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Robert de Saint Vincent M, Rouger V, Rozé JC, Flamant C, Muller JB. Assessing Behavioral Disorders with SDQ in Very Preterm Children at 5 Years of Age in LIFT Cohort. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1191. [PMID: 37508688 PMCID: PMC10378436 DOI: 10.3390/children10071191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 06/20/2023] [Accepted: 06/30/2023] [Indexed: 07/30/2023]
Abstract
BACKGROUND Preterm-born children are at risk of behavioral disorders and the systematic assessment of these disorders remains a challenge. Questions remain about the accuracy of self-reported parent questionnaires and the real everyday life behavior of the child. AIM To evaluate the association between SDQ reported by parents in the preterm and behavioral difficulties in the everyday school life environment reported by teacher. METHODS All children born before 33 weeks and who followed-up in the LIFT (Loire Infant Follow-up team) network were included. The Strengths and Difficulties Parental Questionnaire (SDQ), completed at 5 years, was used to check for behavioral difficulties and identified three groups: "normal", "borderline" and "abnormal". Then, the SDQ results were compared to the Global School Adaptation Score (GSA) at 5 years. RESULTS Out of the 1825 children followed in the cohort at the age of 5, 1397 questionnaires were analyzed. A total of 11.1% of children had an abnormal score, and 9.7% had a borderline score. Male gender and a lower birth weight z-score were significantly associated with the "abnormal SDQ" group. There is a significant relationship between the probability of being in the "abnormal SDQ" group at 5 years and with difficulty in global school adaptation at 5 years, as well as an SDQ borderline score in the preterm (p < 0.001). CONCLUSIONS SDQ abnormal and borderline scores are associated with behavioral difficulties in the classroom and everyday life behavior. In preterm children, one should be alerted even by a borderline SDQ score.
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Affiliation(s)
- Marine Robert de Saint Vincent
- Department of Neonatal Medicine, University Hospital of Nantes, 44000 Nantes, France
- Loire Infant Follow-Up Team (LIFT) Network, 44000 Nantes, France
| | - Valérie Rouger
- Loire Infant Follow-Up Team (LIFT) Network, 44000 Nantes, France
- National Institute of Health and Medical Research, CIC 1413, University Hospital of Nantes, 44000 Nantes, France
| | - Jean Christophe Rozé
- Department of Neonatal Medicine, University Hospital of Nantes, 44000 Nantes, France
- Loire Infant Follow-Up Team (LIFT) Network, 44000 Nantes, France
- National Institute of Health and Medical Research, CIC 1413, University Hospital of Nantes, 44000 Nantes, France
| | - Cyril Flamant
- Department of Neonatal Medicine, University Hospital of Nantes, 44000 Nantes, France
- Loire Infant Follow-Up Team (LIFT) Network, 44000 Nantes, France
- National Institute of Health and Medical Research, CIC 1413, University Hospital of Nantes, 44000 Nantes, France
| | - Jean-Baptiste Muller
- Department of Neonatal Medicine, University Hospital of Nantes, 44000 Nantes, France
- Loire Infant Follow-Up Team (LIFT) Network, 44000 Nantes, France
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2
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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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3
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Ginnell L, Boardman JP, Reynolds RM, Fletcher‐Watson S. Attention profiles following preterm birth: A review of methods and findings from infancy to adulthood. INFANT AND CHILD DEVELOPMENT 2021. [DOI: 10.1002/icd.2255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Lorna Ginnell
- Centre for Clinical Brain Sciences The University of Edinburgh Edinburgh UK
| | - James P. Boardman
- MRC Centre for Reproductive Health, The Queen's Medical Research Institute The University of Edinburgh Edinburgh UK
| | - Rebecca M. Reynolds
- Centre for Cardiovascular Science, The Queen's Medical Research Institute The University of Edinburgh Edinburgh UK
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4
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Cainelli E, Vedovelli L, Wigley ILCM, Bisiacchi PS, Suppiej A. Neonatal spectral EEG is prognostic of cognitive abilities at school age in premature infants without overt brain damage. Eur J Pediatr 2021; 180:909-918. [PMID: 32989487 PMCID: PMC7886838 DOI: 10.1007/s00431-020-03818-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 09/16/2020] [Accepted: 09/21/2020] [Indexed: 11/25/2022]
Abstract
Prematurity is a prototype of biological risk that could affect the late neurocognitive outcome; however, the condition itself remains a non-specific marker. This longitudinal 6-year study aimed to evaluate the prognostic role of neonatal spectral EEG in premature infants without neurological complications. The study cohort was 26 children born 23-34 gestational ages; all neonates underwent multichannel EEG recordings at 35 weeks post-conception. EEG data were transformed into the frequency domain and divided into delta (0.5-4 Hz), theta (5-7 Hz), alpha (8-13 Hz), and beta (14-20 Hz) frequency bands. At 6 years, a neuropsychological and behavioral evaluation was performed. Correlations between spectral bands and neuropsychological assessments were performed with a conservative and robust Bayesian correlation model using weakly informative priors. The correlation of neuropsychological tasks to spectral frequency bands highlighted a significant association with visual and auditory attention tests. The performance on the same tests appears to be mainly impaired.Conclusions: We found that spectral EEG frequencies are independent predictors of performance in attention tasks. We hypothesized that spectral EEG might reflect early circuitries' imbalance in the reticular ascending system and cumulative effect on ongoing development, pointing to the importance of early prognostic instruments. What is Known: • Prematurity is a non-specific marker of late neurocognitive risk. • Precise prognostic instruments are lacking, mostly in patients with low-grade conditions. What is New: • Longitudinal long-term studies are scarce but crucial for the inferential attributive process. • Spectral EEG frequencies are independent predictors of performance in attention tasks.
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Affiliation(s)
- Elisa Cainelli
- Department of General Psychology, University of Padova, via Venezia 8, 35131 Padova, Italy
- Child Neurology and Clinical Neurophysiology, Padua University Hospital, via Giustiniani 3, 35133 Padova, Italy
| | - Luca Vedovelli
- Lab LeSexp, Unit of Biostatistics, Epidemiology, and Public Health, Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padova, via Loredan 18, 35131 Padova, Italy
| | | | - Patrizia Silvia Bisiacchi
- Department of General Psychology, University of Padova, via Venezia 8, 35131 Padova, Italy
- Padova Neuroscience Centre, PNC, Padova, Italy
| | - Agnese Suppiej
- Child Neurology and Clinical Neurophysiology, Padua University Hospital, via Giustiniani 3, 35133 Padova, Italy
- Department of Medical Sciences, Pediatric Section, University of Ferrara, via Aldo Moro 8, 44124 Cona, Fe Italy
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5
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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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6
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Arpi E, D'Amico R, Lucaccioni L, Bedetti L, Berardi A, Ferrari F. Worse global intellectual and worse neuropsychological functioning in preterm-born children at preschool age: a meta-analysis. Acta Paediatr 2019; 108:1567-1579. [PMID: 31069843 DOI: 10.1111/apa.14836] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2019] [Revised: 04/26/2019] [Accepted: 05/03/2019] [Indexed: 11/28/2022]
Abstract
AIM Preterm births (<32 weeks of gestational age) are associated with cognitive problems that are difficult to diagnose in infancy but potentially detectable at preschool age. This review aimed to evaluate the extent to which total intelligence quotient (IQ) and neuropsychological functions at ages three to five years differ between children born at <32 weeks gestational age or < 1500 g birth weight and children born at term. The secondary aim was to determine whether cognitive performance differs between extremely preterm (EPT)/extremely low birth weight (ELBW) children and very preterm (VPT) or very low birth weight (VLBW) children. METHODS PubMed and PsycINFO databases were searched for cohort studies comparing IQ and neuropsychological functions in term-born and preterm-born children born after 1994. RESULTS At ages three to five years, preterm-born children, compared with term-born ones, had worse IQ mean score (d = -0.77 [95% confidence interval -0.88 to -0.66]), attention, memory, visuomotor integration skill and executive functions. No differences were found between VPT/VLBW and EPT/ELBW children. CONCLUSION Preterm-born children showed poorer IQ and neuropsychological functions compared with term-born subjects already at preschool age. The extent of differences is similar to that detected at a later age.
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Affiliation(s)
- Elena Arpi
- Department of Child and Adult Medical and Surgery Science University Hospital of Modena and Reggio Emilia Modena Italy
| | - Roberto D'Amico
- Department of Medical and Surgical Science University Hospital of Modena and Reggio Emilia Modena Italy
| | - Laura Lucaccioni
- Department of Child and Adult Medical and Surgery Science University Hospital of Modena and Reggio Emilia Modena Italy
| | - Luca Bedetti
- Department of Child and Adult Medical and Surgery Science University Hospital of Modena and Reggio Emilia Modena Italy
| | - Alberto Berardi
- Department of Child and Adult Medical and Surgery Science University Hospital of Modena and Reggio Emilia Modena Italy
| | - Fabrizio Ferrari
- Department of Child and Adult Medical and Surgery Science University Hospital of Modena and Reggio Emilia Modena Italy
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Cormack BE, Harding JE, Miller SP, Bloomfield FH. The Influence of Early Nutrition on Brain Growth and Neurodevelopment in Extremely Preterm Babies: A Narrative Review. Nutrients 2019; 11:E2029. [PMID: 31480225 PMCID: PMC6770288 DOI: 10.3390/nu11092029] [Citation(s) in RCA: 83] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 08/22/2019] [Accepted: 08/27/2019] [Indexed: 12/29/2022] Open
Abstract
Extremely preterm babies are at increased risk of less than optimal neurodevelopment compared with their term-born counterparts. Optimising nutrition is a promising avenue to mitigate the adverse neurodevelopmental consequences of preterm birth. In this narrative review, we summarize current knowledge on how nutrition, and in particular, protein intake, affects neurodevelopment in extremely preterm babies. Observational studies consistently report that higher intravenous and enteral protein intakes are associated with improved growth and possibly neurodevelopment, but differences in methodologies and combinations of intravenous and enteral nutrition strategies make it difficult to determine the effects of each intervention. Unfortunately, there are few randomized controlled trials of nutrition in this population conducted to determine neurodevelopmental outcomes. Substantial variation in reporting of trials, both of nutritional intakes and of outcomes, limits conclusions from meta-analyses. Future studies to determine the effects of nutritional intakes in extremely preterm babies need to be adequately powered to assess neurodevelopmental outcomes separately in boys and girls, and designed to address the many potential confounders which may have clouded research findings to date. The development of minimal reporting sets and core outcome sets for nutrition research will aid future meta-analyses.
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Affiliation(s)
- Barbara E Cormack
- Starship Child Health, Auckland City Hospital, Auckland 1023, New Zealand
- Liggins Institute, University of Auckland, Auckland 1142, New Zealand
| | - Jane E Harding
- Liggins Institute, University of Auckland, Auckland 1142, New Zealand
| | - Steven P Miller
- Department of Paediatrics, Hospital for Sick Children, Toronto, ON M5G, Canada
- Department of Paediatrics, University of Toronto, Toronto, ON M5S, Canada
| | - Frank H Bloomfield
- Starship Child Health, Auckland City Hospital, Auckland 1023, New Zealand.
- Liggins Institute, University of Auckland, Auckland 1142, New Zealand.
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8
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Milette I, Martel MJ, Ribeiro da Silva M, Coughlin McNeil M. Guidelines for the Institutional Implementation of Developmental Neuroprotective Care in the Neonatal Intensive Care Unit. Part A: Background and Rationale. A Joint Position Statement From the CANN, CAPWHN, NANN, and COINN. Can J Nurs Res 2019; 49:46-62. [PMID: 28841058 DOI: 10.1177/0844562117706882] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
The use of age-appropriate care as an organized framework for care delivery in the neonatal intensive care unit is founded on the work of Heidelise Als, PhD, and her synactive theory of development. This theoretical construct has recently been advanced by the work of Gibbins and colleagues with the "universe of developmental care" conceptual model and developmental care core measures which were endorsed by the National Association of Neonatal Nurses in their age-appropriate care of premature infant guidelines as best-practice standards for the provision of high-quality care in the neonatal intensive care unit. These guidelines were recently revised and expanded. In alignment with the Joint Commission's requirement for health-care professionals to provide age-specific care across the lifespan, the core measures for developmental care suggest the necessary competencies for those caring for the premature and critically ill hospitalized infant. Further supported by the Primer Standards of Accreditation and Health Canada, the institutional implementation of theses core measures requires a strong framework for institutional operationalization, presented in these guidelines. Part A of this article will present the background and rationale behind the present guidelines and their condensed table of recommendations.
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Affiliation(s)
- Isabelle Milette
- 1 NNP, Neonatal Intensive Care Unit, Mother and Child University Hospital Center Sainte-Justine, Montréal, Québec, Canada.,2 Quebec Nursing Intervention Research Network (RRISIQ), Québec, Canada
| | - Marie-Josée Martel
- 2 Quebec Nursing Intervention Research Network (RRISIQ), Québec, Canada.,3 University of Quebec in Trois-Rivières, Trois-Rivières, Canada.,4 Associate researcher, Sainte-Justine University Hospital Research Center, Montréal, Québec, Canada.,5 Regular researcher, Centre d'études interdisciplinaires sur le développement de l'enfant et la famille (CEIDEF), University of Quebec in Trois-Rivières, Trois-Rivières, Canada
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9
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Zvara BJ, Keim SA, Boone KM, Anderson SE. Associations between parenting behavior and executive function among preschool-aged children born very preterm. EARLY CHILDHOOD RESEARCH QUARTERLY 2019; 48:317-324. [PMID: 32189828 PMCID: PMC7079770 DOI: 10.1016/j.ecresq.2019.01.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The objective of the current study was to determine whether three domains of observed parenting behavior were associated with executive function in preschool-aged children born very preterm (<30 completed weeks' gestation). Executive function of 41 preschool-aged (3.5 to 4.5 years) children was assessed using a standardized protocol (gift delay) and by parent-report (Behavior Rating Inventory of Executive Function-Preschool, BRIEF-P). Observational protocols were used to determine parental sensitivity, harsh intrusiveness, and dyadic mutuality in a semi-structured play task. Parental sensitivity and mutuality were rated as higher, and harsh intrusiveness was rated as lower for children high in executive function on the gift delay task. Similarly, correlations between the three parenting scales and the BRIEF-P Global Executive Composite t-score were in the expected direction though not always statistically significant. Findings suggest that very preterm children who experienced sensitive parenting and were rated as having greater mutuality in their interactions with their caregivers scored higher on executive function tasks. These findings add to the growing literature on the key role that sensitive parenting and mutually responsive, harmonious interactions between caregivers and children may play in the development of executive function in very preterm children.
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Affiliation(s)
- Bharathi J Zvara
- The University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Sarah A Keim
- The Research Institute at Nationwide Children's Hospital, Columbus, Ohio
- College of Public Health, The Ohio State University, Columbus, Ohio
| | - Kelly M Boone
- Schoenbaum Family Center and Crane Center for Early Childhood Research and Policy, The Ohio State University, Columbus, OH
| | - Sarah E Anderson
- College of Public Health, The Ohio State University, Columbus, Ohio
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10
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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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11
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O'Meagher S, Norris K, Kemp N, Anderson P. Parent and teacher reporting of executive function and behavioral difficulties in preterm and term children at kindergarten. APPLIED NEUROPSYCHOLOGY-CHILD 2019; 9:153-164. [DOI: 10.1080/21622965.2018.1550404] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Sari O'Meagher
- School of Medicine (Psychology), University of Tasmania, Hobart, Australia
| | - Kimberley Norris
- School of Medicine (Psychology), University of Tasmania, Hobart, Australia
| | - Nenagh Kemp
- School of Medicine (Psychology), University of Tasmania, Hobart, Australia
| | - Peter Anderson
- Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Melbourne, Australia
- Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia
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12
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FitzGerald TL, Kwong AKL, Cheong JLY, McGinley JL, Doyle LW, Spittle AJ. Body Structure, Function, Activity, and Participation in 3- to 6-Year-Old Children Born Very Preterm: An ICF-Based Systematic Review and Meta-Analysis. Phys Ther 2018; 98:691-704. [PMID: 29912447 DOI: 10.1093/ptj/pzy050] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Accepted: 04/17/2018] [Indexed: 02/09/2023]
Abstract
BACKGROUND The World Health Organization's International Classification of Functioning, Disability, and Health framework, Children and Youth Version (ICF-CY), provides a valuable method of conceptualizing the multidomain difficulties experienced by children born very preterm (VP). Reviews investigating motor outcomes at preschool age across ICF-CY domains are lacking. PURPOSE The purpose of this review is to identify and compare motor outcomes of 3- to 6-year-old children born VP and children born full-term (FT) within the ICF-CY framework. DATA SOURCES Four electronic databases and reference lists of included and key articles were searched. STUDY SELECTION Studies comparing motor outcomes of 3- to 6-year-old children born VP (<32 weeks' gestation or birth weight <1500 g) with peers born FT were included. DATA EXTRACTION Two independent authors extracted data and completed quality assessments. DATA SYNTHESIS Thirty-six studies were included. Activity motor performance of children born VP was consistently poorer compared with peers born FT: standardized mean difference (SMD) was -0.71 (95% CI = -0.80 to -0.61; 14 studies, 2056 participants). Furthermore, children born VP had higher relative risk (RR) of motor impairment (RR = 3.39; 95% CI = 2.68 to 4.27; 9 studies, 3466 participants). Body structure and function outcomes were largely unable to be pooled because assessment tools varied too widely. However, children born VP had higher RR of any neurological dysfunction (Touwen Neurological Examination) (RR = 4.55; 95% CI = 1.20 to 17.17; 3 studies, 1363 participants). There were no participation outcome data. LIMITATIONS Limitations include the lack of consistent assessment tools used in VP follow-up at preschool age and the quality of the evidence. CONCLUSIONS Children born VP experience significant motor impairment across ICF-CY activity and body structure and function domains at preschool age compared with peers born FT. Evidence investigating participation in VP preschool-age populations relative to children born at term is sparse, requiring further research.
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Affiliation(s)
- Tara L FitzGerald
- Department of Physiotherapy, The University of Melbourne, Victoria, Australia.,Newborn Research Centre, The Royal Women's Hospital, Victoria, Australia.,Victorian Infant Brain Studies, Clinical Sciences, Murdoch Children's Research Institute, The Royal Children's Hospital, 50 Flemington Rd, Parkville, Melbourne, Victoria 3052, Australia
| | - Amanda K L Kwong
- Department of Physiotherapy, The University of Melbourne, Victoria, Australia.,Newborn Research Centre, The Royal Women's Hospital, Victoria, Australia.,Victorian Infant Brain Studies, Clinical Sciences, Murdoch Children's Research Institute, The Royal Children's Hospital, 50 Flemington Rd, Parkville, Melbourne, Victoria 3052, Australia
| | - Jeanie L Y Cheong
- Newborn Research Centre, The Royal Women's Hospital, Victoria, Australia.,Victorian Infant Brain Studies, Clinical Sciences, Murdoch Children's Research Institute, The Royal Children's Hospital, 50 Flemington Rd, Parkville, Melbourne, Victoria 3052, Australia.,Department of Obstetrics and Gynaecology, The University of Melbourne, The Royal Women's Hospital
| | - Jennifer L McGinley
- Department of Physiotherapy, The University of Melbourne, Victoria, Australia
| | - Lex W Doyle
- Newborn Research Centre, The Royal Women's Hospital, Victoria, Australia.,Victorian Infant Brain Studies, Clinical Sciences, Murdoch Children's Research Institute, The Royal Children's Hospital, 50 Flemington Rd, Parkville, Melbourne, Victoria 3052, Australia.,Department of Obstetrics and Gynaecology, The University of Melbourne, The Royal Women's Hospital.,Department of Paediatrics, The University of Melbourne, The Royal Women's Hospital
| | - Alicia J Spittle
- Department of Physiotherapy, The University of Melbourne, Victoria, Australia.,Newborn Research Centre, The Royal Women's Hospital, Victoria, Australia.,Victorian Infant Brain Studies, Clinical Sciences, Murdoch Children's Research Institute, The Royal Children's Hospital, 50 Flemington Rd, Parkville, Melbourne, Victoria 3052, Australia
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13
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Dilworth-Bart JE, Poehlmann-Tynan JA, Taub A, Liesen CA, Bolt D. Longitudinal associations between self-regulation and the academic and behavioral adjustment of young children born preterm. EARLY CHILDHOOD RESEARCH QUARTERLY 2017; 42:193-204. [PMID: 29403148 PMCID: PMC5796547 DOI: 10.1016/j.ecresq.2017.09.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Much of the research to date about the structure of self-regulation in early childhood has been conducted with low medical risk samples, with the general conclusion that self-regulation can be separated into overlapping executive function and effortful control factors that differentially predict child outcomes. We examined the factor structure of 36-month self-regulation among children born prematurely (n = 168) and the extent to which self-regulation predicted maternal ratings of children's socioemotional and academic competence when they were six years of age. Statistical analyses revealed a single self-regulation factor for this high neonatal risk sample, and this self-regulation factor mediated associations between early sociodemographic risk and mothers' ratings of academic competence and externalizing problems. Our findings suggest that early intervention research with children born preterm should focus on promoting supportive early environments, particularly parental sensitivity to infant cues.
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Affiliation(s)
- Janean E Dilworth-Bart
- Department of Human Development and Family Studies, University of Wisconsin-Madison when this research was completed
| | - Julie A Poehlmann-Tynan
- Department of Human Development and Family Studies, University of Wisconsin-Madison when this research was completed
| | - Amy Taub
- Department of Human Development and Family Studies, University of Wisconsin-Madison when this research was completed
| | - Carolyn A Liesen
- Department of Human Development and Family Studies, University of Wisconsin-Madison when this research was completed
| | - Daniel Bolt
- Department of Human Development and Family Studies, University of Wisconsin-Madison when this research was completed
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14
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Lowe JR, Rieger RE, Moss NC, Yeo RA, Winter S, Patel S, Phillips J, Campbell R, Baker S, Gonzales S, Ohls RK. Impact of Erythropoiesis-Stimulating Agents on Behavioral Measures in Children Born Preterm. J Pediatr 2017; 184:75-80.e1. [PMID: 28185625 PMCID: PMC6352724 DOI: 10.1016/j.jpeds.2017.01.020] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Revised: 12/09/2016] [Accepted: 01/06/2017] [Indexed: 12/30/2022]
Abstract
OBJECTIVE To evaluate the impact of erythropoiesis-stimulating agents (ESAs) administered during initial hospitalization and family demographic factors on behavior at 3.5-4 years of age. STUDY DESIGN Children were enrolled who had previously participated in a randomized study of ESAs (n = 35) or placebo (n = 14) in infants born preterm with birth weights of 500-1250 g. A term healthy control group (n = 22) also was recruited. Behavior was evaluated by parent report with the Behavioral Assessment System of Children-2. Principal component analyses identified 2 demographic factors, a Socioeconomic Composite (SEC) and a Family Stress Composite. A multivariate general linear model evaluated the impact of study group and sex on the 4 composite scales of the Behavioral Assessment System of Children-2. Demographic factors were treated as covariates and interactions with study group (ESA, placebo, and term) were examined. RESULTS The ESA group had significantly better scores than the placebo group on behavioral symptoms (P = .04) and externalizing scales (P = .04). An interaction was observed between study group and SEC (P = .001). A beneficial effect of ESAs was maximal in the children with lower SEC scores. CONCLUSIONS The beneficial effects of ESAs on childhood behavior were maximal in children with lower SEC scores. ESAs seemed to ameliorate the adverse impact of lower SEC on behavioral domains seen in the placebo group. This effect was independent of the beneficial effect of ESAs on global cognition we reported previously. TRIAL REGISTRATION ClinicalTrials.gov: NCT01207778 and NCT00334737.
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Affiliation(s)
- Jean R. Lowe
- Department of Pediatrics, University of New Mexico School
of Medicine, Albuquerque, NM
| | | | - Natalia C. Moss
- Department of Psychology, University of New Mexico,
Albuquerque, NM
| | - Ronald A. Yeo
- Department of Psychology, University of New Mexico,
Albuquerque, NM
| | - Sarah Winter
- Department of Pediatrics, University of Utah, Salt Lake
City, UT
| | - Shrena Patel
- Department of Pediatrics, University of Utah, Salt Lake
City, UT
| | - John Phillips
- Department of Neurology, University of New Mexico,
Albuquerque, NM
| | - Richard Campbell
- Department of Psychiatry, University of New Mexico,
Albuquerque, NM
| | - Shawna Baker
- Department of Pediatrics, University of Utah, Salt Lake
City, UT
| | - Sean Gonzales
- Department of Pediatrics, University of New Mexico School
of Medicine, Albuquerque, NM
| | - Robin K. Ohls
- Department of Pediatrics, University of New Mexico School
of Medicine, Albuquerque, NM
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15
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Hopp CA, Baron IS. Birth at 22 gestational weeks: case report of cognitive resilience. Clin Neuropsychol 2016; 31:471-486. [DOI: 10.1080/13854046.2016.1224802] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Crista A. Hopp
- Fairfax Neonatal Associates at Inova Children’s Hospital, Falls Church, VA, USA
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16
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Neuropsychological Outcomes in Extremely Preterm Preschoolers Exposed to Tiered Low Oxygen Targets: An Observational Study. J Int Neuropsychol Soc 2016; 22:322-31. [PMID: 26646724 DOI: 10.1017/s1355617715001186] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
An observational study of neuropsychological outcomes at preschool age of tiered lowered oxygen (O2) saturation targets in extremely preterm neonates. We studied 111 three-year-olds born <28 weeks' gestational age. Fifty-nine participants born in 2009-2010 during a time-limited quality improvement initiative each received three-tiered stratification of oxygen rates (83-93% until age 32 weeks, 85-95% until age 35 weeks, and 95% after age 35 weeks), the TieredO2 group. Comparisons were made with 52 participants born in 2007-2008 when pre-initiative saturation targets were non-tiered at 89-100%, the Non-tieredO2 group. Neuropsychological domains included general intellectual, executive, attention, language, visuoperceptual, visual-motor, and fine and gross motor functioning. Descriptive and inferential analyses were conducted. Group comparisons were not statistically significant. Descriptively, the TieredO2 group had better general intellectual, executive function, visual-motor, and motor performance and the Non-tieredO2 group had better language performance. Cohen's d and confidence intervals around d were in similar direction and magnitude across measures. A large effect size was found for recall of digits-forward in participants born at 23 and 24 weeks' gestation, d=0.99 and 1.46, respectively. Better TieredO2 outcomes in all domains except language suggests that the tiered oxygen saturation target method is not harmful and merits further investigation through further studies. Benefit in auditory attention appeared greatest in those born at 23 and 24 weeks. Participants in the tiered oxygen saturation group also had fewer ventilation days and a lower incidence of bronchopulmonary dysplasia, perhaps explanatory for these neuropsychological outcomes at age 3.
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17
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Ritchie K, Bora S, Woodward LJ. Social development of children born very preterm: a systematic review. Dev Med Child Neurol 2015; 57:899-918. [PMID: 25914112 DOI: 10.1111/dmcn.12783] [Citation(s) in RCA: 84] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/16/2015] [Indexed: 01/25/2023]
Abstract
AIM To review systematically studies examining the development of social competence in children born very preterm (VPT) (gestation <33 wks) and identify neonatal and family predictors. METHOD Peer-reviewed original articles were extracted from PubMed and PsycINFO following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Selection criteria included children born VPT and comparison children born at term, sample born after 1990, and children assessed between 0 and 17 years on at least one measure of social competence spanning social adjustment, performance, and/or social skills. RESULTS Twenty-three studies were included. Seven focused on social competence and another 16 examined social competence within a range of outcomes. Study quality was low. Limitations included reliance on single informant data, cross-sectional measurement, use of brief screening tools, absence of child or peer report, and no conceptual model. In terms of social adjustment, 16 out of 21 studies found children born VPT had more peer problems and social withdrawal. Findings of social performance were mixed, with some studies suggesting differences in prosocial behavior (4/14) and others not. Social skills were assessed in four studies and showed children born VPT had poorer skills than children born at term. Predictors of social competence included gestational age, neonatal brain abnormalities, and family socio-economic status. INTERPRETATION Children born VPT have poorer social competence. These difficulties emerge early and persist throughout childhood.
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Affiliation(s)
- Kirsten Ritchie
- Department of Psychology, University of Canterbury, Christchurch, New Zealand
| | - Samudragupta Bora
- Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Lianne J Woodward
- Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
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18
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Molloy CS, Anderson PJ, Anderson VA, Doyle LW. The long-term outcome of extremely preterm (<28 weeks’ gestational age) infants with and without severe retinopathy of prematurity. J Neuropsychol 2015; 10:276-94. [DOI: 10.1111/jnp.12069] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2014] [Revised: 01/24/2015] [Indexed: 12/31/2022]
Affiliation(s)
- Carly S. Molloy
- Murdoch Childrens Research Institute; Melbourne Victoria Australia
| | - Peter J. Anderson
- Murdoch Childrens Research Institute; Melbourne Victoria Australia
- University of Melbourne; Victoria Australia
- Royal Women's Hospital; Melbourne Victoria Australia
| | - Vicki A. Anderson
- Murdoch Childrens Research Institute; Melbourne Victoria Australia
- University of Melbourne; Victoria Australia
- Royal Children's Hospital; Melbourne Victoria Australia
| | - Lex W. Doyle
- Murdoch Childrens Research Institute; Melbourne Victoria Australia
- University of Melbourne; Victoria Australia
- Royal Women's Hospital; Melbourne Victoria Australia
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19
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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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20
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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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21
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Reuner G, Weinschenk A, Pauen S, Pietz J. Cognitive development in 7- to 24-month-old extremely/very-to-moderately/late preterm and full-term born infants: The mediating role of focused attention. Child Neuropsychol 2014; 21:314-30. [PMID: 24697340 DOI: 10.1080/09297049.2014.899571] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
The present study analyzed the links between prematurity, attention, and global cognitive performance in infancy and early childhood. At 7 months, focused attention (FA) was examined with an object examination task in 93 preterm infants (39 of them born extremely/very preterm, 54 born moderately/late preterm, and 38 infants born full-term). Global cognition was assessed at 7 and 24 months with the Bayley-II cognitive scale. Groups did not differ with respect to global cognitive performance but FA of infants born extremely/very preterm was significantly lower than in infants born moderately/late preterm. FA correlated significantly with both prematurity and cognitive performance at 7 months of age but not with global cognition in childhood. Findings point to a subtle adverse effect of prematurity on early attention and reveal evidence for the mediating role of FA on the effect of prematurity on cognition.
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Affiliation(s)
- Gitta Reuner
- a Section Neuropediatrics , Children's University Hospital , Heidelberg , Baden-Wuerttemberg , Germany
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22
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McCann JP, Rider GN, Weiss BA, Litman FR, Baron IS. Latent mean comparisons on the BRIEF in preterm children: Parent and teacher differences. Child Neuropsychol 2013; 20:737-51. [DOI: 10.1080/09297049.2013.859663] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- James P McCann
- a Fairfax Neonatal Associates at Inova Children's Hospital , Fairfax , Virginia , USA
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23
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Arpi E, Ferrari F. Preterm birth and behaviour problems in infants and preschool-age children: a review of the recent literature. Dev Med Child Neurol 2013; 55:788-96. [PMID: 23521214 DOI: 10.1111/dmcn.12142] [Citation(s) in RCA: 172] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/24/2013] [Indexed: 11/29/2022]
Abstract
The behaviour problems of children born preterm at school age are well known, but there have been few studies on the behaviour problems of preterm-born infants during infancy and at preschool age. Fourteen cohort studies published in PubMed and PsycINFO between 2000 and 2012 were reviewed with a focus on the type, occurrence, comorbidity, stability, prediction, perinatal, social, and relational risk factors for behaviour problems of preterm-born children in infancy (0-2y) and at preschool age (3-5y). The relational risk factor was considered in an additional four papers. Very-preterm, very-low-birthweight, and moderately-preterm children, in both age groups, show more behaviour problems than term-born comparison children even after perinatal and social risk factors and cognitive performance have been controlled for. Poor social/interactive skills, poor behavioural and emotional self-regulation, emotional difficulties, and reduced attention are the most common behaviour problems. Behaviour problems in infancy are predictive of later behaviour problems and they should be included in follow-up programmes.
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Affiliation(s)
- Elena Arpi
- Occupational Medicine Services, Padua University Hospital, Padua, Italy
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24
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Pugliese M, Rossi C, Guidotti I, Gallo C, Della Casa E, Bertoncelli N, Coccolini E, Ferrari F. Preterm birth and developmental problems in infancy and preschool age Part II: cognitive, neuropsychological and behavioural outcomes. J Matern Fetal Neonatal Med 2013; 26:1653-7. [PMID: 23570550 DOI: 10.3109/14767058.2013.794205] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Few studies focus on the neuropsychological and behavioural outcomes of preterm children at preschool age. This article reviews the most recent and relevant contributions on cognitive, neuropsychological and behavioural outcomes, and the neuroradiological findings in extremely and very preterm infants. In the first 2 years of life, cognitive impairment is common: it has an incidence of 30-40% and a higher prevalence than neuromotor and neurosensorial impairments. Recent studies report that even preterm infants with no major disabilities at preschool age perform more poorly than term peers in multiple neuropsychological domains, such as language, attention, memory, visuomotor and visuospatial processing and executive functions. The incidence and severity of problems increase with decreasing gestational age. A delayed acquisition of neuropsychological functions and/or the occurrence of behavioural problems at preschool age are likely to be predictive of the high rate of cognitive deficits at school age and in adolescence. Neuropsychological functions across multiple developmental domains should be assessed longitudinally during routine follow-up checks.
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Affiliation(s)
- Marisa Pugliese
- Institute of Pediatrics and Neonatal Medicine and NICU of Modena University Hospital , Modena , Italy
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25
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Heinonen K, Pesonen AK, Lahti J, Pyhälä R, Strang-Karlsson S, Hovi P, Järvenpää AL, Eriksson JG, Andersson S, Kajantie E, Raikkonen K. Self- and parent-rated executive functioning in young adults with very low birth weight. Pediatrics 2013; 131:e243-50. [PMID: 23209110 DOI: 10.1542/peds.2012-0839] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Adults born preterm score lower on performance-based tests of executive functioning (EF) than their term-born peers. These test scores do not necessarily translate to application of these skills in an everyday environment. The objective of the study was to test differences between very low birth weight (VLBW; <1500 g) adults and their term-born peers in self- and parent-rated EF and examine concordance between self- and parent-rated EF and performance-based tests of EF. METHODS A longitudinal study of 90 VLBW adults and 93 term-born controls (aged 21-30 years) was performed. The young adults and their parents filled in the Behavioral Rating Inventory of Executive Functioning-Adult Version, and the adults underwent performance-based tests of EF. RESULTS VLBW young adults and especially those born appropriate for gestational age reported fewer problems in behavioral regulation and global EF than term-born controls; however, parents of VLBW adults born small for gestational age reported more problems for their children in all EF scales than parents of the controls. Compared with their parents, VLBW young adults reported fewer problems in behavioral regulation. Adults' ratings and their parents' ratings correlated significantly among VLBW and control groups. In the VLBW and VLBW/small-for-gestational-age groups, parent ratings of EF were correlated to performance-based tests, whereas among term-born adults, self-reports correlated. CONCLUSIONS These findings reveal that VLBW adults may have learned to compensate in the everyday environment for their EF deficits apparent in performance-based tests. Alternatively, VLBW adults may have positively skewed views of their abilities.
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Affiliation(s)
- Kati Heinonen
- Institute of Behavioural Sciences, University of Helsinki, Helsinki, Finland
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26
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Baron IS, Kerns KA, Müller U, Ahronovich MD, Litman FR. Executive functions in extremely low birth weight and late-preterm preschoolers: Effects on working memory and response inhibition. Child Neuropsychol 2012; 18:586-99. [PMID: 22122351 DOI: 10.1080/09297049.2011.631906] [Citation(s) in RCA: 78] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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27
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Wilkening GN, Madden JR. Memory Disorders in Children With Central Nervous System Germ Cell Tumors. J Pediatr Oncol Nurs 2012; 29:161-70. [DOI: 10.1177/1043454212439938] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Memory disorders in children and adolescents with brain tumors are rare, but devastating to social, academic, and vocational development. Many pediatric patients with intracranial germ cell tumors (GCTs) complain of memory difficulties. This study investigated memory across a series of GCT patients. A total of 33 GCT patients were retrospectively examined for diagnosis, imaging results, intelligence quotient, treatment variables, evidence of increased intracranial pressure at diagnosis, and memory. The incidence of amnesia in GCT patients was 55%. Memory disturbance could not be predicted by intelligence quotient, treatment, location of lesion, or hydrocephalus at diagnosis. The high incidence of memory deficits in GCT patients suggests a risk to memory in patients with GCT. Formal memory assessment should be considered in all patients with central nervous system GCTs. Specific counseling and planning to assist in adjustment and to ensure safety should be considered standard care for those with memory deficits. The nurse should be instrumental in facilitating understanding of this specific injury in the brain tumor population.
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28
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Abstract
Our objectives were to examine cognitive outcomes for extremely preterm/extremely low birth weight (EPT/ELBW, gestational age <28 weeks and/or birth weight <1000 g) children in kindergarten and the associations of these outcomes with neonatal factors, early childhood neurodevelopmental impairment, and socioeconomic status (SES). The sample comprised a hospital-based 2001-2003 birth cohort of 148 EPT/ELBW children (mean birth weight 818 g; mean gestational age 26 weeks) and a comparison group of 111 term-born normal birth weight (NBW) classmate controls. Controlling for background factors, the EPT/ELBW group had pervasive deficits relative to the NBW group on a comprehensive test battery, with rates of cognitive deficits that were 3 to 6 times higher in the EPT/ELBW group. Deficits on a measure of response inhibition were found in 48% versus 10%, odds ratio (95% confidence interval) = 7.32 (3.32, 16.16), p < .001. Deficits on measures of executive function and motor and perceptual-motor abilities were found even when controlling for acquired verbal knowledge. Neonatal risk factors, early neurodevelopmental impairment, and lower SES were associated with higher rates of deficits within the EPT/ELBW group. The findings document both global and selective cognitive deficits in EPT/ELBW children at school entry and justify efforts at early identification and intervention.
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29
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Baron IS, Brandt J, Ahronovich MD, Baker R, Erickson K, Litman FR. Selective deficit in spatial location memory in extremely low birth weight children at age six: the PETIT study. Child Neuropsychol 2011; 18:299-311. [PMID: 21961936 DOI: 10.1080/09297049.2011.613815] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Spatial location memory has rarely been assessed in young children due to a scarcity of developmentally appropriate tests. This study sought to compare nonverbal learning and recall in children born extremely low birth weight (ELBW; <1000 g) and less than 33 gestational weeks (GW) with term-born children at early school age using a recently developed and adapted test. We administered a modification of the Hopkins Board to 210 children at age six; 84 born ELBW (35 born < 26 GW; 49 born 26-33 GW) and 126 term-born. Six measures were obtained: naming, trials-to-criterion, errors-to-criterion, delayed item recall, delayed location recall, and percent retention. After age correction, ELBW children had worse general cognition, item naming, delayed item recall, delayed location recall, and percent retention than term-born children. Delayed item recall and percent retention performances of ELBW children remained worse after correction for general cognition. ELBW groups (< 26 GW and 26-33 GW) groups performed worse than term-born children in naming and delayed item recall with chronological age as covariate. Those born before 26 GW, but not 26-33 GW, performed worse than term-born children in delayed location recall and percent retention. Differences remained significant after controlling for gender, maternal education, and delivery type. All three groups' performance declined from final learning trial to delayed location recall, with a decline greater for less than 26 GW than term-born children. Extreme prematurity (< 26 GW) and ELBW are significant risk factors for spatial location memory deficit. The modified Hopkins Board discriminated high-risk preterm and term-born children at early school age and appears to be a useful test to measure this rarely studied cognitive capacity.
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Affiliation(s)
- Ida Sue Baron
- a Fairfax Neonatal Associates at Inova Fairfax Hospital for Children , Falls Church , Virginia , USA
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30
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Abstract
There are concerns regarding accurate measurement of cognitive function in infants, particularly those at biologic risk. Herein we discuss these issues and make recommendations. Concerns include: 1) secular changes in test norms, referred to as the Flynn effect; 2) changes in the content of revised test versions; 3) recent findings of higher mean scores in newer test versions when compared to previous scores; and 4) correction for prematurity. Caution is necessary when comparing the same test scores over extended periods of time, and using different versions of the same test when mean scores of the tests vary or evaluate different areas of functioning. Ideal solutions are not readily apparent and thus we provide several suggestions: control groups are essential for longitudinal studies; clinicians should not rely totally on cognitive scores; and further investigation of the Flynn effect in different subgroups of children at different ages is necessary.
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31
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Anderson PJ, Dewey D. Introduction: The Consequences of Being Born Very Early or Very Small. Dev Neuropsychol 2011; 36:1-4. [DOI: 10.1080/87565641.2011.540522] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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