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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Neurodevelopmental follow-up after preterm birth: follow up after two years
1The Wolfson Centre, Consultant Community Paediatrician, Mecklenburgh Square, London WC1N 2AP, United Kingdom. a.salt@ich.ucl.ac.uk
Insights
Children born prematurely face ongoing neurodevelopmental challenges impacting learning, behavior, and overall achievement. Extended follow-up is crucial for understanding and addressing these subtle, long-term effects.
Area of Science:
- Neuroscience
- Developmental Pediatrics
- Child Psychology
Background:
- Preterm birth is associated with significant differences in neurological and health status compared to term-born infants.
- While severe disabilities are identifiable early, subtle neurodevelopmental issues emerge later in childhood.
Purpose of the Study:
- To highlight the need for extended follow-up beyond early childhood for preterm infants.
- To emphasize the importance of standardized assessments for comparing outcomes across populations.
- To inform parental counseling, health/education planning, and service evaluation for preterm children.
Main Methods:
- Longitudinal assessment of neurological and health status.
- Evaluation of intellectual functioning, school performance, and behavior.
- Identification of specific neurodevelopmental deficits in later childhood.
Main Results:
- Preterm children exhibit subtle problems including learning disabilities, executive function deficits, visual-motor and perceptual difficulties, language impairments, motor coordination disorders, and ADHD.
- Reduced educational achievement is a common outcome.
- Early assessments may underestimate the full spectrum of neurodevelopmental challenges.
Conclusions:
- Extended follow-up is essential to accurately determine the prevalence and nature of neurodevelopmental problems in preterm children.
- Standardized assessment protocols are necessary for consistent evaluation and comparison of outcomes.
- Understanding long-term effects is vital for optimizing support and interventions for this population.
Abstract:
Marked differences are seen in neurological and health status, intellectual functioning, school performance and behaviour between children born prematurely and those born at term. Assessment in later childhood has identified more subtle problems than the severe disability or sensory deficits readily identifiable at two years. These problems include learning disabilities, specific neuropsychological deficits in executive function, difficulties in visual-motor integration and perception, selective language impairment, motor coordination disorders, behaviour problems, attention deficit hyperactivity disorder (ADHD), and reduced educational achievement. Follow-up to school entry and beyond is thus required to determine the true prevalence and nature of the neurodevelopmental problems arising from preterm birth. Consensus about the assessment used, definitions of disability and health status, age of assessment and who undertakes it are necessary and should allow comparison across populations; this may help to maximise outcomes for children clearly at biological risk. Assessment of outcome for children born preterm beyond two years is required for counselling parents, planning health and education provision, for evaluation of services and to facilitate understanding of the longer term effects of preterm birth on brain development.
