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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Are multidisciplinary neurodevelopmental profiles of children born very preterm at age 2 relevant to their long-term
Inge L van Noort-van der Spek1, Lottie W Stipdonk1, André Goedegebure1
1Department of Otorhinolaryngology, Erasmus University Medical Center-Sophia Children's Hospital, Rotterdam, Netherlands.
Insights
Children born very preterm (VPT) show diverse neurodevelopmental profiles. Early high performers may decline, while others show improvement, highlighting the need for tailored interventions.
Area of Science:
- Neuroscience
- Developmental Pediatrics
- Child Psychology
Background:
- Children born very preterm (VPT) often exhibit neurodevelopmental challenges.
- Longitudinal studies are crucial for understanding the developmental trajectories of VPT children.
Purpose of the Study:
- To identify distinct neurodevelopmental profiles in VPT children at age 2.
- To describe the longitudinal course of these profiles up to age 10.
- To inform targeted interventions and improve counseling for VPT populations.
Main Methods:
- Factor and cluster analysis of multidisciplinary assessments (cognitive, language, motor, behavioral, auditory) at corrected age 2 in 84 VPT children.
- Longitudinal follow-up assessments at age 10 for cognitive, language, and behavioral function in 61 children.
- Descriptive statistics to analyze profile trajectories.
Main Results:
- Four distinct neurodevelopmental profiles were identified at age 2.
- Profile 1: Initially high performers showed an unexpected decline by age 10.
- Profile 2: Consistently low performers; Profile 3: Showed improvement; Profile 4: Exhibited wide variation.
Conclusions:
- A multidisciplinary, profile-oriented approach is vital for VPT children.
- Early high neurodevelopmental function does not guarantee sustained development.
- Behavioral and auditory nerve function influence developmental trajectories.
Abstract:
To identify distinctive multidisciplinary neurodevelopmental profiles of relatively healthy children born very preterm (VPT) and describe the longitudinal course of these profiles up to age 10. At 2 years of corrected age, 84 children born VPT underwent standardized testing for cognitive, language, speech, motor, behavioral, and auditory nerve function. These data were submitted to factor and cluster analysis. Sixty-one of these children underwent cognitive, language, and behavioral assessment again at age 10. Descriptive statistics were used to analyze longitudinal trajectories for each profile. Four neurodevelopmental profiles were identified at age 2. Profile 1 children (n = 22/26%) had excellent cognitive-language-motor function, normal behavioral and auditory nerve function, but showed an unexpected severe decline up to age 10. Profile 2 children (n = 16/19%) had very low behavioral function, low cognitive-language-motor function, and accelerated auditory nerve function. Their scores remained low up until age 10. Profile 3 children (n = 17/20%) had delayed auditory nerve function, low behavioral function, and slightly lower cognitive-language-motor function. They showed the most increasing trajectory. Profile 4 children (n = 29/35%) had very low cognitive-language-motor function, normal behavioral and auditory nerve function, but showed wide variation in their trajectory. Our preliminary study showed that a multidisciplinary profile-oriented approach may be important in children born VPT to improve counseling and provide targeted treatment for at risk children. High performers at age 2 may not be expected to maintain their favorable development. Behavioral problems might negatively impact language development. Delayed auditory nerve function might represent a slow start and catch-up development.
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