Did you know behavior and cognitive performance at 18 months is predictive of performance at 36 months
in former preterm infants?
Historically, literature suggests that children born preterm have more behavioral and cognitive challenges than their peers born at term. Such challenges include lower cognitive function, withdrawn and anxious behaviors, ADHD, and much higher rate of Autism Spectrum Disorders. Researchers believe that these findings can be related to increased risk of brain injury, disruption in brain function and cerebral lesions in children born prematurely.
Ross and Perlman designed a study to examine the relationship between socioeconomic status and gender on behavior and cognition at 18 and 36 months, as well as to determine if withdrawn, anxious or attention problems at 18 months predicted performance at 36 months. They reviewed the charts of 124 VLBW preterm infants <1250g and <32 weeks at birth between 2010 and 2015 who were enrolled in the Developmental follow up Clinic for 18 month and 36 month evaluations.
At each visit, parents were asked to complete the Child Behavior Checklist. Anxious, depressed and attention behaviors were evaluated at 18 months and 36 months. At the 18 month visit, the Cognitive Scale of the Bayley Scales of Infant and Toddler Development was completed. At 36 months, the Wechsler Preschool and Primary Scale provided a Full Scale IQ Score. Pediatricians also examined the children at 36 months of age and evaluated the participants for ASD or ADHD as well.
MANOVA analysis of data found that socioeconomic status was significantly (p<.05) related to behavior and attention problems at 18 months and 36 months. Gender was not found to be statistically significant. Further, withdrawn behaviors at 18 months and 36 were related to lower cognitive scores at 18 months (p=0.36) and 36 months (p<0.03). In examining scores and behaviors at 18 months as possible predictors of function at 36 months, researchers found that withdrawn behavior and attention issues at 18 months predicted cognitive scores at 36 months (p=0.006 and p=0.021 respectively).
Researchers concluded that withdrawn, anxious or depressed children and children with attention issues at 18 months had lower cognitive scores at 36 months. Children should be closely monitored in the toddler and preschool years for the need for early intervention. This need is greater in VLBW children in lower socioeconomic class situations regardless of gender. Families should be followed closely in Developmental Follow-Up Clinics to screen early and intervene as early as possible to assist with a positive outcome as children start the preschool years.