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Neonatal predictors of school-based services used by NICU graduates at school age
Linda L Lindeke1, Jennifer R Stanley, Beth S Else
1School of Nursing, Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA. linde001@umn.edu
Insights
Neonatal risk factors, like longer NICU stays, can predict a child's need for special school services. This helps identify at-risk children early for necessary support and interventions.
Area of Science:
- Neonatal intensive care
- Pediatric health outcomes
- Educational support services
Background:
- Premature infants face higher risks of long-term childhood health issues.
- Federal laws mandate early intervention and special education for children with special needs.
- Identifying at-risk premature children is crucial for targeted service provision.
Purpose of the Study:
- To determine if neonatal characteristics can predict the need for special school-based services in later childhood.
- To investigate the relationship between neonatal risk factors and educational support utilization.
Main Methods:
- Study included 53 children (ages 7-11) who graduated from a Level 3 neonatal intensive care unit (NICU).
- Neurobiologic Risk Scores (NBRS) were calculated using neonatal illness factors.
- Birth weight, NICU length of stay, and NBRS were compared with school performance and report cards.
Main Results:
- Most children did not receive special school services.
- NBRS correlated with parent-reported child competency (p=0.01).
- Longer NICU stays predicted lower academic performance and increased use of special school services (p=0.04, p=0.03).
- Higher NBRS scores were associated with decreased report card performance.
Conclusions:
- Neonatal characteristics are significant predictors of school-age service needs.
- Nurses can use these predictors to identify high-risk children for timely assessment and referral.
- Accurate outcome data is vital for informing health, educational, and social policies.
Background:
Ill or premature newborns are at increased risk for ongoing morbidity throughout childhood. Federal legislation now mandates that states provide early intervention, special education, and disability accommodations for children with special needs. Because all children born prematurely do not require all services, targeting services to the children with greatest risk is essential. This study examined whether neonatal characteristics could predict special school-based service use (speech, occupational, physical therapy, special education) in later childhood.
Methods:
Subjects were 53 children, ages 7 to 11 years, graduates of one Midwest Level 3 neonatal intensive care unit (NICU). Neonatal data were used to calculate Neurobiologic Risk Scores (NBRS), a sum of illness factors related to brain damage. Birth weight, length of NICU stay, and NBRS were compared to the children's school performance on standardized tools and to report cards.
Results:
Most children studied were not receiving special school services. The NBRS and parent report of child competency were related (p = 0.01). Length of NICU stay correlated with teachers' reports of children's academic performance (p = 0.04), and to use of special school services use (p = 0.03). As the NBRS score increased, report card performance decreased.
Conclusions:
Neonatal characteristics predicted school-age service use. This is important for nurses because predicting which children are most likely to need special services can aid in tracking children at high risk for prompt assessments and referrals. Parents, healthcare providers, educators, advocacy groups, and funding agencies need accurate outcome data to influence health, educational, and social policy decisions.