Reaching skills of infants born very preterm predict neurodevelopment at 2.5 years

The purpose was to investigate associations between quality of reaching for moving objects at 8 months corrected age and neurodevelopment at 2.5 years in children born very preterm (gestational age (GA), 24–31 weeks). Thirtysix infants were assessed while reaching for moving objects. The movements were recorded by a 3D motion capture system. Reaching parameters included aiming, relative length of the reach, number of movement units, proportion of bimanual coupled reaches and number of hits. Neurodevelopment was assessed at 2.5 years by the Bayley Scales of Infant Development III. There were strong associations between infant reaching kinematics and neurodevelopment of cognition and language but the patterns differed: in children born extremely preterm (GA < 28 weeks), planning and control of reaching was strongly related to outcome, while in children born very preterm (GA 28–31 weeks) number of hits and bimanual strategies were of greater relevance. In conclusion, for extremely preterm infants, basic problems on how motion information is incorporated with action planning prevail, while in very preterm infants the coordination of bimanual reaches is more at the focus. We conclude that the results reflect GA related differences in neural vulnerability and that early motor coordination deficits have a cascading effect on neurodevelopment.     

Dyadic processes between mothers and preterm infants: Development at ages 2 to 5 years

In order to identify antecedents to cognitive, language, and social competence from 2 to 5 years of age in preterm children at biological and social risk, this study used multiple procedures, administered in the laboratory, at 13 and 20 months, to measure components of the social interactions between 51 mothers and their preterm infants. Two variables, maternal responsiveness to infant vocalization and infant irritability, were found to be significant predictors of later competence. Whereas greater maternal responsiveness, as expected, led to increased language and social skills, greater infant irritability during stressful situations also foretold later increased competence in expressive and receptive language and social cognition. Children born at higher birthweights and with longer gestations were more likely to be more irritable than those born at very low birthweights. The findings suggest different implications for negative affect in preterms who have experienced respiratory distress as contrasted to full-term children, but indicate similar positive consequences for maternal verbal responsiveness.     

Social anxiety and social adaptation among adolescents at three age levels

The aim of the study was to examine the relationship between social anxiety and social adaptation among adolescents. This is the first study to research these parameters among three age groups: early, middle and late adolescence. On the whole, a negative relation was found between social anxiety and social adaptation. Specifically, for adolescents aged 12?C13, social anxiety was positively associated with social rejection, and negatively associated with social acceptance and popularity. The same was true of adolescents aged 14?C15, but the correlations were lower. For late adolescents (aged 17?C18), social anxiety was not significantly correlated with any dimension of social adaptation. The results provide evidence that young adolescents (12?C13) suffer from higher levels of social anxiety than their older counterparts. The relation found between social anxiety and social adaptation may indicate that high levels of social anxiety may cause intense distress, which can be expected to impair adolescents?? social performance.     

Attenuated brain responses to speech sounds in moderate preterm infants at term age

Recent findings have revealed that very preterm neonates already show the typical brain responses to place of articulation changes in stop consonants, but data on their sensitivity to other types of phonetic changes remain scarce. Here, we examined the impact of 7–8 weeks of extra‐uterine life on the automatic processing of syllables in 20 healthy moderate preterm infants (mean gestational age at birth 33 weeks) matched in maturational age with 20 full‐term neonates, thus differing in their previous auditory experience. This design allows elucidating the contribution of extra‐uterine auditory experience in the immature brain on the encoding of linguistically relevant speech features. Specifically, we collected brain responses to natural CV syllables differing in three dimensions using a multi‐feature mismatch paradigm, with the syllable/ba/ as the standard and three deviants: a pitch change, a vowel change to/bo/ and a consonant voice‐onset time (VOT) change to/pa/. No significant between‐group differences were found for pitch and consonant VOT deviants. However, moderate preterm infants showed attenuated responses to vowel deviants compared to full terms. These results suggest that moderate preterm infants' limited experience with low‐pass filtered speech prenatally can hinder vowel change detection and that exposure to natural speech after birth does not seem to contribute to improve this capacity. These data are in line with recent evidence suggesting a sequential development of a hierarchical functional architecture of speech processing that is highly sensitive to early auditory experience.     

Phonotactic acquisition in healthy preterm infants

Previous work has shown that preterm infants are at higher risk for cognitive/language delays than full‐term infants. Recent studies, focusing on prosody (i.e. rhythm, intonation), have suggested that prosodic perception development in preterms is indexed by maturational rather than postnatal/listening age. However, because prosody is heard in‐utero, and preterms thus lose significant amounts of prenatal prosodic experience, both their maturation level and their prosodic experience (listening age) are shorter than that of full‐terms for the same postnatal age. This confound does not apply to the acquisition of phonetics/phonotactics (i.e. identity and order of consonants/vowels), given that consonant differences in particular are only perceived after birth, which could lead to a different developmental pattern. Accordingly, we explore the possibility that consonant‐based phonotactic perception develops according to listening age. Healthy French‐learning full‐term and preterm infants were tested on the perception of consonant sequences in a behavioral paradigm. The pattern of development for full‐term infants revealed that 7‐month‐olds look equally at labial‐coronal (i.e. /pat/) compared to coronal‐labial sequences (i.e. /tap/), but that 10‐month‐olds prefer the labial‐coronal sequences that are more frequent in the French lexicon. Preterm 10‐month‐olds (having 10 months of phonetic listening experience but 7 months of maturational age) behaved as full‐term 10‐month‐olds. These results establish that preterm developmental timing for consonant‐based phonotactic acquisition is based on listening age (experience with input). This questions the interpretation of previous results on prosodic acquisition in terms of maturational constraints, and raises the possibility that different constraints apply to the acquisition of different phonological subcomponents.     

Attachment representations in mothers of preterm infants

The aim of the study was to assess attachment representations in mothers of preterm infants using the Working Model of Child Interview (WMCI) at the 12 months of the infant's corrected age. In addition, the relation between WMCI representation categories and the Edinburgh Postnatal Depression Scale score at 6 months of the infant's corrected age was studied. There were 38 mothers of preterm infants (<1500 g or <32 gestational weeks) and 45 mothers of full-term infants. The results showed no differences between the study groups in the distribution of the three main representation categories (balanced, disengaged and distorted). However, there were qualitative differences in representations between the groups. Furthermore, maternal depression symptoms were associated with distorted representation category. We suggest that despite the qualitative differences in the mothers’ representations, mothers of preterm infants are as likely to form balanced attachments with their infants as mothers of full-term infants.     

Visual and auditory orienting responses in preterm infants: a comparison of three cohorts over time.

Visual and auditory orienting responses were compared in three cohorts of preterm infants (N = 351) born between 1977 and 1987. The infants were divided into one group born between 25 and 34 weeks gestational age (n = 140) and one group born between 35 and 37 weeks gestational age (n = 211). Ratings were made of the infants' best orienting responses to a bull's-eye, rattle, bell, voice, and face plus voice combined. Analyses of covariance were computed to adjust for changes in perinatal variables between 1977 and 1987. For both groups, there were significant differences between cohorts on orienting to the bull's-eye, with a trend for the 25- to 34-week group on orienting to the rattle. Behavioral outcome for preterm infants has improved with changes in neonatal intensive care.     

Emotional and neuroendocrine regulation in very preterm and full-term infants at six months of age

Emotional and neuroendocrine regulation have been shown to be associated. However, results are inconsistent. This paper explores the functioning and relationships between these two systems in 54 healthy preterm and 25 full-term born infants at six months of age. Results showed significant differences between very preterm and full-term children in emotional intensity and regulation, as well as in neuroendocrine regulation. No evidence of an association between neuroendocrine and emotional regulations was found. Results suggest a possible delay in the maturation of the neuroendocrine system as well as in emotional regulation in very preterm infants.     

Face-to-face interaction in term and preterm infants

Previous research has found that mothers of preterm infants work harder in a face-to-face situation with their infants than mothers of term infants. Data have also revealed that preterm infants are less responsive than term infants in a social interaction. To date, there have been few studies that have attempted to determine the range of facial expressive cues that preterms may be emitting or the possible physiological basis for this behavior. In an attempt to investigate these questions, preterm and term infants were observed in a face-to-face situation. Prior to the session, three minutes of resting EKG was recorded. The infant's facial behavior was coded with a discrete facial action coding system. Maternal behavior was also coded. Measures of heart rate as well as short and long term variability were computed. Results revealed no differences in facial lability or in facial expressiveness between term and preterm infant. In addition, there were no differences in maternal behavior to either term or preterm. There were, however, reliable contingent relationships between facial expression of the infant and maternal behavior. In addition, there was a significant association between short term variability (vagal tone) and infant facial behavior.     

Preference for infant-directed speech in preterm infants

The current study explores the effects of exposure to maternal voice on infant sucking in preterm infants. Twenty-four preterm infants averaging 35 weeks gestational age were divided randomly into two groups. A contingency between high-amplitude sucking and presentation of maternal voice was instituted for one group while the other group served as a yoked control. No significant differences were observed in sucking of the two groups, but the degree of pitch modulation of the maternal voice predicted an increase in the rate of infant sucking.     

Emotional interaction in a group of preterm infants at 3 and 6 months of corrected age

Twenty preterm infants (birthweight<1500 g) and 20 healthy fullterm infants were compared with respect to emotional interaction with their mothers in a face‐to‐face situation at 3 months of age and in a feeding situation at 6 months of age (ages corrected for preterm birth). The assessed outcome was analysed with respect to infant variables (group, gender, gestational age, birthweight and neonatal risk factors) and maternal variables (age, education and parity). The outcomes at 3 and 6 months of age were also compared with findings of Griffiths’ testing at 10 months of age. At 3 months of age, the findings reveal no significant difference between the two groups with respect to emotional interaction. Maternal variables are more important for this interaction than are infant variables. The mother's level of formal education has a significant impact in both groups. In the group of fullterm infants, significantly lower scores for interaction are obtained by first‐time mothers in comparison with multi‐parae mothers. At 6 months of age, the difference between fullterm and preterm infants is significant. The preterm infants and their mothers now relate to one another more poorly than is the case for the fullterm dyads. These findings suggest that the difficulties encountered by the preterm infant emerge with time. Emotional interaction at this age and the results of Griffiths’ testing 4 months later are significantly correlated. Copyright © 1999 John Wiley & Sons, Ltd.     

Socioemotional functioning of creative preschoolers

This study investigated the relationship between original thinking and socioemotional characteristics of 40 preschoolers, ranging in age from 44 to 68 mo. (M = 56.2 mo.). Socioemotional behavior was assessed by teachers on two ratings, the Kohn Social Competency and the Child's Behavior Traits scales. Creative potential was assessed by the Multidimensional Stimulus Fluency Measure which measures ideational fluency. Contrary to expectations, no statistically significant differences in psychosocial adjustment were found between the more and less creative preschoolers on a median split. A significant effect for sex was detected on six of seven socioemotional variables examined, with girls scoring higher than boys on over-all adjustment. Similarly, more positive attributes of preschool girls are indicated in areas of functioning that traditionally have been reported to be characteristic of boys.     

Visual attention at three months as a predictor of cognitive functioning at two years of age

The purpose of the present study was to examine the predictive power of various cognitive skills at 3 months of age in terms of later cognitive functioning. Habituating to redundant and recovering to novel stimuli at 3 months of age were found to predict later intellectual functioning at 24 months better than 3-month global intelligence or object permanence scores. In terms of information processing skills, recovery predicted later intelligence test scores better than habituation. It is suggested that changes in cognitive functioning may be viewed as a transformation of skills from one age to another rather than as a continuum of the same skills. With regard to the cognitive abilities of the 3-month-old, it is suggested that information processing may be central to cognitive functioning at this age.     

Temperature increases in preterm infants during massage therapy

Temperature was assessed in 72 preterm infants randomly assigned to a control or a massage therapy group. A greater increase in temperature was noted for preterm infants receiving massage therapy versus a control group, even though the incubator portholes remained open during the 15 min massage therapy session but not for the control group over an equivalent time period.     

Patterns of psychological distress in mothers of preterm infants

Mothers of preterm infants experience significant psychological distress, with elevated levels of inter-correlated depressive, stress, anxiety and post-traumatic stress symptoms. In a sample of racially and ethnically diverse mothers of preterm infants, we identified differing patterns of psychological distress during infant hospitalization and examined the effect of these psychological distress patterns on longitudinal trajectories of each psychological distress measure and on maternal perceptions of the child over the first year of the infant's life. Mothers of preterm infants (N = 232) completed five questionnaires assessing depressive symptoms, anxiety, post-traumatic stress symptoms, stress due to infant appearance, and stress due to parental role alteration during enrollment during the neonatal hospitalization, discharge, and at 2, 6, and 12 months of age adjusted for prematurity. Latent class analysis on the enrollment psychological distress variables allowed us to identify five sub-groups of mothers exhibiting similar patterns of psychological distress, differing primarily in degree and type: low distress, moderate distress, high NICU-related distress, high depressive and anxiety symptoms, and extreme distress. These classes continued to show different longitudinal trajectories for the psychological distress measures through 12 months corrected age. Mothers in the extreme distress class and, to a lesser degree, mothers in the high depressive and anxiety symptom class remained at risk of significant psychological distress one year after discharge and had less positive perceptions of their child (greater worry and higher perceptions of child vulnerability). In conclusion, distinctive sub-groups of mothers during hospitalization had different patterns of psychological distress throughout the 12-month period and may require different interventions in the NICU.     

Stability of developmental status and risk of impairment at 24 and 36 months in late preterm infants

BackgroundFew studies investigated whether late preterm infants might have developmental delays in several domains in early life and how stable the lag in developmental status might be.AimWe aimed to examine the stability of potential delays across developmental domains at 24 and 36 months of age in late preterm (34°-36⁶ weeks) and term (≥37 weeks) children and whether the risk of delays remained high at 36 months.Study design, subjects, and outcome measureWe conducted a prospective cohort analysis of the children of pregnant women participating in the Vitamin Antenatal Asthma Reduction Trial (VDAART). 652 children who were prospectively followed up and had parent-completed Ages Stages Questionnaires (ASQ-3) questionnaires at both 24 and 36 months were analyzed to assess their domain-specific developmental status.Results6.61 % (42/635) of children had a late preterm birth. Developmental delays were stable between 24 and 36 months on all 5 domains for the children born preterm and on 4/5 domains for those born at term. The developmental domains with the status stability at 24 and 36 months in both late preterm and term children were the gross motor, communication, personal-social skills, and problem-solving. Late preterm children compared with term children remained at higher risk of delays at 36 months for gross motor, communication, and problem-solving skills (aOR = 4.54, 95 %CI: 1.81−10.79; aOR = 8.60, 95 %CI: 3.10−23.28 and aOR = 3.80, 95 %CI: 1.58−8.73, respectively).ConclusionLate preterm birth is associated with suboptimal development and stability in several domains at both 24 and 36 months and compared with term birth, requiring early monitoring and assessment of the developmental lag to avoid potential long-term implications.