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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Behaviour problems in extremely low birthweight children at 5 and 8 years of age
M Miller1, J R Bowen, F L Gibson
1Department of Psychology, Macquarie University, and Department of Neonatology, Royal North Shore Hospital, St. Leonards, NSW, Australia.
Insights
Extremely low birthweight (ELBW) infants showed fewer behavior problems than expected, with little continuity between ages 5 and 8. Family factors, not medical issues, predicted later behavior difficulties.
Area of Science:
- Developmental Psychology
- Pediatric Medicine
- Child Psychiatry
Background:
- Extremely low birthweight (ELBW) infants face risks for developmental and behavioral issues.
- Understanding the long-term behavioral outcomes in ELBW children is crucial for early intervention.
Purpose of the Study:
- To explore the prevalence and stability of behavior problems in ELBW children at 5 and 8 years.
- To identify predictors of these behavior problems from neonatal, medical, and family factors.
Main Methods:
- Utilized the Child Behaviour Checklist and Conners' Rating Scale for behavior assessment.
- Assessed a cohort of ELBW infants at 5 and 8 years of age.
- Examined neonatal, medical, and family context factors as potential predictors.
Main Results:
- Prevalence of behavior difficulties was lower than reported in other studies and varied by measure/informant.
- Little continuity in behavior problems was observed between 5 and 8 years.
- Maternal education and family stress, not neonatal or medical factors, predicted behavior difficulties at 8 years.
Conclusions:
- ELBW status and associated medical complications do not necessarily predispose infants to later behavior difficulties.
- Family context factors play a significant role in the behavioral development of ELBW children.
- Targeting family support may be beneficial for mitigating behavioral issues in this population.
Abstract:
This study explored the prevalence and stability of behaviour problems and their prediction from neonatal, medical and family context factors in a group of extremely low birthweight (ELBW) infants assessed at 5 and 8 years of age. Behaviour problems were identified on the basis of several measures: the Total Behaviour Problem Scale and the Adaptive Function Scale of the Child Behaviour Checklist, and the Hyperactivity Index and Hyperactivity Scale from the Conners' Rating Scale. In this group of ELBW infants, the prevalence of behaviour difficulties was somewhat lower than that reported in other studies, and varied according to the measure and informant (parent vs. teacher) used. Also, there was little continuity between those children identified by their parents at 5 years of age as having behaviour problems and those children identified by parent and/or teacher report at 8 years of age. Most of the children identified with behaviour difficulties at 8 years were also reported to have academic difficulties. None of the neonatal or medical factors predicted behaviour difficulties at 8 years of age. In contrast, two family context factors, maternal level of education and family stress, were related to behaviour difficulties at 8 years. These findings indicate that ELBW and the often associated medical complications may not necessarily predispose infants to develop subsequent behaviour difficulties later on in childhood.
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