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Published on: January 23, 2017
Very preterm children who do not cooperate with assessments at three years of age: skill differences at five years
1Neonatal Development Follow-Up Clinic, Department of Neonatal Medicine, King George V Hospital, Camperdown, Sydney, Australia. crista@peri.rpa.cs.nsw.gov.au
Insights
Uncooperative very preterm children at age 3 showed poorer visual/spatial skills and more neurological dysfunction at age 5. This behavior may indicate risk for nonverbal learning disabilities in this vulnerable population.
Area of Science:
- Developmental Pediatrics
- Neurodevelopmental Disorders
- Preterm Infant Research
Background:
- Very preterm infants (<30 weeks gestation) face developmental challenges.
- Early behavioral assessments can predict later outcomes.
- Identifying risk factors for learning disabilities is crucial for timely intervention.
Purpose of the Study:
- To investigate skill differences at 5 years of age in very preterm children based on their cooperation during developmental testing at 3 years.
- To determine if uncooperative behavior at 3 years is associated with specific neurodevelopmental outcomes at 5 years.
- To explore the potential link between early uncooperative behavior and the risk of nonverbal learning disabilities.
Main Methods:
- Prospective follow-up of 201 children born between 1986-1991 at <30 weeks gestation.
- Matched comparison of 24 uncooperative children with cooperative controls based on sex, gestation, and birth weight.
- Nonparametric statistical analyses of cognitive and neurological assessments at 3 and 5 years.
Main Results:
- Significant differences were found in Binet Pattern Analysis and Bead Memory subtest scores (p < .01).
- Uncooperative children scored significantly higher in the at-risk range for minor neurological dysfunction (MND) (p < .01).
- Uncooperative behavior at 3 years was associated with poorer visual/spatial skills and higher MND at 5 years.
Conclusions:
- Uncooperative behavior in very preterm children at age 3 may signal underlying visual/spatial deficits.
- A high level of minor neurological dysfunction at age 5 in previously uncooperative children suggests increased risk.
- Early uncooperative behavior could be an indicator for identifying very preterm children at risk for nonverbal learning disabilities.
Abstract:
This study examined skill differences at 5 years of age for very preterm children who were or were not cooperative with developmental testing at 3 years of age. All children born between 1986 and 1991 who were less than 30 weeks of gestation were followed prospectively. Two hundred one children were seen at both the 3- and 5-year assessments. Of the 201 children, 24 (11.9%) who had been uncooperative in the assessment at 3 years were seen at 5 years. Uncooperative children were matched to a group of cooperative children for sex, gestation, and/or birth weight. Nonparametric analyses revealed that scores on the Binet Pattern Analysis (p < .01) and the Bead Memory (p < .01) subtests were significantly different between the groups. The uncooperative children scored significantly more often in the at-risk range for tests of minor neurological dysfunction (MND; p < .01) compared with cooperative matched controls. The authors speculate that in very preterm children, uncooperative behavior shown at 3 years of age associated with poor visual/spatial skills and a high level of MND at 5 years of age may reveal children at risk for the development of nonverbal learning disabilities.
