Research Disproves the Theory that Preemies Catch Up By Age Three
By Patti Wrape
Continued from previous
26. A nine year follow up of 116 children born in 1971 to 1974 with a
birthweight of 1,500 grams or less found that 59 had died and 7 had extreme
handicaps or blindness. The low birthweight children without extreme handicaps
were found to have impaired motor function, speech defects and impaired
school achievements more often than the controls. Nine Year Follow
Up of Infants Weighing 1,500 grams or Less at Birth. Michelsson K, Lindahl
E, Parre M, Helenius M. Acta Paediatr Scand. November 1984; 73 (6): 835-41.
27. Thirty five of 45 long term survivors with birth weights of 1,000
grams or less whor were cared for in the University of Washington, Seattle,
Neonatal Intensive Care Unit, from 1960 to 1972 were examined at an average
age of 10 ½ years. Twenty eight percent had one or more major neurological
or sensory handicap, 64% have been or are presently in a special education
program. Only 28% are currently rated by their teachers to be achieving
at or above grade level. Arithmetic reasoning, mathematics achievement
and reading comprehension were specific weaknesses. Fine and gross motor
skills were impaired. Perceptual skills were impaired to a lesser degree.
School Performance of Children with Birth Weights of 1,000 Grams or
Less. Nickel RE, Bennett FC, Lamson FN. Am J Dis Child, Feb 1982; 136
28. This study examined the relationship between very low birthweight
children and possible developmental delay in the absence of frank developmental
disability. Subjects were asymptomatic for disabling conditions but apparently
well, very low birthweight, children were consistently at greater risk
for both moderate and severe measures of delay across four functional
areas. Relation Between Very Low Birth Weight and Developmental Delay
Among Preschool Children Without Disabilities. Schendel DE, Stockbauer
JW, Hoffman HJ, Herman AA, Berg CJ, Schramm WF. Developmental Disabilites
Branch, Centers for Disease Control and Prevention, Chamblee GA, Usaam
J. Epidemiol, November 1, 1997; 146 (9): 740-9.
29. At the adjusted age of 5 years the development of 106 children born
5 or more weeks before term was compared with the development of 103 children
born at term. No children with cerebral palsy were included and the groups
were matched in terms of sex, age, birthplace, race and residential location.
The results indicated a significant difference between the two groups
including preterm children having small involuntary hand movements, less
competent gross motor ability, poorer verbal performance and more variability
in behavior postural response and balance. A higher than average incidence
of minor motor, speech, behavior and learning problems in early school
years is probable. Language and Motor Development in Pre Term Children:
Some Questions. Le Normand MT, Vaivre-Douret L, Delfosse MJ. INSERM, Hospital
de La Salpetriere, Paris, France. Child Care Health Dev, March 1995; 21
30. A study conducted in a Southern Swedish population compared extremely
preterm children to a control group of full term children at age 10. Health,
cognitive development, school achievement and behavior were evaluated.
Thirty eight percent of the extremely preterm children performed below
grade level at school. Thirty two percent had general behavioral problems
and 20% had attention deficit hyperactivity disorder compared with 10%
and 8 % respectively in the full term group. The study concluded that
extremely preterm children require intervention to support development
and reduce behavioral problems. Ten Year Follow Up of Children Born
Before 29 Gestational Weeks: Health, Cognitive Development, Behaviour
and School Achievement. Stjernqvist K, Svenningsen NW. Department of Psychology,
Lund University, Sweden. Acta Paediatr, May 1999; 88 (5): 557-62.
31. Cognition, school performance and behavior were assessed at 8 years
of age in 132 very low birth weight children who were otherwise free of
major sensineural impairments and were compared with a control group of
full term normal birthweight children. While the very low birth weight
children were developing normally in many academic and social areas they
were significantly inferior on tests of cognition, including tests of
intelligence and visual memory and on teachersí reports of motor skills
and intelligence. Proportionally more very low birth weight children (20.5%)
than normal birth weight children (5.9%) were reported by their parents
to be not coping at school. Cognition, School Performance and Behavior
in Very Low Birth Weight and Normal Birth Weight Children at 8 Years of
Age: A Longitudinal Study. Rickards AL, Kitchen WH, Doyle LW, Ford GW,
Kelly EA, Callanan C. Division of Pediatrics, Royal Womenís Hospital,
Melbourne, Australia. J Dev Pediatr, December 1993; 14 (6): 363-8.
32. The intellectual, psychoeducational and functional status of a group
of 129 extremely low birth weight children born between 1977-1981 and
weighing 501 to 1,800 grams at birth were compared with a matched control
group. The children were tested at an average unadjusted age of 8 years.
The average IQ was 91 for extremely low birth weight children and 104
for the control group. Between 8 to 12% scored in the abnormal IQ range
compared with 1 to 2% of the control group. The low birth weight children
did less well on reading, spelling and math tests and their motor performance
and visual motor integration were poorer. Approximately 15% of the extremely
low birth weight study participants perfomred in the abnormal range on
the Vineland Adaptive Behavior Scales. Although about 2/3rds fo the low
birth weight children performed in the normal range on intellectual measures
they were significantly disadvantaged on every measure tested. Cognitive
Abilities and School Performance of Extremely Low Birth Weight Children
and Matched Term Control Children at Age 8 Years: A Regional Study. Saigal
S, Szatmari P, Rosenbaum P, Campbell D, King S. Department of Pediatrics,
McMaster University, Hamilton, Ontario, Canada. J Pediatri, May 1991;
118 (5): 751-60.
33. A study was conducted to examine developmental and educational outcomes
in a group fo predominantly white, middle class, extremely low birth weight
children (less than 1,000 grams birthweight). Fifty four extremely low
birthweight children with an average age of 7 were compared to a children
in a control group matched for gender, race and socioeconomic factors
and were sorted to low and normal birthweight groups. Teachersí reports,
special education evaluations, and test of cognitive, motor, language
and visual motor integration abilities were studied. Fifty percent of
the extremely low birth weight children were in regular classrooms compared
to 70% of low birth weight children and 93% of full term children. The
extremely low birth weight children scored significantly lower than the
comparison groups on all tests. While 79% of the extremely low birthweight
children had average cognition scores, they average 14 to 17 points lower
than the two comparison groups. Twenty percent of the extremely low birth
weight children had significant disabilities including cerebral palsy,
mental retardation, autism and low intelligence with severe learning problems.
The study concluded that there is an increasing need for special services
with decreasing birth weights. Even with optimal socioeconomic environments,
20% of extremely low birthweight children are significantly disabled and
1 out of every 2 extremely low birth weight children requires special
educational services. Extremely Low Birth Weight Children and Their
Peers, A Comparision of School-Age Outcomes, Halsey CL, Collin MF, Anderson
CL. Loyola University Medical Center, Maywood, ILL, USA Arch Pediatric
Adolesc Med August 1996; 150 (8): 790-4.
34. Children with a birthweight of 2,000 grams or less born in Merseyside,
England from 1980-1981 were assessed at age 8. The children and a matched
control group were assessed using the Wechsler Intelligence Scale for
Children (WISC) , the Neale analysis of Reading ability and the Stott-Moyes-Henderson
test of Motor Impairment (TOMI). Children with low birth weight had a
lower WISC IQ score, a lower reading age, and poorer motor performance.
Clinical and Subclinical Deficits at 8 Years in a Geographically Defined
Cohort of Low Birthweight Infants. Pharoah PO, Stevenson CJ, Cooke RW,
Stevenson RC. Department of Public Health, University of Liverpool, Arch
Dis Child, April 1994; 70 (4): 246-70.
35. Fifty one children who were born at the same hospital in Liverpool,
England, with weights of 1,250 grams or less were followed through age
8. The extremely low birth weight group of 8 year olds were compared with
a control group of the same age, race, economic group and sex. The low
birth weight children performed less well on basic math tests, spelling
tests, and tests of motor impairment. Twenty three percent of very low
birth weight children were having difficulty with one or more school subjects
compared with 19% of controls and 26% had difficulties in 2 or more areas
compared with 3% of the control group. Teachers identified characteristics
typical of emotional disorders and overactivity more frequently among
the very low birthweight group. The study concluded that children with
birthweights of 1,250 grams or less and no major impairment have a high
frequency of learning difficulties that become more apparent with advancing
age. Outcome at 8 Years for Children with Birth Weights of 1,250 Grams
or Less. Marlow N, Roberts L, Cooke R. Department of Child Health, Liverpool
Maternity Hospital. Arch Dis Child, March 1993; 68 (3 Spec No): 286-90.
36. Neurodevelopmental, health and growth outcomes for 28 six year olds
weight birthweights of less than 1,001 grams were compared with a control
group of 26 full term birth children. Sixty one percent of the extremely
low birth weight children had mild or moderate to severe neurological
problems compared with the control group children (23%). A significant
portion of extremely low birthweight children had no severe disabilities,
but many had dysfunctions likely to affect learning and behavior in school.
Neurodevelopmental, Health and Growth Status at Age 6 Years of Children
with Birth Weights Less than 1,001 Grams. Teplin SW, Burchinal M, Johnson-Martin
N, Humphry RA, Kraybill EN. Clinical Center for the Study of Development
and Learning, Frank Porter Graham Child Development Center, University
of North Carolina, J Pediatri, May 1991; 118 (5): 768-77.
27. Thirty four long term survivors of a five year period (1977-1981)
weighing 1,000 grams or less at birth were followed up at 8 to 11 years
of age. Three (8.8%) of the children had severe functional handicap, seven
(20.6%) had moderate impairments with the need for special schooling.
Twenty four (70.6%) attended normal school but 7 (20.6%) needed special
help. Infants Weighing 1,000 Grams or Less at Birth. Outcome at 8-11
Years of Age. Vekerdy-Lakatos Z, Lakatos L, Ittzes-Nagy-B. Department
of Pediatrics, University Medical School, Debrecen, Hungary, Acta Paediatr
Scand Suppl 1989; 360: 62-71.
38. This study tested the hypothesis that very low birth weight children
(less than 1.5 kg) whose head size is not normal by 8 months (adjusted
age) have significantly poorer growth and neurocognitive abilities at
school age than very low birth weight children with a normal head size
at eight months. A group of 249 children born from 1977 to 1979 were evaluated
at age 8 to 9 years; the 33 children with subnormal head sizes at the
age of 8 months had significantly lower average birth weights and higher
neonatal risk scores (71 versus 53) and at the age of eight years had
a higher incidence of neurologic impairment (21% versus 8%) and lower
IQ scores (average verbal 84 versus 98%). The conclusions of the study
indicate that in very low birth weight infants, pernatal growth failure,
as evidenced by a subnormal head circumference at 8 months of age, is
associated with poor cognitive function, academic achievement and behavior
at 8 years of age. Effect of Very Low Birth Weight and Subnormal Head
Size on Cognitive Abilities at School Age. Hack M, Breslau N, Weissman
B, Aram D, Klein N, Borawski E. Department of Pediatrics, School of Medicine,
Case Western Reserve University, Cleveland, OH. New England Journal of
Medicine, July 25, 1991; 325 (4): 231-7.
39. In 1990 to 1992 a study was conducted in which randomly selected and
evaluated low birthweight and normal birthweight children from the 1983-1985
newborn lists of two major hospitals in Southeast Michigan. Low birth
weight children scored significantly lower than normal birth weight children
on tests measuring language, spatial., fine motor, tactile and attention
abilities with appropriate controls for site, race, maternal IQ and education.
Analysis revealed that test performance varied within birth weight levels
and that performance continued to improve with increased birth weight
well above 3,000 grams. Low Birth Weight and Neurocognitive Stauts
at Six Years of Age. Breslau N, Chilcoat H, DelDotto J, Andreski P, Brown
G. Department of Psychiatry, Henry Ford Health Sciences Center, Detroit,
MI. Biol Psychiatry, Sept 1, 1996; 40 (5): 389-97.
40. Survival of extremely low birth weight infants, (less than 1,000 grams)
has increased. From the period of 1943 to 1945 the survival rate of infants
born weighing less than 800 grams was 0% but increased to 49% to 70% for
the period 1994-1995. Rates of cerebral palsy. mental retardation, blindness
and deafness have remained stable in the 1980ís and 1990ís. There is evidence.
however, that the percent of functional limitations may be increasing
as the requirement for special education resources among very low birthweight
infants remains high at 44% to 56%. Neuropsychological and Functional
Outcomes of Very Low Birth Weight Infants, Vohr BR, Msall ME. Women and
Infants Hospital, Child Development Center of Rhode Island Hospital, Brown
University School of Medicine, Providence, RI. Semin Perinatol, June 1997;
21 (3): 202-20.
41. A study was conducted in which very low birth weight infants were
compared with heavier low birth weight infants and normal birth weight
children to assess the risk of behavior problems and school difficulty.
Analysis revealed that 34% of very low birth weight children could be
characterized as having school difficulty compared with 20% of heavier
low birth weight children and 14% of normal birthweight children. Very
low birthweight and hyperactivity scores contributed, independent or other
sociodemographic factors, to the risk of academic problems. Very Low
Birth Weight Children: Behavior Problems and School Difficulty in a National
Sample. McCormick MC, Gortmaker SL, Sobol AM. Department of Behavioral
Sciences, Harvard School of Public Health, Boston, Mass. J Pediatr, Nov
1990; 117 (5): 687-93.
42. A review of 20 years experience with neonatal intensive care for very
low birth weight infants indicates that an increasing proportion survive
free of moderate to severe handicap. However, increasing literature suggests
that early findings may be insufficient to characterize later outcomes,
particularly problems encountered as children enter school. The study
concludes that further definition of long term outcomes for very low birth
weight children is critical to assess the utility of neonatal intensive
care unit interventions and at the individual level for counseling families
as to the health and educational needs of these children. Long Term
Follow Up of Infants Discharged from Neonatal Intensive Care Units. McCormick
MC. Joint Program in Neonatology, Harvard Medical School, Boston, Mass.
JAMA, March 24-31, 1989; 261 (12): 1767-72.
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Goals for Advocating for Premature Children", by Patti