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Behaviour of 4- to 5-year-old nondisabled ELBW children: Outcomes following group-based physiotherapy intervention
L Brown1,2, Y R Burns1,3, P Watter3
1Growth and Development Unit, Mater Mothers' Hospital, Raymond Terrace, South Brisbane, QLD, Australia.
Insights
Behavioral outcomes in extremely low birth weight (ELBW) children aged 4-5 years were within the normal range. Both intervention and standard care showed improvements, with no significant differences between groups.
Area of Science:
- Developmental Pediatrics
- Child Psychology
- Neonatal Follow-up
Background:
- Extremely low birth weight (ELBW) and extreme prematurity can negatively impact child behavior.
- Nondisabled ELBW children are at risk for behavioral issues, especially upon entering formal education.
- This study investigated behavioral and emotional problems in nondisabled ELBW children at 4-5 years old.
Purpose of the Study:
- To determine the frequency of behavioral and emotional problems in nondisabled ELBW children.
- To assess the influence of a specific intervention on behavior.
- To explore the relationship between behavior, gender, and other developmental areas at age 5.
Main Methods:
- Fifty 4-year-old children born <28 weeks gestation or <1,000g with minimal/mild motor impairment were randomized.
- Intervention group received 6 weekly physiotherapy sessions and a home program; control group received standard care.
- The Child Behavior Checklist (CBCL) was administered at baseline and 1-year follow-up, alongside other developmental assessments.
Main Results:
- The entire cohort showed significant improvement in CBCL total problems scores from baseline to follow-up (p=.004).
- No significant differences in CBCL scores were found between the intervention and standard care groups over time.
- Males exhibited higher total problems scores than females, yet remained within the normal range.
Conclusions:
- Nondisabled ELBW children's behavior at 4-5 years generally falls within the normal range.
- Both the specialized intervention and standard care appeared to contribute to positive behavioral changes.
- Behavioral outcomes were not correlated with performance in other developmental domains.
Background:
Extreme prematurity or extremely low birth weight (ELBW) can adversely affect behaviour. Nondisabled ELBW children are at risk of behavioural problems, which may become a particular concern after commencement of formal education. This study explored the frequency of behavioural and emotional problems amongst nondisabled ELBW children at 4 to 5 years of age and whether intervention had a positive influence on behaviour. The relationship between behaviour, gender, and other areas of performance at 5 years was explored.
Methods:
Fifty 4-year-old children (born <28 weeks gestation or birth weight <1,000 g) with minimal/mild motor impairment were randomly allocated to intervention (n = 24) or standard care (n = 26). Intervention was 6 group-based physiotherapy weekly sessions and home programme. Standard care was best practice advice. The Child Behavior Checklist (CBCL) for preschool children was completed at baseline and at 1-year post-baseline. Other measures at follow-up included Movement Assessment Battery for Children Second Edition, Beery Visual-Motor Integration Test 5th Edition, and Peabody Picture Vocabulary Test 4th Edition.
Results:
The whole cohort improved on CBCL total problems score between baseline (mean 50.0, SD 11.1) and 1-year follow-up (mean 45.2, SD 10.3), p = .004. There were no significant differences between groups over time on CBCL internalizing, externalizing, or total problems scores. The intervention group showed a mean difference in total problems score of -3.8 (CI [1.5, 9.1]) between times, with standard care group values being -4.4 (CI [1.6, 7.1]). Males had higher total problems scores than females (p = .026), although still performed within the "normal" range. CBCL scores did not correlate with other scores.
Conclusions:
The behaviour of nondisabled ELBW children was within the "normal" range at 4 to 5 years, and both intervention and standard care may have contributed to improved behavioural outcomes. Behaviour was not related to performance in other developmental domains.
