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Extremely low birth weight children and their peers: a comparison of preschool performance
C L Halsey1, M F Collin, C L Anderson
1Dept of Pediatrics, Loyola University Medical Center, Maywood, IL 60153.
Insights
Extremely low birth weight (ELBW) children show weaker cognitive and developmental skills before school entry compared to peers. Further follow-up is needed to determine if these differences lead to future learning disabilities.
Area of Science:
- Developmental Pediatrics
- Child Psychology
- Neurodevelopmental Disorders
Background:
- Extremely low birth weight (ELBW; < 1000 g) is a significant risk factor for developmental disability.
- ELBW children often face school problems, but detailed prospective studies are limited.
- This research addresses a gap in understanding ELBW child development in the US.
Purpose of the Study:
- To prospectively document the developmental and educational progress of ELBW children.
- To compare the development of ELBW children with heavier birth weight peer groups.
- To identify early indicators of potential developmental challenges in ELBW individuals.
Main Methods:
- A cohort of 60 ELBW children was compared to 60 matched peers with heavier birth weights.
- Children were assessed at age 4 using the McCarthy Scales of Children's Abilities, Peabody Picture Vocabulary Test, and Beery Test of Visual-Motor Integration.
- Cognitive and developmental assessments were administered to evaluate performance across various domains.
Main Results:
- ELBW children scored significantly lower than peers on all cognitive and developmental measures.
- While most ELBW children's scores were within 1 SD of the test mean, 23% were classified as disabled.
- Comparison groups demonstrated optimal development more frequently and had higher mean cognitive scores.
- 51% of ELBW children showed borderline scores or average cognitive ability with specific deficits.
Conclusions:
- Nondisabled ELBW children exhibit weaker performance across multiple developmental areas before school entry compared to peers.
- The long-term implications of these early deficits require further investigation through continued follow-up.
- Understanding these early differences is crucial for early intervention and support for ELBW children.
Abstract:
Though not well studied, extremely low birth weight (ELBW; < 1000 g) appears to be a major risk factor for developmental disability, with most affected children experiencing school problems (40% to 64%) rather than severe handicap (25%). This study marks the first published US attempt to document prospectively the developmental/educational progress of a cohort of predominantly white, middle-class ELBW children with randomly selected and matched heavier birth weight (1500 through 2500 g and > 2500 g) peer comparison groups. Sixty ELBW children and 60 peers were administered a test battery at age 4 years, including the McCarthy Scales of Children's Abilities, Peabody Picture Vocabulary Test, and Beery Test of Visual-Motor Integration. The ELBW group mean scores were significantly lower than those of the peer groups on every measure, although generally still within 1 SD of the test mean. Twenty-three percent were clearly disabled; 26% had optimal development, having attained at least average scores on all measures; and 51% attained borderline scores globally or had an average cognitive score, but specifically poor performance in one or more areas. Comparison groups were 2 1/2 times more likely to have optimal development and had mean cognitive scores 15 to 18 points higher than the ELBW group. In summary, weaker performance on all measures exists prior to school entry among nondisabled ELBW children compared with their peers. It is unclear whether these data portend emerging school-based disabilities or describe a continuing recovery process to be completed in middle childhood. Continued follow-up of this cohort at 7 and 10 years of age will address these questions.