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Assessing independency in daily activities in very preterm children at preschool age
Gijs Verkerk1, Martine Jeukens-Visser, Aleid van Wassenaer-Leemhuis
1Department of Rehabilitation, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands. g.j.verkerk@amc.uva.nl
Insights
Very low birth weight (VLBW) preschoolers without cerebral palsy often experience daily activity disabilities, particularly in mobility and social functioning. Early developmental assessments can help identify at-risk children before school entry.
Area of Science:
- Pediatrics
- Developmental Psychology
- Rehabilitation Medicine
Background:
- Very low birth weight (VLBW) is associated with developmental challenges.
- Preschoolers born VLBW may face disabilities in daily activities, impacting their functional independence.
- Understanding risk factors is crucial for early intervention in VLBW populations.
Purpose of the Study:
- To investigate the prevalence of daily activity disabilities in VLBW preschoolers without cerebral palsy (CP).
- To identify risk factors associated with these disabilities.
- To inform early screening and intervention strategies for VLBW children.
Main Methods:
- Utilized the Dutch Pediatric Evaluation of Disability Inventory (PEDI-NL) for disability assessment.
- Included 143 VLBW children without CP at 44 months corrected age (CA).
- Analyzed data from Bayley Scales of Infant Development II (BSID II) at 24 months CA, alongside perinatal and socio-economic factors.
Main Results:
- Disability in daily activities was observed in 19% of VLBW preschoolers without CP.
- Mobility (13%) and social functioning (8%) domains showed high frequencies of disability.
- Low BSID II outcomes (<2 SD) were identified as risk factors for mobility-related disabilities.
Conclusions:
- VLBW preschoolers without CP exhibit a higher frequency of daily activity disabilities compared to term-born peers.
- Early developmental assessments (BSID II) show moderate predictive value for mobility disabilities.
- Routine assessment of daily activity performance is recommended for VLBW children before school entry.
Abstract:
This study investigates whether very low birth weight (VLBW) preschoolers experience disability in daily activities and what the risk factors for disability in daily activities are. The Dutch Pediatric Evaluation of Disability Inventory (PEDI-NL) was used to detect disability in daily activities in 143 VLBW children without cerebral palsy (CP) at 44 months of corrected age (CA). Data from the psychomotor-developmental index (PDI) and the mental developmental index (MDI) of the Bayley Scales of Infant Development II (BSID II) at 24 months CA, and data relating to perinatal and socio-economic status were available. Disability in daily activities was found in 27 (19%) VLBW children without CP. High frequencies of disability were found in 19 (13%) children on the mobility domain and in 12 (8%) children on the social functioning domain. The multiple logistic regression analyses showed that low BSID II outcomes (<2 SD) were risk factors for disability in the mobility domain, but not for disability in the social functioning domain. The predictive value of the BSID II outcomes is moderate, 46% of the VLBW children with a low PDI and 44% with a low MDI developed a disability in the mobility domain. This study showed a higher frequency of disability in daily activities in VLBW preschoolers compared to term born peers. Therefore, it is suggested to assess VLBW children's performance of daily activities before they start school.
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