picardie University Hospital, Amiens, France; Normandie Univ, UNIROUEN, PSY-NCA, Rouen, France
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Academic Achievement Deficits and Their Neuropsychological Correlates in Children Born Extremely Preterm. J Dev Behav Pediatr 2017; 38:627-637. [PMID: 28877090 PMCID: PMC5646684 DOI: 10.1097/dbp.0000000000000479] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The purpose of this study was to examine the risks associated with learning disabilities (LDs) in a large sample of children born extremely preterm. We predicted higher than expected rates of LD, particularly in math, and children with LD in math, reading, or both would have lower intelligence quotients (IQs) and specific patterns of neuropsychological deficits. METHODS We evaluated academic achievement, rates of LD, and their neuropsychological correlates in the Extremely Low Gestational Age Newborns (ELGANs) Study cohort of 10-year-old children born at 23 to 27 weeks gestational age. Primary analyses focused on children without intellectual disability (verbal IQ > 70 and nonverbal IQ > 70; N = 668). Low achievement was defined as a standard score ≤85 on the reading or math measures. RESULTS The risk of low math achievement scores (27%) was 1.5 times higher than the risk of low reading achievement scores (17%). Children were classified as having LD based on low achievement criteria in reading only (RD, 6.4% of sample), math only (MD, 16.2%), both reading and math (RD/MD, 8.3%), or no reading or math disabilities (No LD, 69.1%). Although all 3 LD groups had multiple neuropsychological weaknesses compared with the No LD group, the RD and MD groups had different patterns of neuropsychological impairment. CONCLUSION These children from the ELGAN cohort had higher than expected rates of LD, particularly in mathematics, even after taking socioeconomic status into consideration. These results indicate specific cognitive weaknesses that differ between extremely preterm children with RD and MD.
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Babik I, Galloway JC, Lobo MA. Infants Born Preterm Demonstrate Impaired Exploration of Their Bodies and Surfaces Throughout the First 2 Years of Life. Phys Ther 2017; 97:915-925. [PMID: 28605484 DOI: 10.1093/ptj/pzx064] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Accepted: 06/07/2017] [Indexed: 02/09/2023]
Abstract
BACKGROUND Non-object-oriented exploratory behaviors infants perform with their bodies and surfaces have been proposed to be key precursors of infants' object exploration, early learning, and future cognitive development. Little is known about the developmental trajectories of these behaviors, especially for infants born preterm. OBJECTIVE The purpose of the study was to longitudinally compare non-object-oriented exploratory behaviors performed by full-term and preterm infants. DESIGN The study followed 24 full-term and 30 preterm infants (6 with significant brain injury) performing non-object-oriented exploratory behaviors in prone, supine, and sitting from birth through 24 months. METHODS Infants were observed without objects or direct social interaction for 3 minutes in prone and supine (0 through 9 months) and in sitting (3 through 24 months). Behavioral coding produced data that were analyzed using hierarchical linear modeling. Developmental trajectories of behaviors were compared among full-term infants, preterm infants without significant brain injury, and preterm infants with significant brain injury. RESULTS Compared to full-term peers, preterm infants showed poorer postural control (less head lifting in prone), midline behavior (holding the head in midline, holding both hands in midline), hand-to-mouth and visual-motor behaviors against gravity, and more asymmetrical one-handed fisting. Preterm infants performed fewer bouts of non-object-oriented exploratory behaviors, and their behaviors were less variable with fewer combinations. LIMITATIONS There was a limited sample of infants born preterm with significant brain injury. CONCLUSIONS Non-object-oriented exploratory behaviors are important for early perceptual-motor development. Key differences were noted in these behaviors for infants born preterm. These differences may lead to impaired reaching, object exploration, and cognition. Early intervention programs should utilize assessments and interventions that target these very early non-object-oriented exploratory behaviors.
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Affiliation(s)
- Iryna Babik
- Department of Physical Therapy, University of Delaware, Newark, Delaware
| | - James Cole Galloway
- Department of Physical Therapy and Biomechanics and Movement Science Program, University of Delaware
| | - Michele A Lobo
- Department of Physical Therapy, Biomechanics and Movement Science Program, University of Delaware, 210K CHS Building, 540 South College Ave, Newark, DE 19713 (USA)
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Functional neural bases of numerosity judgments in healthy adults born preterm. Brain Cogn 2017; 118:90-99. [PMID: 28802184 DOI: 10.1016/j.bandc.2017.07.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2017] [Revised: 07/25/2017] [Accepted: 07/31/2017] [Indexed: 11/20/2022]
Abstract
High rates of mathematics learning disabilities among individuals born preterm (<37weeksGA) have spurred calls for a greater understanding of the nature of these weaknesses and their neural underpinnings. Groups of healthy, high functioning young adults born preterm and full term (n=20) completed a symbolic and non-symbolic magnitude comparison task while undergoing functional MRI scanning. Collectively, participants showed activation in superior and inferior frontal and parietal regions previously linked to numeric processing when comparing non-symbolic magnitude arrays separated by small numeric distances. Simultaneous deactivation of the default mode network also was evident during these trials. Individuals born preterm showed increased signal change relative to their full term peers in right inferior frontal and parietal regions when comparing the non-symbolic magnitude arrays. Elevated signal change during non-symbolic task blocks was associated with poorer performance on a calculation task administered outside of the scanner. These findings indicate that healthy, high-functioning adults born preterm may recruit fronto-parietal networks more extensively when processing non-symbolic magnitudes, suggesting that approximate number system training may be an inroad for early intervention to prevent mathematics difficulties in this population.
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Scott MN, Hunter SJ, Joseph RM, OʼShea TM, Hooper SR, Allred EN, Leviton A, Kuban K. Neurocognitive Correlates of Attention-Deficit Hyperactivity Disorder Symptoms in Children Born at Extremely Low Gestational Age. J Dev Behav Pediatr 2017; 38:249-259. [PMID: 28410255 PMCID: PMC5746049 DOI: 10.1097/dbp.0000000000000436] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Compared with children born near term, those born extremely preterm (EP) are at much higher risk for attention-deficit hyperactivity disorder (ADHD). Little information is available about differences in neuropsychological outcomes among EP children with and without ADHD. Our analyses aimed to evaluate the neuropsychological correlates of ADHD symptoms in extremely low gestational age newborns (ELGANs). METHODS We obtained Child Symptom Inventory-4 reports from parents (n = 871) and teachers (n = 634) of 10-year-old children born before the 28th week of gestation. Participants completed standardized assessments of neurocognitive and academic functioning. RESULTS In the total sample, children who screened positive for ADHD symptoms were at increased risk for neurocognitive limitations. These associations were weaker when the sample was limited to those with intelligence quotient (IQ) ≥70 or ≥85. Even those with IQ ≥85 who screened positive for ADHD symptoms were more likely than their peers to have deficits on the DAS-II Working Memory Cluster and the NEPSY-II Auditory Response subtest. The risks for impaired academic performance (Z ≤ -1) on components of the WIAT-III were 2-to-3 times higher in this group than among ELGANs not classified as having ADHD symptoms. CONCLUSION Among children born EP, those with ADHD symptoms are more likely to have global neurocognitive impairment. When IQ is within normal limits, ADHD symptoms are associated with deficits in executive functioning skills. These findings highlight a group at risk for executive functioning deficits and related academic difficulties, even in the absence of intellectual disability.
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Affiliation(s)
- Megan N Scott
- *Department of Psychiatry and Behavioral Neuroscience, The University of Chicago Medicine, Chicago, IL; †Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, MA; ‡Division of Neonatology, Department of Pediatrics, University of North Carolina School of Medicine, Chapel Hill, NC; §Department of Allied Health Sciences, University of North Carolina School of Medicine, Chapel Hill, NC; Departments of ‖Neurology and ¶Neurology Research, Boston Children's Hospital and Harvard Medical School, Boston MA; **Division of Pediatric Neurology, Boston Medical Center, Boston University School of Medicine, Boston, MA
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Casey KF, Levesque ML, Szyf M, Ismaylova E, Verner M, Suderman M, Vitaro F, Brendgen M, Dionne G, Boivin M, Tremblay RE, Booij L. Birth weight discordance, DNA methylation, and cortical morphology of adolescent monozygotic twins. Hum Brain Mapp 2017; 38:2037-2050. [PMID: 28032437 PMCID: PMC6866862 DOI: 10.1002/hbm.23503] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2016] [Revised: 11/25/2016] [Accepted: 12/12/2016] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Several studies have shown that the in utero environment, which can be indexed by birth weight (BW), is associated with cortical morphology in adolescence and adulthood. Work in monozygotic (MZ) twins suggests that this association is driven by non-shared environmental factors. This correlation could be the result of in utero impacts on DNA methylation. The aim of the present study with MZ twins is to replicate the association between discordance in BW and brain morphology and test whether discordance in DNA methylation mediates this relationship. METHODS One hundred and four adolescent MZ twins (52 pairs, of which 42% were male pairs) who have been followed regularly since birth underwent T1 weighted structural MRI, and epigenome-wide assessment of DNA methylation from saliva at age 15. RESULTS Co-twins had very similar measures of DNA methylation and cortical morphology. Higher BW members of a twin pair had increased total cortical surface area, and decreased cortical thickness compared to their lower BW sibling. BW Discordance was positively associated with both cortical surface area and cortical volume discordance. Genes involved in neurodevelopment were tentatively identified as mediators of both the BW - cortical volume, and BW- cortical surface area relationships. CONCLUSIONS The association between BW and cortical morphology in adolescence appears to be attributable to in utero environmental effects, and DNA methylation may play a role in mediating this relationship. Hum Brain Mapp 38:2037-2050, 2017. © 2017 Wiley Periodicals, Inc.
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Affiliation(s)
| | - Melissa L. Levesque
- CHU Sainte‐Justine Research CenterMontrealQuébecCanada
- Department of PsychiatryUniversity of MontrealMontrealQuébecCanada
| | - Moshe Szyf
- Department of Pharmacology and TherapeuticsMcGill UniversityMontrealQuébecCanada
| | - Elmira Ismaylova
- CHU Sainte‐Justine Research CenterMontrealQuébecCanada
- Department of PsychiatryUniversity of MontrealMontrealQuébecCanada
| | - Marie‐Pier Verner
- CHU Sainte‐Justine Research CenterMontrealQuébecCanada
- Department of PsychiatryUniversity of MontrealMontrealQuébecCanada
| | - Matthew Suderman
- Department of Social and Community MedicineUniversity of BristolBristolUnited Kingdom
| | - Frank Vitaro
- Psychoeducation, University of MontrealMontrealQuébecCanada
| | | | - Ginette Dionne
- School of PsychologyUniversity of LavalQuébec CityQuébecCanada
| | - Michel Boivin
- School of PsychologyUniversity of LavalQuébec CityQuébecCanada
- Institute of Genetic, Neurobiological, and Social Foundations of Child Development, Tomsk State University, TomskSiberiaRussian Federation
| | - Richard E. Tremblay
- CHU Sainte‐Justine Research CenterMontrealQuébecCanada
- Department of Psychology & PediatricsUniversity of MontrealMontrealQuébecCanada
- School of Public Health, Physiotherapy and Population Science, University College DublinDublinIreland
| | - Linda Booij
- CHU Sainte‐Justine Research CenterMontrealQuébecCanada
- Department of PsychiatryUniversity of MontrealMontrealQuébecCanada
- Department of PsychologyConcordia UniversityMontrealQuébecCanada
- Department of PsychiatryMcGill UniversityMontrealQuébecCanada
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Linsell L, Malouf R, Morris J, Kurinczuk JJ, Marlow N. Risk Factor Models for Neurodevelopmental Outcomes in Children Born Very Preterm or With Very Low Birth Weight: A Systematic Review of Methodology and Reporting. Am J Epidemiol 2017; 185:601-612. [PMID: 28338817 DOI: 10.1093/aje/kww135] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Accepted: 03/03/2016] [Indexed: 01/08/2023] Open
Abstract
The prediction of long-term outcomes in surviving infants born very preterm (VPT) or with very low birth weight (VLBW) is necessary to guide clinical management, provide information to parents, and help target and evaluate interventions. There is a large body of literature describing risk factor models for neurodevelopmental outcomes in VPT/VLBW children, yet few, if any, have been developed for use in routine clinical practice or adopted for use in research studies or policy evaluation. We sought to systematically review the methods and reporting of studies that have developed a multivariable risk factor model for neurodevelopment in surviving VPT/VLBW children. We searched the MEDLINE, Embase, and PsycINFO databases from January 1, 1990, to June 1, 2014, and identified 78 studies reporting 222 risk factor models. Most studies presented risk factor analyses that were not intended to be used for prediction, confirming that there is a dearth of specifically designed prognostic modeling studies for long-term outcomes in surviving VPT/VLBW children. We highlight the strengths and weaknesses of the research methodology and reporting to date, and provide recommendations for the design and analysis of future studies seeking to analyze risk prediction or develop prognostic models for VPT/VLBW children.
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Carniel CZ, Furtado MCDC, Vicente JB, Abreu RZD, Tarozzo RM, Cardia SETR, Massei MCI, Cerveira RCGF. Influência de fatores de risco sobre o desenvolvimento da linguagem e contribuições da estimulação precoce: revisão integrativa da literatura. REVISTA CEFAC 2017. [DOI: 10.1590/1982-0216201719115616] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO O objetivo do estudo foi identificar evidências na literatura a respeito da influência dos fatores de risco sobre o desenvolvimento da linguagem da criança e as contribuições da estimulação precoce. Trata-se de uma revisão integrativa, que utilizou as bases de dados Lilacs, PubMed e SciELO e os descritores: linguagem infantil, fatores de risco, prematuro, criança pós-termo, índice de Apgar, estimulação precoce. A partir dos achados, extraíram-se os seguintes dados: autores, ano de publicação, objetivo, desenho do estudo, participantes e critérios, variáveis estudadas, principais achados. Para a organização e análise foi utilizada a técnica de Análise de Conteúdo do tipo temática. Foram identificados 1.421 artigos, 29 atenderam os critérios de inclusão. Os estudos foram categorizados por resultados afins; A maioria dos artigos selecionados trata do efeito da prematuridade sobre o desenvolvimento da linguagem. Quatro estudos investigaram a associação entre fatores de risco e problemas no desenvolvimento da linguagem. Um dos estudos avaliou crianças em idade escolar e associou valores de Apgar com DEL. Foi unanime a recomendação acerca do acompanhamento e intervenção precoce. Conclui-se que os fatores de risco elencados influenciam negativamente no desenvolvimento da linguagem. Reforça-se a recomendação do atendimento precoce e qualificado dessas crianças, evitando e/ou minimizando alterações futuras.
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Alanko O, Niemi P, Munck P, Matomäki J, Turunen T, Nurmi JE, Lehtonen L, Haataja L, Rautava P. Reading and math abilities of Finnish school beginners born very preterm or with very low birth weight. LEARNING AND INDIVIDUAL DIFFERENCES 2017. [DOI: 10.1016/j.lindif.2017.01.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Johnson S, Marlow N. Early and long-term outcome of infants born extremely preterm. Arch Dis Child 2017; 102:97-102. [PMID: 27512082 DOI: 10.1136/archdischild-2015-309581] [Citation(s) in RCA: 177] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Accepted: 07/12/2016] [Indexed: 01/26/2023]
Abstract
There is no question that birth at extremely low gestational ages presents a significant threat to an infant's survival, health and development. Growing evidence suggests that gestational age may be conceptualised as a continuum in which births before 28 weeks of gestation (extremely preterm: EP) represent the severe end of a spectrum of health and developmental adversity. Although comprising just 1%-2% of all births, EP deliveries pose the greatest challenge to neonatal medicine and to health, education and social services for the provision of ongoing support for survivors with additional needs. Studying the outcomes of these infants remains critical for evaluating and enhancing clinical care, planning long-term support and for advancing our understanding of the life-course consequences of immaturity at birth. Here we review literature relating to early and long-term neurodevelopmental, cognitive, behavioural and educational outcomes following EP birth focusing on key themes and considering implications for intervention.
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Affiliation(s)
- Samantha Johnson
- Department of Health Sciences, University of Leicester, Leicester, UK
| | - Neil Marlow
- Institute for Women's Health, University College London, London, UK
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Learning disabilities among extremely preterm children without neurosensory impairment: Comorbidity, neuropsychological profiles and scholastic outcomes. Early Hum Dev 2016; 103:69-75. [PMID: 27517525 DOI: 10.1016/j.earlhumdev.2016.07.009] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Revised: 06/07/2016] [Accepted: 07/19/2016] [Indexed: 11/23/2022]
Abstract
BACKGROUND Children born extremely preterm are at high risk for intellectual disability, learning disabilities, executive dysfunction and special educational needs, but little is understood about the comorbidity of intellectual and learning disabilities in this population. AIMS This study explored comorbidity in intellectual disability (ID) and learning disabilities (LD) in children born extremely preterm (EP; <26+0weeks' gestation). SUBJECTS AND STUDY DESIGN A UK national cohort of 161 EP children and 153 term-born controls without neurosensory impairments was assessed at 11years of age (the EPICure Study). OUTCOME MEASURES IQ, mathematics and reading attainment, executive function, visuospatial processing and sensorimotor skills were assessed using standardised tests, and curriculum-based attainment and special educational needs (SEN) using teacher reports. RESULTS Overall, 75 (47%) EP children and 7 (4.6%) controls had ID or LD (RR 10.12; 95% CI 4.81, 21.27). Comorbidity in ID/LD was more common among EP children than controls (24% vs. 0%). EP children with comorbid ID/LD had significantly poorer neuropsychological abilities and curriculum-based attainment than EP children with an isolated disability or no disabilities. LD were associated with a 3 times increased risk for SEN. However, EP children with ID alone had poorer neuropsychological abilities and curriculum-based attainment than children with no disabilities, yet there was no increase in SEN provision among this group. CONCLUSIONS EP children are at high risk for comorbid intellectual and learning disabilities. Education professionals should be aware of the complex nature of EP children's difficulties and the need for multi-domain assessments to guide intervention.
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Squarza C, Picciolini O, Gardon L, Giannì ML, Murru A, Gangi S, Cortinovis I, Milani S, Mosca F. Learning Disabilities in Extremely Low Birth Weight Children and Neurodevelopmental Profiles at Preschool Age. Front Psychol 2016; 7:998. [PMID: 27445952 PMCID: PMC4923155 DOI: 10.3389/fpsyg.2016.00998] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Accepted: 06/17/2016] [Indexed: 11/13/2022] Open
Abstract
At school age extremely low birth weight (ELBW) and extremely low gestational age (ELGAN) children are more likely to show Learning Disabilities (LDs) and difficulties in emotional regulation. The aim of this study was to investigate the incidence of LDs at school age and to detect neurodevelopmental indicators of risk for LDs at preschool ages in a cohort of ELBW/ELGAN children with broadly average intelligence. All consecutively newborns 2001-2006 admitted to the same Institution entered the study. Inclusion criteria were BW < 1000 g and/or GA < 28 weeks. Exclusion criteria were severe cerebral injuries, neurosensory disabilities, genetic abnormalities, and/or a Developmental Quotient below normal limits (< 1 SD) at 6 years. The presence of learning disabilities at school age was investigated through a parent-report questionnaire at children's age range 9-10 years. Neurodevelopmental profiles were assessed through the Griffiths Mental Development Scales at 1 and 2 years of corrected age and at 3, 4, 5, and 6 years of chronological age and were analyzed comparing two groups of children: those with LDs and those without. At school age 24 on 102 (23.5%) of our ELBW/ELGAN children met criteria for LDs in one or more areas, with 70.8% comorbidity with emotional/attention difficulties. Children with LDs scored significantly lower in the Griffiths Locomotor and Language subscales at 2 years of corrected age and in the Personal-social, Performance and Practical Reasoning subscales at 5 years of chronological age. Our findings suggest that, among the early developmental indicators of adverse school outcome, there is a poor motor experimentation, language delay, and personal-social immaturity. Cognitive rigidity and poor ability to manage practical situations also affect academic attainment. Timely detection of these early indicators of risk is crucial to assist the transition to school.
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Affiliation(s)
- Chiara Squarza
- NICU, Department of Clinical Sciences and Community Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano Milan, Italy
| | - Odoardo Picciolini
- NICU, Department of Clinical Sciences and Community Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano Milan, Italy
| | - Laura Gardon
- NICU, Department of Clinical Sciences and Community Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano Milan, Italy
| | - Maria L Giannì
- NICU, Department of Clinical Sciences and Community Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano Milan, Italy
| | - Alessandra Murru
- NICU, Department of Clinical Sciences and Community Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano Milan, Italy
| | - Silvana Gangi
- NICU, Department of Clinical Sciences and Community Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano Milan, Italy
| | - Ivan Cortinovis
- Laboratory of Medical Statistics, Biometry and Epidemiology, Department of Clinical Sciences and Community Health, Università degli Studi di Milano Milan, Italy
| | - Silvano Milani
- Laboratory of Medical Statistics, Biometry and Epidemiology, Department of Clinical Sciences and Community Health, Università degli Studi di Milano Milan, Italy
| | - Fabio Mosca
- NICU, Department of Clinical Sciences and Community Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano Milan, Italy
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Tatsuoka C, McGowan B, Yamada T, Espy KA, Minich N, Taylor HG. Effects of Extreme Prematurity on Numerical Skills and Executive Function in Kindergarten Children: An Application of Partially Ordered Classification Modeling. LEARNING AND INDIVIDUAL DIFFERENCES 2016; 49:332-340. [PMID: 27818602 DOI: 10.1016/j.lindif.2016.05.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Although mathematics disabilities (MD) are common in extremely preterm/extremely low birth weight (EPT/ELBW) children, little is known about the nature of these problems. In this study partially ordered set (POSET) models were applied to classify 140 EPT/ELBW kindergarten children (gestational age <28 weeks and/or birth weight <1000 g) and 110 normal birth weight (NBW) controls into profiles of numerical and cognitive skills. Models based on five numerical skills and five executive function and processing speed skills provided a good fit to performance data. The EPT/ELBW group had poorer skills in all areas than NBW controls but the models also revealed substantial individual variability in skill profiles. Weaknesses in executive function were associated with poorer mastery of numerical skills. The findings illustrate the applicability of POSET models to research on MD and suggest distinct types of early numerical deficits in EPT/ELBW children that are related to their impairments in executive function.
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Affiliation(s)
- Curtis Tatsuoka
- Department of Neurology, Case Western Reserve University and the Neurological Institute, University Hospitals Case Medical Center, 11100 Euclid Avenue, Cleveland, Ohio 44106 USA.; Department of Epidemiology and Biostatistics, Case Western Reserve University, 2109 Adelbert Road, Cleveland, Ohio 44106 USA
| | - Bridget McGowan
- Case Western Reserve University School of Medicine, 2109 Adelbert Road, Cleveland, Ohio 44106 USA
| | - Tomoko Yamada
- Department of Neurology, Case Western Reserve University and the Neurological Institute, University Hospitals Case Medical Center, 11100 Euclid Avenue, Cleveland, Ohio 44106 USA
| | - Kimberly Andrews Espy
- Administration Building 512, P.O. Box 210066, University of Arizona, Tuscon, Arizona 85721-0066 USA
| | - Nori Minich
- Department of Pediatrics, Case Western Reserve University and University Hospitals Case Medical Center, 11000 Cedar Road, 4 Floor, Cleveland, Ohio 44106 USA
| | - H Gerry Taylor
- Department of Pediatrics, Case Western Reserve University and University Hospitals Case Medical Center, 11000 Cedar Road, 4 Floor, Cleveland, Ohio 44106 USA
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Linsell L, Malouf R, Morris J, Kurinczuk JJ, Marlow N. Prognostic Factors for Poor Cognitive Development in Children Born Very Preterm or With Very Low Birth Weight: A Systematic Review. JAMA Pediatr 2015; 169:1162-72. [PMID: 26457641 PMCID: PMC5122448 DOI: 10.1001/jamapediatrics.2015.2175] [Citation(s) in RCA: 218] [Impact Index Per Article: 24.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
IMPORTANCE Cognitive delay is the most common form of impairment among children born very preterm (VPT) at 32 weeks or less or with very low birth weight (VLBW) of 1250 g or less. It is important to identify factors that are robust predictors of long-term outcome because the ability to predict future prognosis will assist in health care and educational service planning and provision. OBJECTIVE To identify prognostic factors for poor cognitive development in children born VPT or with VLBW. EVIDENCE REVIEW A systematic review was conducted using MEDLINE, EMBASE, and PyscINFO databases to identify studies published between January 1, 1990, and June 1, 2014, reporting multivariable prediction models for neurodevelopment in VPT or VLBW children. Thirty-one studies comprising 98 risk factor models for cognitive outcome were identified. Two independent reviewers extracted key information on study design, outcome definition, risk factor selection, model development, and reporting and conducted a risk-of-bias assessment. FINDINGS There was evidence that male sex, nonwhite race/ethnicity, lower level of parental education, and lower birth weight were predictive of global cognitive impairment in children younger than 5 years. In older children, only the influence of parental education was sustained. Male sex was also predictive of language impairment in early infancy, but not in middle childhood. Gestational age was a poor predictor of cognitive outcome, probably because of a reduced discriminatory power in cohorts restricted to a narrow gestational age range. The prognostic value of neonatal brain injury was unclear; however, studies adopted mixed strategies for managing children with physical or neurosensory disability. CONCLUSIONS AND RELEVANCE The influence of perinatal risk factors on cognitive development of VPT or VLBW children appears to diminish over time as environmental factors become more important. It is difficult to isolate cognitive outcomes from motor and neurosensory impairment, and the strategy for dealing with untestable children has implications for risk prediction.
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Affiliation(s)
- Louise Linsell
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, England
| | - Reem Malouf
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, England
| | - Joan Morris
- Centre for Environmental and Preventive Medicine, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, England
| | - Jennifer J. Kurinczuk
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, England
| | - Neil Marlow
- Institute of Women’s Health, University College London, London, England
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Kovachy VN, Adams JN, Tamaresis JS, Feldman HM. Reading abilities in school-aged preterm children: a review and meta-analysis. Dev Med Child Neurol 2015; 57:410-9. [PMID: 25516105 PMCID: PMC4397135 DOI: 10.1111/dmcn.12652] [Citation(s) in RCA: 67] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/16/2014] [Indexed: 12/19/2022]
Abstract
AIM Children born preterm (at ≤32wks) are at risk of developing deficits in reading ability. This meta-analysis aims to determine whether or not school-aged preterm children perform worse than those born at term in single-word reading (decoding) and reading comprehension. METHOD Electronic databases were searched for studies published between 2000 and 2013, which assessed decoding or reading comprehension performance in English-speaking preterm and term-born children aged between 6 years and 13 years, and born after 1990. Standardized mean differences in decoding and reading comprehension scores were calculated. RESULTS Nine studies were suitable for analysis of decoding, and five for analysis of reading comprehension. Random-effects meta-analyses showed that children born preterm had significantly lower scores (reported as Cohen's d values [d] with 95% confidence intervals [CIs]) than those born at term for decoding (d=-0.42, 95% CI -0.57 to -0.27, p<0.001) and reading comprehension (d=-0.57, 95% CI -0.68 to -0.46, p<0.001). Meta-regressions showed that lower gestational age was associated with larger differences in decoding (Q[1]=5.92, p=0.02) and reading comprehension (Q[1]=4.69, p=0.03) between preterm and term groups. Differences between groups increased with age for reading comprehension (Q[1]=5.10, p=0.02) and, although not significant, there was also a trend for increased group differences for decoding (Q[1]=3.44, p=0.06). INTERPRETATION Preterm children perform worse than peers born at term on decoding and reading comprehension. These findings suggest that preterm children should receive more ongoing monitoring for reading difficulties throughout their education.
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Affiliation(s)
- Vanessa N Kovachy
- Department of Pediatrics, Stanford School of Medicine, Palo Alto, CA, USA
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Lobo MA, Kokkoni E, Cunha AB, Galloway JC. Infants born preterm demonstrate impaired object exploration behaviors throughout infancy and toddlerhood. Phys Ther 2015; 95:51-64. [PMID: 25169919 PMCID: PMC4295084 DOI: 10.2522/ptj.20130584] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2013] [Accepted: 08/24/2014] [Indexed: 11/17/2022]
Abstract
BACKGROUND Object exploration behaviors form the foundation for future global development, but little is known about how these behaviors are exhibited by infants born preterm. OBJECTIVE The study objective was to longitudinally compare a comprehensive set of object exploration behaviors in infants born preterm and infants born full-term from infancy into toddlerhood. DESIGN Twenty-two infants born full-term and 28 infants born preterm were monitored as they interacted with objects throughout their first 2 years. METHODS Infants were provided up to 30 seconds to interact with each of 7 objects across 9 visits. Experimenters coded videos of infants' behaviors. Growth modeling and t tests were used to compare how much infants exhibited behaviors and how well they matched their behaviors to the properties of objects. RESULTS Infants born preterm explored objects less in the first 6 months, exhibited less visual-haptic multimodal exploration, displayed reduced variability of exploratory behavior in a manner that reflected severity of risk, and were less able to match their behaviors to the properties of objects in a manner that reflected severity of risk. Infants born preterm with significant brain injury also had impaired bimanual abilities. LIMITATIONS There was a limited sample of infants born preterm with significant brain injury. CONCLUSIONS Infants born preterm have impaired abilities to interact with objects even in the first months of life. This impairment likely limits the knowledge they acquire about objects and about how they can act on them; this limited knowledge may, in turn, impair their early learning abilities. These results highlight the need for assessment and intervention tools specific for object exploration in young infants.
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Affiliation(s)
- Michele A Lobo
- M.A. Lobo, PT, PhD, Department of Physical Therapy, University of Delaware, 210K STAR, 540 South College Ave, Newark, DE 19713 (USA).
| | - Elena Kokkoni
- E. Kokkoni, MSc, Department of Physical Therapy, University of Delaware
| | - Andrea Baraldi Cunha
- A.B. Cunha, PT, PhD, Department of Physical Therapy, Federal University of São Carlos, São Carlos, São Paulo, Brazil
| | - James Cole Galloway
- J.C. Galloway, PT, PhD, Department of Physical Therapy, University of Delaware
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Wong T, Taylor HG, Klein N, Espy KA, Anselmo MG, Minich N, Hack M. Kindergarten classroom functioning of extremely preterm/extremely low birth weight children. Early Hum Dev 2014; 90:907-14. [PMID: 25448780 PMCID: PMC4254534 DOI: 10.1016/j.earlhumdev.2014.09.011] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2013] [Revised: 08/12/2014] [Accepted: 09/19/2014] [Indexed: 11/27/2022]
Abstract
BACKGROUND Cognitive, behavioral, and learning problems are evident in extremely preterm/extremely low birth weight (EPT/ELBW, <28 weeks gestational age or <1000 g) children by early school age. However, we know little about how they function within the classroom once they start school. AIMS To determine how EPT/ELBW children function in kindergarten classrooms compared to termborn normal birth weight (NBW) classmates and identify factors related to difficulties in classroom functioning. METHODS A 2001-2003 birth cohort of 111 EPT/ELBW children and 110 NBW classmate controls were observed in regular kindergarten classrooms during a 1-hour instructional period using a time-sample method. The groups were compared on frequencies of individual teacher attention, competing or offtask behaviors, task management/preparation, and academic responding. Regression analysis was also conducted within the EPT/ELBW group to examine associations of these measures with neonatal and developmental risk factors, kindergarten neuropsychological and behavioral assessments, and classroom characteristics. RESULTS The EPT/ELBW group received more individual teacher attention and was more often off-task than the NBW controls. Poorer classroom functioning in the EPT/ELBW group was associated with higher neonatal and developmental risk, poorer executive function skills, more negative teaching ratings of behavior and learning progress, and classroom characteristics. CONCLUSION EPT/ELBW children require more teacher support and are less able to engage in instructional activities than their NBW classmates. Associations of classroom functioning with developmental history and cognitive and behavioral traits suggest that these factors may be useful in identifying the children most in need of special educational interventions.
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Affiliation(s)
- Taylor Wong
- Department of Pediatrics, Case Western Reserve University and Rainbow Babies & Children’s Hospital, University Hospitals Case Medical Center, Cleveland, OH
| | - H. Gerry Taylor
- Department of Pediatrics, Case Western Reserve University and Rainbow Babies & Children’s Hospital, University Hospitals Case Medical Center, Cleveland, OH,Corresponding author at: W.O. Walker Building, Suite 3150, 10524 Euclid Avenue, Cleveland, OH 4106 United States, Tel: +1 216-368-5768; fax: +1 216-368-6640, (H.G. Taylor)
| | - Nancy Klein
- Department of Education, Cleveland State University, Cleveland, OH
| | - Kimberly A. Espy
- Departments of Psychology and of Special Education & Clinical Sciences, University of Oregon, Eugene, OR, and Developmental Cognitive Neuroscience Laboratory, University of Nebraska-Lincoln, Lincoln, NE
| | | | - Nori Minich
- Department of Pediatrics, Case Western Reserve University and Rainbow Babies & Children’s Hospital, University Hospitals Case Medical Center, Cleveland, OH
| | - Maureen Hack
- Department of Pediatrics, Case Western Reserve University and Rainbow Babies & Children’s Hospital, University Hospitals Case Medical Center, Cleveland, OH
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Pessoa RR, Isotani SM, Perissinoto J, Puccini RF. School children with low birth weight inserted in system of Embu's education: construction of sentences. Codas 2014; 26:315-21. [PMID: 25211691 DOI: 10.1590/2317-1782/201420130068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2013] [Accepted: 06/30/2014] [Indexed: 11/22/2022] Open
Abstract
PURPOSE To characterize the construction of sentences in schoolchildren born with low weight. METHODS We selected 413 students from Embu das Artes (SP), Brazil. Application of Recreating Speech Acts of Test of Language Competence sub-test. We analyzed the number of words and the holistic score. Age group of 6-10 years old, female/male, with low birth weight (<2,500 g) in Study Group (SG; n=238), and birth weight above or equal to 2,500 g composing the Control Group (CG; n=175). Children with anomalies were excluded. The both groups' responses were considered as well as the association of the responses with variables birth weight, gender, age of child and maternal age and education, through Student's t-test, χ2test and linear regression. RESULTS The SG scored less on the total number of words and had worst performance in items that involved prepositions with a sense of temporality and place, with adverb functions. There was no difference between groups regarding the holistic score. It was found positive impact of the variables birth weight (p=0.002), age of child, age of mother and maternal education on standard test scores in both groups. CONCLUSION The SG had fewer words compared to CG. The higher the birth weight, the higher the score test pattern. It was evident the age-related changes in morpho-syntactic skills addressed in the study, and protection factors mother's schooling and age had a positive impact on language performance.
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Affiliation(s)
| | - Selma Mie Isotani
- Department of Speech-Language Pathology and Audiology, Universidade Federal São Paulo, São Paulo, SP, Brazil
| | - Jacy Perissinoto
- Department of Speech-Language Pathology and Audiology, Universidade Federal São Paulo, São Paulo, SP, Brazil
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Månsson J, Stjernqvist K. Children born extremely preterm show significant lower cognitive, language and motor function levels compared with children born at term, as measured by the Bayley-III at 2.5 years. Acta Paediatr 2014; 103:504-11. [PMID: 24494838 DOI: 10.1111/apa.12585] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2013] [Revised: 12/09/2013] [Accepted: 01/29/2014] [Indexed: 11/30/2022]
Abstract
AIM To assess developmental outcomes of children aged 2.5 years born extremely preterm. METHODS As a part of the population-based Extremely Preterm Infants in Sweden Study (EXPRESS), 399 children born before 27 weeks of gestation and 366 control children born at term were assessed with the Bayley Scales of Infant and Toddler Development, third edition (Bayley-III), assigning scores for cognition, receptive and expressive communication, fine and gross motor functions. Based on control group means, prevalences of developmental delay in the preterm group were calculated. Mean score differences between subtests constituting the overall Bayley-III indices were analysed within both groups. RESULTS After controlling for socio-demographic, child and assessment variables, analyses showed significantly lower performances of the preterm group compared with the control group on the Bayley-III subtests. Prevalence of moderate-severe delay was 10.8% in cognitive, 14.9% in receptive communication, 14.5% in expressive communication, 12.4% in fine motor and 7.0% in gross motor functions. Significant differences between performances on subtests included in the same indices were detected. CONCLUSION Extremely preterm children show significant lower cognitive, communicative and motor function levels at 2.5 years compared with children born at term. Bayley-III assessments permit the acquisition of nuanced information about development following extreme prematurity.
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Affiliation(s)
- J Månsson
- Department of Psychology; Lund University; Lund Sweden
| | - K Stjernqvist
- Department of Psychology; Lund University; Lund Sweden
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Loe IM, Chatav M, Alduncin N. Complementary assessments of executive function in preterm and full-term preschoolers. Child Neuropsychol 2014; 21:331-53. [PMID: 24754400 DOI: 10.1080/09297049.2014.906568] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Executive functions (EFs) are interrelated cognitive processes that have been studied in relation to behavior, attention, academic achievement, and developmental disorders. Studies of EF skills assessed through parent report and performance-based measures show correlations between them ranging from none to modest. Few studies have examined the relationship between EF skills measured through parent report and performance-based measures in relation to adaptive function. The present study included preschool children born preterm as a population at high risk for EF impairments. Preschool children (N = 149) completed a battery of EF tasks that assess working memory, response inhibition, idea generation, and attention shifting or cognitive flexibility. Parents reported on children's EF and adaptive skills. Preterm children showed more parent-rated and performance-based EF impairments than did full-term children. The combined use of either parent report or performance-based measures resulted in the identification of a large number of children at risk for EF impairment, especially in the preterm group. Both parent report and performance-based EF measures were associated with children's adaptive function. EF skills are measurable in young child'ren, and we suggest that EF skills may serve as targets for intervention to improve functional outcomes. We recommend the use of both parent report and performance-based measures to characterize children's EF profiles and to customize treatment.
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Affiliation(s)
- Irene M Loe
- a Division of Neonatal and Developmental Medicine, Department of Pediatrics , Stanford University School of Medicine , Stanford , CA , USA
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