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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Neurocognitive test profiles of extremely low birth weight five-year-old children differ according to neuromotor
Marit Korkman1, Kaija Mikkola, Niina Ritari
1Department of Psychology, University of Helsinki, Helsinki, Finland. marit.korkman@helsinki.fi
Insights
Children born extremely low birth weight (ELBW) with neuromotor signs face neurocognitive impairment risks, even with average intelligence. Subtle motor issues predict uneven cognitive profiles, necessitating early assessment.
Area of Science:
- Neuroscience
- Developmental Pediatrics
- Cognitive Psychology
Background:
- Extremely low birth weight (ELBW) children exhibit variable neurocognitive outcomes.
- Neuromotor status significantly influences cognitive development in ELBW survivors.
- Comprehensive neuropsychological profiles across different neuromotor groups remain understudied.
Purpose of the Study:
- To compare detailed neuropsychological test profiles in ELBW children categorized by neuromotor status at age 5.
- To identify specific cognitive and functional deficits associated with varying degrees of neuromotor impairment.
Main Methods:
- A national cohort of 5-year-old ELBW children (N=120) was assessed.
- Participants were grouped based on neurological examination: normal neuromotor status, motor coordination problems, subtle neuromotor signs, and spastic diplegia.
- Neurocognitive assessment included intelligence (WPPSI-R) and detailed attention, executive functions, verbal, motor, visuoconstructional, and learning subtests (NEPSY).
Main Results:
- Children with normal neuromotor status performed within the average range.
- Motor coordination problems correlated with widespread neurocognitive impairment.
- Spastic diplegia and subtle neuromotor signs groups showed uneven profiles, with relative verbal strengths but significant weaknesses in attention, executive functions, manual motor, and visuoconstructional tasks.
Conclusions:
- Neuromotor signs in very preterm children, including motor coordination problems, indicate a risk for neurocognitive impairment, irrespective of average intelligence.
- Greater neuromotor impairment is associated with more irregular neuropsychological test profiles.
- Routine follow-up and neuropsychological assessments are crucial for very preterm children with even minor neuromotor signs.
Abstract:
The neurocognitive outcome of children born with extremely low birth weight (ELBW) is highly variable due to the complexity of morbidity. So far, no study has compared comprehensive neuropsychological test profiles in groups with different neuromotor status. In a national cohort of ELBW children neuropsychological test profiles were assessed in 4 groups defined according to a neurological examination at 5 years of age: normal neuromotor status (N = 56), motor coordination problems (N = 32), multiple subtle neuromotor signs including both motor coordination problems and deviant reflexes (N = 20), and spastic diplegia (N = 12). The neurocognitive assessment included a test of intelligence, the Wechsler Primary and Preschool Scale of Intelligence-Revised (WPPSI-R) and 14 subtests of attention and executive functions, verbal functions, manual motor functions, visuoconstructional functions and verbal learning (NEPSY). The children with normal neuromotor status performed within the average range; children with motor coordination problems had widespread impairment; and children with spastic diplegia and children with multiple minor neuromotor signs had uneven test profiles with stronger verbal results but weaknesses in attention and executive functions, and in manual motor and visuoconstructional tasks. In conclusion, very preterm children with neuromotor signs, including motor coordination problems, are at risk for neurocognitive impairment, in spite of average intelligence. More impaired children have more irregular test profiles. Follow-up and neuropsychological assessment of very preterm children with minor neuromotor signs are therefore indicated.
