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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Predicting neurodevelopmental outcomes at preschool age for children with very low birth weight
Tsu-Hsin Howe1, Ching-Fan Sheu2, Yung-Wen Hsu3
1Department of Occupational Therapy, Steinhardt School of Culture, Education and Human Development, New York University, New York, NY, United States.
Insights
Early assessments predict cognitive, motor, and adaptive skills in very low birth weight (VLBW) children. Medical history, maternal education, and early tests significantly forecast 5-year outcomes.
Area of Science:
- Pediatrics
- Developmental Psychology
- Neonatology
Background:
- Very low birth weight (VLBW) infants face risks for neurodevelopmental challenges.
- Early identification of predictors is crucial for timely interventions.
- Understanding long-term outcomes informs clinical practice and parental support.
Purpose of the Study:
- To identify predictors of neurodevelopmental outcomes in VLBW children at age 5.
- To assess the contribution of early neurodevelopmental assessments to later outcomes.
- To explore factors influencing cognitive, motor, and adaptive behaviors.
Main Methods:
- Longitudinal study of 126 VLBW children without major impairments.
- Neurodevelopmental assessments at 5 years, including cognitive, motor, and adaptive behavior.
- Analysis of predictors: medical complications, maternal education, early cognitive and motor assessments.
Main Results:
- Four key predictors explained over 50% of intelligence and 30% of motor/adaptive behavior at age 5.
- Medical complications, maternal education, and early assessments were significant predictors.
- Early assessments at multiple time points enhanced predictive accuracy for later outcomes.
- VLBW children showed a tendency towards lower adaptive behavior at age 5.
Conclusions:
- Early assessments and specific background factors are valuable for predicting neurodevelopmental outcomes in VLBW children.
- Adaptive behavior at age 5 may reflect integrated abilities and warrants further investigation.
- Targeted interventions can be developed by understanding factors influencing adaptive function.
Abstract:
The purpose of this study was to examine predictors of neurodevelopmental outcome in very low birth weight children without major impairment at 5 years of age, as well as to identify the contribution of early neurodevelopmental assessment to preterm children's later developmental outcomes. The participants in this study included 126 children who were prematurely born with very low birth weight. Outcomes of the childrens' later development were measured in tests that factored cognitive function, motor performance, and adaptive behavior. The results indicated that more than 50% of full-scale intelligence and 30% of both motor performance and adaptive behavior at the age of 5 can be explained by four predictors. The four predictors include preterm children's medical complications at birth, maternal education, early motor assessments, and cognitive assessments. Adding each test score obtained in early ages provides additional information to predict children's cognitive, motor, and adaptive behavior at 5 years of age. Manifold assessments conducted in multiple time periods strengthen the predictive values of later developmental outcomes. In addition, the findings of this study indicate that very low birth weight children tend to have lower adaptive behavior at 5 years old. With regard to our findings, we believe that having adaptive function is a reflection of a child's overall integrated abilities. Further study is warranted to increase understanding of this topic, as well as to be able to predict adaptive strengths and weakness and pinpoint limiting factors that may be useful for targeting behaviors in intervention.
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