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Developmental Outcomes at Ages 3-5 among Very-low and Extremely-low-birthweight Children without Major Complications

Noriko Yamaoka1, Satoshi Takada2

  • 1Faculty of Nursing, Kobe Tokiwa University, Kobe, Japan.

The Kobe Journal of Medical Sciences
|November 17, 2025
PubMed

Insights

Low birthweight infants, including very-low-birthweight (VLBW) and extremely-low-birthweight (ELBW) children, may exhibit preschool behavioral and emotional issues. Early screening with the Modified Checklist for Autism in Toddlers (M-CHAT) can indicate potential challenges.

Area of Science:

  • Pediatrics
  • Developmental Psychology
  • Neonatology

Background:

  • Low birthweight affects approximately 9.4% of infants in Japan.
  • While 18-month development in very-low-birthweight (VLBW) and extremely-low-birthweight (ELBW) infants is studied, preschool outcomes remain less understood.
  • This research focuses on VLBW and ELBW infants without major complications.

Purpose of the Study:

  • To identify behavioral and emotional characteristics of VLBW and ELBW children in preschool.
  • To compare preschool outcomes with infantile development assessments.
  • To investigate the predictive value of early screening tools for later behavioral issues.

Main Methods:

  • A cohort of 28 VLBW and ELBW children without major complications was studied.
  • The Child Behavior Checklist (CBCL) 1.5-5 was administered to parents at ages 3-5.
  • The Modified Checklist for Autism in Toddlers (M-CHAT) was used for screening, with outcomes assessed at 18-24 months.

Main Results:

  • 17 out of 28 children scored borderline or clinically significant on CBCL scales.
  • 7 children screened positive on M-CHAT, all showing borderline or clinical CBCL scores.
  • M-CHAT positive infants were more likely to have preschool behavioral and emotional problems; however, issues also emerged in M-CHAT negative infants.

Conclusions:

  • M-CHAT screening can identify infants at higher risk for preschool behavioral and emotional difficulties.
  • Even infants screening negative for autism-related traits may develop behavioral or emotional problems by preschool age.
  • Longitudinal monitoring is crucial for VLBW and ELBW infants to address emerging developmental and behavioral challenges.

Keywords:
Child Behavior Checklist (CBCL) 1.5–5Developmental outcomesJapanModified Checklist for Autism in Toddlers (M-CHAT)Very-low-birthweight infants

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