Very Low Birth Weight and Attention Deficit/Hyperactivity Disorder

It is well recognized that reaction time performance of term-born children with a normal birth weight (NBW > 2500 g) who fulfill the DSM-IV criteria for attention deficit/hyperactivity disorder (ADHD) in the primary school age is sensitive for the presentation rate of stimuli. They have been found to perform more poorly in conditions of relatively slow event rates as compared with fast event rates. The purpose of the current study was to explore whether reaction time performance of children with very low birth weight (VLBW < 1500 g) with or without ADHD showed the same sensitivity for the factor presentation rate of stimuli compared to children with a normal birth weight plus ADHD. To this end, reaction time performance of four groups of children was compared on a Go/No-Go test with a fast presentation rate of 1 second and a slow presentation rate of 6 seconds. Groups were: children with VLBW plus ADHD, children with VLBW only, children born full term with normal birth weight (NBW >2500 g) plus ADHD, and children born full term without ADHD (the control group). Findings indicated that, compared to the non-ADHD groups, the groups with ADHD (NBW and VLBW) showed a more dramatic decline in their reaction time performance in the slow condition: a state regulation deficit. In addition, both groups showed a response inhibition deficit. No difference was found in reaction time performance between the groups of children with VLBW only and the control group.     

Cognitive control deficits in adolescents born with very low birth weight (≤ 1500 g): Evidence from dichotic listening

The objective of the paper is to explore bottom‐up auditory and top‐down cognitive processing abilities as part of long‐term outcome assessment of preterm birth. Fifty‐five adolescents (age 13–15) born with very low birth weight (VLBW) were compared to 80 matched controls born to term, using three consonant‐vowel dichotic listening (DL) instruction conditions (non‐forced, forced‐right and forced‐left). DL scores were correlated with cortical gray matter thickness derived from T1‐weighted structural MRI volumes using FreeSurfer to examine group differences also in the neural correlates of higher cognitive processes. While showing normal bottom‐up processing, VLBW adolescents displayed impaired top‐down controlled conflict processing related to significant cortical thickness differences in left superior temporal gryus and anterior cingulate cortex. Preterm birth with VLBW induces fundamental changes in brain function and structure posing a risk for long‐term neurocognitive impairments. Deficits emerge in situations of increasing cognitive conflict and can be related to measures of executive functions as well as morphology.     

Impaired prospective memory but intact episodic memory in intellectually average 7- to 9-year-olds born very preterm and/or very low birth weight

Relatively little is known about episodic memory (EM: memory for personally-experienced events) and prospective memory (PM: memory for intended actions) in children born very preterm (VP) or with very low birth weight (VLBW). This study evaluates EM and PM in mainstream-schooled 7- to 9-year-olds born VP (≤ 32 weeks) and/or VLBW (< 1500 g) and matches full-term children for comparison (n = 35 and n = 37, respectively). Additionally, participants were assessed for verbal and non-verbal ability, executive function (EF), and theory of mind (ToM). The results show that the VP/VLBW children were outperformed by the full-term children on the memory tests overall, with a significant univariate group difference in PM. Moreover, within the VP/VLBW group, the measures of PM, verbal ability and working memory all displayed reliable negative correlations with severity of neonatal illness. PM was found to be independent of EM and cognitive functioning, suggesting that this form of memory might constitute a domain of specific vulnerability for VP/VLBW children.     

Prereading skills of very-low-birth-weight prematurely born Finnish children

Our objective was to study the prereading skills of very-low-birth-weight (VLBW; ≤ 1500 g) prematurely born children at the age of five years. A regional cohort of 89 VLBW children and 152 full-term (FT) born children was assessed for letter knowledge, phonological processing, and speeded naming. Full-scale IQ (FSIQ) was assessed using a short version of WPPSI-R. The associations of parental and neonatal factors, and FSIQ with prereading skills were assessed. VLBW group had poorer prereading skills, and there were more VLBW children at-risk (performing < ?1 SD) compared to FT children in phonological processing (23% vs. 9%, p = .002), letter knowledge (27% vs. 14%, p = .017), and the accuracy of speeded naming (26% vs. 13%, p = .020). VLBW children had lower average FSIQ and Performance IQ (both comparisons p < .001) than FT controls, but Verbal IQ did not differ. When FSIQ was used as a covariate, VLBW children did not differ from the FT group in prereading skills indicating that they are at risk for more global developmental problems. Lower parental level of education as well as parent's reading problems were negatively associated with VLBW children's prereading skills. Positively, about 75% of VLBW children performed within the normal range in each individual prereading skill.     

Responsive parenting: establishing early foundations for social, communication, and independent problem-solving skills

Mothers whose infants varied in early biological characteristics (born at term, n = 120; born at very low birth weight [VLBW], n = 144) were randomized to a target group (n = 133) or developmental feedback comparison group (n = 131) to determine whether learning responsive behaviors would facilitate infant development. The target condition included videotaped examples, problem-solving activities, and mothers' critique of their own behaviors through video procedures across 10 home visits. All target versus comparison mothers showed greater increases across multiple responsiveness behaviors observed in 4 assessments conducted across 6-13 months of age; changes in emotionally supportive behaviors were strongest for target mothers of infants born at VLBW. Increased maternal responsiveness facilitated greater growth in target infants' social, emotional, communication, and cognitive competence, supporting a causal role for responsiveness on infant development. Although benefits were generally comparable across risk groups, aspects of social and emotional skills showed greater change for those born at VLBW. Evidence for responsiveness as a multidimensional construct was provided as well as the importance of different aspects of responsiveness mediating the effect of the intervention on different infant skill domains.     

School performance and IQ-test scores at age 13 as related to birth weight and gestational age

The cohort in the present longitudinal research program consisted of 873 children in an entire school grade, in a Swedish community. The present results showed a main effect of birth weight; low birth weight (LBW) children had lower school performance and intelligence-test (IQ) scores at age 13 than did normal birth weight (NBW) children irrespective of parental SES. Second, there was no significant main effect of gestational age (GA) on scholastic performance and IQ-test scores. Third, there was a significant main effect of the combination of birth weight and GA on scholastic performance and IQ-test scores. The LBW children born at term (38-40 pregnancy weeks; pw) had significantly lower scores and school grades as compared to the control group while the LBW children born with short gestational age (34-37 pw) and with very short gestational age (less than 34 pw) had significantly lower scores and marks in fewer areas of academic attainment.     

Sources of variability in sequelae of very low birth weight.

Few investigations have examined the specificity of sequelae of very low birth weight (VLBW, <1500 g) or sources of variability in outcome. To better understand the nature and determinants of outcome, we assessed neuropsychological and achievement skills at mean age 11 years in 62 children with <750 g birth weight, 54 with 750-1499 g birth weight, and 66 term-born controls. Distinct cognitive constructs were identified by factor analysis, and the three birthweight groups were compared on these constructs and on composite measures of achievement. Although the group with <750 g birth weight performed less well on all tests than term-born controls, group differences in a perceptual planning factor and in mathematics remained even when IQ was controlled, and deficits were more pronounced in mathematics than in reading. Results from structural equation modeling were consistent with the hypothesis that neuropsychological skills mediated the relationship between birth weight and achievement. The findings confirm the differential deficit hypothesis, support the need to consider multiple sources of variability in VLBW outcomes, and highlight the importance of neuropsychological constructs in developing an explanatory framework.     

Sources of Variability in Sequelae of Very Low Birth Weight

Few investigations have examined the specificity of sequelae of very low birth weight (VLBW, &lt;1500 g) or sources of variability in outcome. To better understand the nature and determinants of outcome, we assessed neuropsychological and achievement skills at mean age 11 years in 62 children with &lt;750 g birth weight, 54 with 750-1499 g birth weight, and 66 term-born controls. Distinct cognitive constructs were identified by factor analysis, and the three birthweight groups were compared on these constructs and on composite measures of achievement. Although the group with &lt;750 g birth weight performed less well on all tests than term-born controls, group differences in a perceptual planning factor and in mathematics remained even when IQ was controlled, and deficits were more pronounced in mathematics than in reading. Results from structural equation modeling were consistent with the hypothesis that neuropsychological skills mediated the relationship between birth weight and achievement. The findings confirm the differential deficit hypothesis, support the need to consider multiple sources of variability in VLBW outcomes, and highlight the importance of neuropsychological constructs in developing an explanatory framework.     

Maternal and Paternal Perception of Child Vulnerability and Behaviour Problems in Very Preterm Born Children

Preterm born children have more behaviour problems than term born children. Perinatal risks, current child functioning, sociodemographic characteristics, parental psychological distress and parental perceptions of child vulnerability (PCV) have been shown to be risk factors for behaviour problems. However, the role of maternal and paternal PCV is unclear, as these have not been investigated as a risk factor for behaviour problems, with all other risk factors taken into account. Aim of this study is to investigate whether maternal and paternal PCV are independent risk factors for behaviour problems in very preterm (VP) and term born children. The present study is a single centre prospective cohort study. Preterm children (n = 104), born at <30 weeks' gestation and/or birth weight <1000 g, and term children (n = 95) were assessed at age 5. Results showed that risk factors for parent‐rated behaviour problems were low/middle parental education, VP birth, parental stress and, in VP children, maternal PCV. Risk factors for teacher‐rated behaviour problems were low/middle parental education, foreign parental country of birth, intrauterine growth restriction and objective child vulnerabilities. It can be concluded that maternal PCV is a risk factor for parent‐rated behaviour problems in VP children. When VP children are presented with behavioural problems, clinicians ought to be aware of the possibility that parents might still perceive their child as vulnerable. The neonatal history of the child, the way parents experienced that period, their perceptions of the child and possible consequences of these perceptions could be subjects for conversation during visits at follow‐up clinics. Copyright © 2015 John Wiley & Sons, Ltd.     

Measuring functional outcomes after prematurity: developmental impact of very low birth weight and extremely low birth weight status on childhood disability

Our purpose was to describe functional outcomes in essential activities in preschool, school-age, and adolescent children who were born very (<32 weeks gestation) and extremely (<28 weeks gestation) prematurely. Very low birth weight (VLBW; 1000-1499 g), or extremely low birth weight (ELBW;<1000 g) populations are the focus of our analysis. We describe models of disablement and enablement for specifying the complexity of childhood outcomes using a framework of pathophysiology, impairment, functional limitation and functional strengths, disability in social roles and social participation, societal limitations and environmental facilitators. Representative early childhood, preschool, school-age, and adolescent studies were examined in terms of describing children's functional strengths and challenges after VLBW and ELBW survival. In early childhood, disability was assessed by diagnosing neurosensory impairments and delays on developmental testing. Instruments for measuring functional status in essential activities of self-care, mobility, communication and learning are described. Rates of neurosensory disability in the first three years among recent ELBW survivors ranged from 9-26% for cerebral palsy, 1-15% for blindness, 0-9% for deafness, and 6-42% for evolving cognitive disability (MDI <70). Rates of preschool functional limitation were 5-27% motor, 5-30% self-care, and 5-22% communicative. Rates of school-age functional educational disabilities exceeded 50%. Rates of adolescent activity limitation were 13-32% and vocational limitations were 27-71%. By examining the functional strengths and challenges of children with major neurodevelopmental impairments after very or extremely preterm birth, we can examine causal pathways that lessen the risk of severe functional disability. Among children with mild to moderate disability, we can enhance functional outcomes, optimize community participation, and provide quality family supports. In order to assess the changing outcomes of this vulnerable population of survivors, combinations of clinical and survey based methodologies are required.     

父母冲突、青少年的认知评价及其与青少年社会适应的关系

以446名小学五年级至初中二年级的学生为被试,采用问卷法,让被试报告父母冲突形式、内容,对父母冲突的认知评价,以及抑郁、焦虑、自尊、学习问题和不良行为,以探讨父母冲突形式和内容、青少年对冲突的评价与其社会适应的关系,并检验认知评价在父母冲突与青少年适应间的中介作用。结果发现：（1）男女生除在父母情绪冲突和自尊方面的报告有显著差异外,其余各个方面都没有显著差异;随年级升高,儿童知觉的父母冲突内容显著增多,抑郁情绪、学习问题显著增多,而自尊水平显著下降;（2）父母冲突的不同形式和内容,以及青少年对父母冲突的不同认知评价可以预测青少年不同方面的社会适应;（3）认知评价在父母冲突与青少年的内部适应中起中介作用,但在父母冲突与青少年的外部适应中不起中介作用。     

Associations between parental educational/occupational levels and cognitive performance in Spanish adolescents: the AVENA study

We examined the associations between parental educational/occupational levels and cognitive performance in Spanish adolescents. Cognitive performance was measured by a validated Scholar Aptitudes test in 2,162 participants. Parental educational and occupational levels were positively associated with all specific cognitive abilities and the overall score (p<001 to .04). The odds ratios of having a high cognitive performance (top quartile) in adolescents with high parental educational level were 1.6 to 1.7 times higher than for those with a low parental educational level. Similarly, the odds ratios were 1.9 to 2.4 times higher for adolescents with high parental occupational level. These findings suggest an association between parental educational/occupational levels and cognitive performance in Spanish adolescents and support the parents' role in the creation of a stimulating intellectual environment.     

Behavior at 10 and 13 years of age for children with low birth weight

This study was based on data from a longitudinal research program. The cohort consisted of 874 normal children in an entire school grade in a Swedish community. The aim of the study was to investigate the relation between birth weight and behavior at school, for all children and for each sex separately. The results identified specific aspects of behaviour disorder significantly related to low birth weight (LBW) for children at the age of 10 but not at the age of 13. When the sexes were separated, there were no relations between birth weight and deviant behaviour for boys of low birth weight as compared to boys of normal birth weight, while girls of low birth weight showed specific behavioural disorders at age 10 as compared to girls of normal birth weight. For girls reared in families of low parental socioeconomic status, aggressiveness and motor restlessness at age 10 but not at age 13 was also present. Further analyses showed that girls born small-for-gestational age showed lack of school motivation and concentration difficulties both at age 10 and age 13.     

Pathways to behavior problems in Norwegian kindergarten children: The role of parent emotion socialization and child emotion understanding

More than two decades of research have shown that parental emotion-related socialization behaviors (ERSBs) significantly predict child emotion understanding and externalizing behavior problems. This study aimed to replicate these findings in a sample of 40 Norwegian preschool children and to test whether the effect of parental ERSBs on externalizing child behavior problems was mediated through child emotion understanding. Parental report on ERSBs was obtained using the Coping with Children’s Negative Emotions Scale (CCNES) questionnaire. Child emotion understanding was assessed directly using the Test of Emotion Comprehension (TEC). The results showed that parental distress reactions and externalizing child behavior problems were significantly correlated and that parental expressive encouragement was significantly correlated with child emotion understanding. Estimation of indirect effects was conducted using process analysis and showed that parental expressive encouragement was indirectly related to externalizing child behavior problems (b = −0.17) via child emotion understanding. The results suggest that better child emotion understanding, and lower parental distress are related to lower levels of behavior problems in preschool children. These findings provide support for the Parental Meta-Emotion Philosophy (PMEP) model, where the effect of parental emotion socialization on externalizing child behavior problems is mediated through emotion understanding.     

Kicking coordination captures differences between full-term and premature infants with white matter disorder

This study explores the relation of white matter disorder (WMD) to intralimb coordination patterns in premature infants with very low birth weight (VLBW). We specifically measured the temporal-spatial characteristics of intralimb coordination patterns of the legs. Three groups of infants were compared at one month corrected age (CA): 10 premature infants born VLBW and WMD (PTWMD), 10 premature infants born VLBW without WMD (PT) and 10 full term infants (FT). Using kinematic variables, we discriminate among VLBW infants with WMD from the two comparison groups. Infants born with WMD maintain patterns of tight coupling among leg joints (all flexion or all extension) while PT and FT term infants have begun to decouple leg joints by this age (combinations of flexion with extension). The coupling pattern is captured through joint correlations, discrete relative phase, and phase plane portraits. The PTWMD infants also demonstrate aberrant patterns of coordination evident through both temporal and spatial characteristics of the kicks. This is the first evidence that movement disorder associated with brain lesions can be identified and quantified with kinematic variables as early as one month of age.     

Verbal memory deficits in children with less than 750 g birth weight.

Numerous studies have documented memory deficits in very low birthweight (VLBW, < 1500 g) children, yet we know little about the nature of these memory problems. To clarify memory sequelae and examine memory deficits in relation to the degree of low birth weight, we administered the California Verbal Learning Test-Children's Version (CVLT-C) to a regional sample of 57 < 750 g birthweight children and to groups of 53 750-1499 g birthweight children and 49 term-born controls. Group comparisons revealed significant differences between the < 750 g birthweight group and term-born children on measures of list learning, delayed recall, and inaccurate recall. In addition, the percentage improvement in correct recognitions relative to long-term delayed recall was greater in the < 750 g group than in the term-born controls. Similar differences were observed between VLBW children with and without abnormal neonatal cerebral ultrasounds (high- and low-risk groups). Differences in learning rate between the VLBW and term-born groups, and between high- and low-risk VLBW children, were evident even when vocabulary skill was covaried or when children with neurosensory deficits or IQ < 80 were excluded from analysis. The findings document deficits in verbal memory in the subset of VLBW children at greatest biological risk, and suggest that acquisition processes are selectively impaired.     

The role of maternal responsiveness in predicting infant affect during the still face paradigm with infants born very low birth weight

There is limited empirical literature addressing infants' response to a standardized stressor with infants born very low birth weight (VLBW). The purpose of this study was to assess the relative strength of maternal responsiveness in predicting infant affect in response to the Still Face (SF) paradigm in a cross‐sectional cohort of ethnically diverse infants born VLBW and their mothers (N = 50; infants 6–8 months old). Infant affect and maternal responsiveness were coded in 1‐s intervals while dyads participated in the SF. In addition, perinatal medical status, developmental status, and infant temperament were assessed. Findings revealed that positive infant affect during and after the SF stressor were strongly associated with baseline infant positive affect and maternal responsiveness at the reunion episode, respectively. In contrast, when predicting negative infant affect during and after the SF stressor, prior infant negative affect was strongly and uniquely significant. Infant positive affect, negative affect, and maternal responsiveness were not significantly associated with gender, infant perinatal medical history, developmental status, or temperament. Future research is warranted to determine how these findings relate to infants' stress reactions in naturalistic settings and if relationship‐focused interventions may reverse infant negative emotionality, enhance positive emotionality, and thereby improve self‐regulation and longer term social and cognitive developmental outcomes in medically at‐risk infants.     

Birth weight and cognitive ability in childhood: a systematic review

Individual differences in cognitive ability may in part have prenatal origins. In high-risk (low birth weight/premature) babies, birth weight correlates positively with cognitive test scores in childhood, but it is unclear whether this holds for those with birth weights in the normal range. The authors systematically reviewed literature on the relationship between normal birth weight (more than 2,500 g) and childhood intelligence in term (37-42-week gestation) deliveries. Six studies met the inclusion criteria, and the authors present a comprehensive narrative review of these studies. There was a small, consistent, positive association between birth weight and childhood cognitive ability, even when corrected for confounders. Parental social class accounted for a larger proportion of the variance than birth weight, and these 2 variables were largely independent.     

Verbal Memory Deficits in Children with Less than 750 g Birth Weight

Numerous studies have documented memory deficits in very low birthweight (VLBW, &lt; 1500 g) children, yet we know little about the nature of these memory problems. To clarify memory sequelae and examine memory deficits in relation to the degree of low birth weight, we administered the California Verbal Learning Test–Children’s Version (CVLT-C) to a regional sample of 57 &lt; 750 g birthweight children and to groups of 53 750–1499 g birthweight children and 49 term-born controls. Group comparisons revealed significant differences between the &lt; 750 g birthweight group and term-born children on measures of list learning, delayed recall, and inaccurate recall. In addition, the percentage improvement in correct recognitions relative to long-term delayed recall was greater in the &lt; 750 g group than in the term-born controls. Similar differences were observed between VLBW children with and without abnormal neonatal cerebral ultrasounds (high- and low-risk groups). Differences in learning rate between the VLBW and term-born groups, and between high- and low-risk VLBW children, were evident even when vocabulary skill was covaried or when children with neurosensory deficits or IQ &lt; 80 were excluded from analysis. The findings document deficits in verbal memory in the subset of VLBW children at greatest biological risk, and suggest that acquisition processes are selectively impaired.     

Maternal attitudes and attachment styles in mothers of obese children

This study evaluated categories of attachment style and the maternal attitude toward educational role in a sample of 30 mothers of obese children and a control group of 80 mothers of children of normal weight. All mothers completed the 1994 Attachment Style Questionnaire and the 1958 Parental Attitude Research Instrument. 30 mothers (M age 37.4 yr., range 31 to 54 years; M yr. of education 11.6, range 5 to 18 years) of obese children (range 30 to 60% above normal weight) and a control group of 80 mothers (M age 37.1 yr., range 29 to 52 years; M yr. of schooling 11.4, range 5 to 18 years) of children with normal weight were contacted at the primary school attended by their children and joined the project voluntarily. Age and number of years of education were not significantly different between the two groups of women. There was a significant prevalence of the Insecure Attachment Style in the group of mothers with obese children (66.6%) as compared to the control group of mothers of children of normal weight (38.5%) and significantly higher scores on 6 subscales of the Parental Attitude Research Instrument of Obese compared to Nonobese children. These data indicate that obese children's mothers tend to make the family their exclusive centre of interest. They also tend to dedicate themselves to their children with possessiveness and hyperprotection. They seem to have an insistent requirement of idealisation of their own role as parent and reward expectations that confirm the efficiency of the care they provide their children. Consequently, these findings suggest that in addition to dietetic treatment, it may be important to include a psychological intervention, which involves the mother and aims to modify the relational dynamics between the mother and her obese child.