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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Early emergence of behavior and social-emotional problems in very preterm infants
Alicia J Spittle1, Karli Treyvaud1, Lex W Doyle1
1All of the authors are part of the Victorian Infant Brain Studies (VIBeS) team, Murdoch Childrens Research Institute. Drs. Spittle, Doyle, Lee, Cheong, Hunt, and Anderson are with the University of Melbourne. Dr. Inder is with Washington University.
Insights
Very preterm children show more social-emotional and behavioral issues, including internalizing and dysregulation problems, by age two. This early identification helps pinpoint those most at risk for developmental challenges.
Area of Science:
- Neonatal research
- Developmental pediatrics
- Child psychology
Background:
- Children born very preterm often face social, emotional, and behavioral challenges.
- Early identification of these issues is crucial for timely intervention.
Purpose of the Study:
- To compare social-emotional difficulties and competencies in very preterm and full-term children at 2 years' corrected age.
- To examine the relationship between perinatal factors and early behavioral problems in very preterm infants.
Main Methods:
- Infant Toddler Social and Emotional Assessment administered to parents of 188 very preterm and 70 full-term children at 2 years' corrected age.
- Collection of perinatal data including gestational age, birth weight, and neonatal brain imaging (white matter abnormalities).
Main Results:
- Very preterm children had significantly higher internalizing and dysregulation scores and lower competence scores compared to full-term peers.
- No significant difference in externalizing scores was observed between the groups.
- Lower competence was associated with female sex, lower birth weight z-score, white matter abnormalities, and postnatal corticosteroid use in the very preterm group.
Conclusions:
- Very preterm infants demonstrate increased behavioral problems, specifically internalizing and dysregulation issues, and reduced social-emotional competence at an early age.
- Perinatal factors significantly influence early social-emotional development in very preterm children.
Objective:
Children born very preterm are reported to have an increased frequency of social, emotional, and behavioral problems at school age compared with their peers born at term. The primary aim of this study was to compare social-emotional difficulties and competencies of very preterm and full-term children at 2 years' corrected age. In addition, the relation between perinatal variables and early behavior problems was also examined to help identify those very preterm children most at risk.
Method:
At 2 years' corrected age, the parents of 188 very preterm (gestational age <30 weeks or birth weight <1,250 g) and 70 full-term (gestational age >or=37 weeks) children completed the Infant Toddler Social and Emotional Assessment to determine externalizing, internalizing, and dysregulation problems and social-emotional competencies. For the very preterm sample, extensive perinatal data were collected including sex, birth weight, gestational age, chronic lung disease, and postnatal steroids, as well as neonatal cerebral white matter abnormalities detected by magnetic resonance imaging.
Results:
The very preterm children at 2 years demonstrated significantly higher internalizing and dysregulation scores and lower competence scores than peers born at term. There was no significant difference in externalizing scores between groups. Female sex, lower birth weight z score, white matter abnormalities, and postnatal corticosteroids were significantly associated with lower competence scores in the very preterm group.
Conclusions:
Very preterm children exhibit higher rates of behavior problems early in development, in particular internalizing and dysregulation problems and poorer competence.
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