Behavioral problems are associated with cognitive and language scores in toddlers born extremely preterm

Abstract

Objective: To evaluate the relationship of parent-reported child behaviors on the Child Behavior Checklist (CBCL) to cognition, language, and motor skills on the Bayley Scales of Infant and Toddler Development – III (Bayley-III) in toddlers born extremely preterm. Study Design: Toddlers born extremely preterm (gestational ages 22 0/7 to 26 6/7 weeks) were tested at 22 – 26 months corrected age with Bayley-III while parents completed the CBCL. Socio-demographic variables and medical history were recorded. Linear regression models were used to assess the relationship of Bayley-III cognitive, motor, and language scores with CBCL scores, adjusting for medical and socio-demographic factors. Results: Internalizing, affective, and pervasive development problem behavior scores on the CBCL correlated significantly with lower Bayley-III cognitive, language, and motor scores on unadjusted and adjusted analyses. Although externalizing and anxiety problems were significantly associated with cognitive and language scores on unadjusted analysis, the relationships were not significant after adjusting for socio-economic factors. CBCL scores were similar for boys and girls, with the exception of the pervasive developmental problem scale; boys had significantly more problems than girls (p=0.02). Conclusions: This study showed that parent reported behavior problems were related to lower cognitive, language, and motor development in toddlers born extremely preterm. Early findings of behavioral problems in toddlers born extremely premature may help identify children at greater risk for later learning difficulties. Adding a measure of behavior to the evaluation of these children may help better understand factors that can contribute to delays, especially in cognition and language.

Strategies for assessing the impact of loss to follow-up on estimates of neurodevelopmental impairment in a very preterm cohort at 2 years of age

“…In our sample, the response rate was 54.2% which is at the lower end reported in other very preterm cohorts in early childhood which range from about 50 to 90% [6,7,12,38,39,40]. Follow-up rates tend to be higher for studies from neonatal networks when compared to population-based studies and those that have regular contact with families after discharge.…”

“…As in our study, fewer and less consistent associations have been observed between follow-up and perinatal variables which are the strongest predictors of poor outcome for VPT children [44], as we saw in this study; many of the studies cited above report similar neonatal characteristics and morbidities for responders and nonresponders. Higher birthweight has been related to lower follow-up rates in some neonatal network studies which Table 2 Maternal, pregnancy and perinatal characteristics associated with loss to follow-up and the presence or absence of neurodevelopmental impairment at 2 years of corrected age (N = 1737) (Continued) may reflect a closer connection between families and the NICU for higher risk low-birthweight infants [38,39]. In contrast, in some studies, families with more impaired children were less likely to attend clinical assessments or responded by postal questionnaires only versus full participation.…”

Mapping the neuroanatomical impact of very preterm birth across childhood

“…These areas have been linked to natural speech production, particularly synchronous speech (Alexandrou, Saarinen, Kujala, & Salmelin, 2016;Jasmin et al, 2016). VPT children have been highlighted to have language difficulties (Peña, Pittaluga, & Mehler, 2010;Vohr, 2014), which extend to social communication difficulties (Lowe et al, 2019); thus, slower maturation of this brain area may underlie those commonly reported weaknesses in VPT cohorts.…”

“…Slower maturation of these regions could affect the VPT child's processing of complex visual stimuli, impacting both learning and social behaviour. VPT children have been highlighted to have language difficulties(Peña, Pittaluga, & Mehler, 2010;Vohr, 2014), which extend to social communication difficulties(Lowe et al, 2019); thus, slower maturation of this brain area may underlie those commonly reported weaknesses in VPT cohorts. These areas have been linked to natural speech production, particularly synchronous speech(Alexandrou, Saarinen, Kujala, & Salmelin, 2016;Jasmin et al, 2016).…”

Yürüme döneminde küçük konuşmacılar: Gelişimsel bir bakış

“…Preterm labor has also been shown to affect negatively language skills of children in toodlerhood (Lowe et al, 2019;Marchman, Adams, Loi, Fernald and Feldman, 2016;Brosch-Fohraheim, Fuiko, Marschik & Resch, 2019). In the studies conducted during the toddlerhood, it was found that humanity affects language development in favor of girls (Gudmundsson, 2015;Stangeland, Lundetrae & Reikeras, 2018).…”