Parents' report of sensory responsiveness and temperament in preterm infants. Long-term impact of neonatal intensive care and surgery on somatosensory perception in children born extremely preterm Prediction of participation and sensory modulation of late preterm infants at 12 months: a prospective study. Abnormal sensory reactivity in preterm infants during the first year correlates with adverse neurodevelopmental outcomes at 2 years of age Brief parenting intervention for parents of NICU graduates: a randomized, clinical trial of Primary Care Triple P Alterations in brain structure and neurodevelopmental outcome in preterm infants hospitalized in different neonatal intensive care unit environments. Early Sensitivity Training for Parents of Preterm Infants: Impact on the Developing Brain Cerebral Palsy Among Very Preterm Children in Relation to Gestational Age and Neonatal Ultrasound Abnormalities: The EPIPAGE Cohort Study Neonatal pain, parenting stress and interaction, in relation to cognitive and motor development at 8 and 18months in preterm infants Brain structure and neurocognitive and behavioural function in adolescents who were born very preterm Neurocognitive enhancement in older adults: Comparison of three cognitive training tasks to test a hypothesis of training transfer in brain connectivity Early exposure to maternal voice: effects on preterm infants development. Neurodevelopmental pathways to preterm children's specific and general mathematic abilities. Functional Outcome at School Age of Preterm Infants With Periventricular Hemorrhagic Infarction Functional impairments at school age of preterm born children with late-onset sepsis. Patterns of visual impairment associated with lesions of the preterm infant brain. Recurrent respiratory symptoms in the first year of life following preterm delivery Autism spectrum disorders in extremely preterm children. Cognitive development in low risk preterm infants at 3–4 years of life Long-term cognition, achievement, socioemotional, and behavioral development of healthy late-preterm infants. A Systematic Review of Behavioral and Environmental Interventions for Procedural Pain Management in Preterm Infants★ Neonatal hydrocortisone treatment: neurodevelopmental outcome and MRI at school age in preterm-born children. Associations between parental psychological well-being and socio-emotional development in 5-year-old preterm children.
OBJECTIVES Although most infants born prematurely do not have major developmental problems , those with perinatal medical problems and lengthy stays in the neonatal intensive care unit are at risk for sensory modulation problems and developmental sequelae . This study compared sensory responsiveness in preterm and full-term infants and examined the relationship of sensory responsiveness to temperament and developmental function . METHOD Caregivers of infants with ( n = 45 ) and without ( n = 22 ) prematurity were asked to complete the  Sensory Rating Scale .  The preterm infants were also evaluated with the Bayley Scales of Infant Development , Second Edition ( BSID-II ) . RESULTS The preterm infants exhibited more frequent behaviors indicating tactile defensiveness and difficult temperament than did the full-term infants . When specific items were examined , the preterm infants displayed sensory-seeking behaviors and high activity levels . As measured by caregivers ' report , sensory responsiveness was significantly related to temperament . It was not related to BSID-II Mental and Psychomotor scale scores . CONCLUSION This study supports the findings of others that preterm infants have mild problems in sensory responsiveness and temperament . Correlational results do not support a definitive relationship between parents ' reports of their infants ' sensory responsiveness and developmental function Abstract Alterations in neural activity due to pain and injury in early development may produce long‐term effects on sensory processing and future responses to pain . To investigate persistent alterations in sensory perception , we performed quantitative sensory testing ( QST ) in extremely preterm ( EP ) children ( n = 43 ) recruited from the UK EPICure cohort ( born less than 26 weeks gestation in 1995 ) and in age and sex matched term‐born controls ( TC ; n = 44 ) . EP children had a generalized decreased sensitivity to all thermal modalities , but no difference in mechanical sensitivity at the thenar eminence . EP children who also required neonatal surgery had more marked thermal hypoalgesia , but did not differ from non‐surgical EP children in the measures of neonatal brain injury or current cognitive ability . Adjacent to neonatal thoracotomy scars there was a localized decrease in both thermal and mechanical sensitivity that differed from EP children with scars relating to less invasive procedural interventions or from those without scars . No relationship was found between sensory perception thresholds and current pain experience or pain coping styles in EP or TC children . Neonatal care and surgery in EP children are associated with persistent modality‐specific changes in sensory processing . Decreases in mechanical and thermal sensitivity adjacent to scars may be related to localized tissue injury , whereas generalized decreases in thermal sensitivity but not in mechanical sensitivity suggest central ly mediated alterations in the modulation of C‐fibre nociceptor pathways , which may impact on responses to future pain or surgery The aim of the study was to prospect ively assess the differences in participation and sensory modulation between late preterm infants ( LPI ) and term babies , and to predict it by LPI characteristics . The study population includes 124 late preterm infants at gestational age between 34 and 35 6/7 weeks who were born at the same medical center . The control group comprised of 33 term babies ( 18 boys , 15 girls ) , born during the same period and location ( mean age 12.47 , SD = 0.73 ) .  Sensory modulation  was assessed by the test of sensory functions in infants and the infant/toddler sensory profile and for assessment of participation and parents ' satisfaction we used question naires . Term infants had better sensory modulation than LPI . Approximately 10 % of the sensory modulation of participants in the study was explained by gestational age and head circumference .  LPI participation and parental satisfaction decreased in the LPI group . Among all the explanatory variables only multiple gestations and head circumference contributed to the explained variance of participation ( 16 % ) , and parents ' satisfaction ( 13 % ) . At age of 1 year , children born as late preterm are at increased risk of developing sensory modulation disorder , showing less participation , and result ing in less parental satisfaction Background Sensory experience is the basis for learning in infancy . In older children , abnormal sensory reactivity is associated with behavioural and developmental disorders . We hypothesised that in preterm infants , abnormal sensory reactivity during infancy would be associated with perinatal characteristics and correlate with 2-year neurodevelopmental outcomes . Methods We conducted a prospect i ve observational study of infants with birth weight ≤1500 g using the Test of Sensory Function in Infants ( TSFI ) in the first year . Infants with gestational age ≤30 weeks were tested with the  Bayley Scales of Infant and Toddler Development III ( BSID III ) at 24 months . Results Of the 72 participants evaluated at 4–12 months corrected age ( median 8 months ) , 59 ( 82 % ) had a least one TSFI score concerning for abnormal sensory reactivity . Lower gestational age was associated with abnormal reactivity to deep pressure and vestibular stimulation ( p<0.001 ) . Poor ocular-motor control predicted worse cognitive and motor scores in early childhood ( OR 16.7 ; p=0.004 ) , but was tightly correlated to the presence of severe white matter injury . Poor adaptive motor function in response to tactile stimuli predicted worse BSID III motor ( p=0.01 ) and language scores ( p=0.04 ) at 2 years , even after adjusting for confounders . Conclusions Abnormal sensory reactivity is common in preterm infants ; is associated with immaturity at birth , severe white matter injury and lower primary caregiver education ; and predicts neurodevelopmental delays . Early identification of abnormal sensory reactivity of very preterm infants may promote parental support and education and may facilitate improved neurodevelopment Background Preterm-born or asphyxiated term-born children who received neonatal intensive care show more emotional and behavioral problems than term-born children without a medical condition . It is uncertain whether regular parenting intervention programs to which the parents of these children are usually referred , are effective in reducing child problem behavior in this specific population . Our objective was to investigate whether a regular , brief parenting intervention , Primary Care Triple P , is effective in decreasing emotional and behavioral problems in preterm-born or asphyxiated term-born preschoolers . Methods For this pragmatic , open r and omized clinical trial , participants were recruited from a cohort of infants admitted to the neonatal intensive care units ( NICU ) of two Dutch hospitals . Children born with a gestational age < 32 weeks or birth weight < 1500 g and children born at a gestational age 37–42 weeks with perinatal asphyxia were included . After screening for a t-score ≥60 on the Child Behavior Checklist ( CBCL ) , children were r and omly assigned to Primary Care Triple P ( n = 34 ) or a wait-list control group ( n = 33 ) . The primary outcome was child emotional and behavioral problems reported by parents on the CBCL , 6 months after the start of the trial . Results There was no effect of the intervention on the CBCL at the trial endpoint ( t64 = 0.54 , P = .30 ) . On secondary measurements of child problem behavior , parenting style , parenting stress , and parent perceived child vulnerability , groups either did not differ significantly or the intervention group showed more problems . In both the intervention and control group there was a significant decrease in emotional and behavioral problems during the trial . Conclusions Primary Care Triple P , a brief parenting intervention , is not effective in reducing child emotional and behavioral problems in preterm-born children or term-born children with perinatal asphyxia . Trial registration Netherl and s National Trial Register ( NTR ) : OBJECTIVE To evaluate associations between neonatal intensive care unit ( NICU ) room type ( open ward and private room ) and medical outcomes ; neurobehavior , electrophysiology , and brain structure at hospital discharge ; and developmental outcomes at 2 years of age . STUDY DESIGN In this prospect i ve longitudinal cohort study , we enrolled 136 preterm infants born < 30 weeks gestation from an urban , 75-bed level III NICU from 2007 - 2010 . Upon admission , each participant was assigned to a bedspace in an open ward or private room within the same hospital , based on space and staffing availability , where they remained for the duration of hospitalization . The primary outcome was developmental performance at 2 years of age ( n = 86 infants returned for testing , which was 83 % of survivors ) measured using the Bayley Scales of Infant and Toddler Development , 3rd Edition . Secondary outcomes were : ( 1 ) medical factors throughout the hospitalization ; ( 2 ) neurobehavior ; and ( 3 ) cerebral injury and maturation ( determined by magnetic resonance imaging and electroencephalography ) . RESULTS At term equivalent age , infants in private rooms were characterized by a diminution of normal hemispheric asymmetry and a trend toward having lower amplitude integrated electroencephalography cerebral maturation scores ( P = .02 ; β = -0.52 [ CI -0.95 , -0.10 ] ) . At age 2 years , infants from private rooms had lower language scores ( P = .006 ; β = -8.3 [ CI -14.2 , -2.4 ] ) and a trend toward lower motor scores ( P = .02 ; β = -6.3 [ CI -11.7 , -0.99 ] ) , which persisted after adjustment for potential confounders . CONCLUSION These findings raise concerns that highlight the need for further research into the potential adverse effects of different amounts of sensory exposure in the NICU environment After birth , preterm infants face a stressful environment , which may negatively impact early brain development and subsequent neurobehavioral outcomes . This r and omized controlled trial involving 45 women with infants < 30-wk gestation , assessed the effectiveness of training parents  in reducing stressful experiences . Intervention consisted of 10 sessions in the Neonatal Intensive Care Unit ( NICU ) . Postintervention , at term-equivalent ( 40-wk postmenstrual age ) , magnetic resonance imaging ( MRI ) was performed to evaluate brain structure and development . Quantitative volumetric techniques were used to estimate overall and regional brain volumes for different tissue types including CSF , CGM , DNGM , UWM , and MWM . DTI was used to evaluate the integrity and maturation of white matter by ADC and FA . Maturation and connectivity of white matter , characterized by diffusion MR measures of ADC and FA , were significantly enhanced in the intervention group , who displayed greater restriction in ADC and increase in FA . There were no significant effects on either brain volumes or on short-term medical outcomes . Thus , sensitivity training for parents in the NICU is associated with improved cerebral white matter micro-structural development in preterm infants OBJECTIVE . To estimate the prevalence of cerebral palsy at 2 years of age among children born very preterm , according to gestational age , infant gender , plurality , and neonatal cranial ultrasound abnormalities . METHODS . All infants born between 22 and 32 weeks of gestation in 9 regions of France in 1997 were included in this prospect i ve , population -based , cohort study . The main outcome measure was cerebral palsy prevalence at 2 years . Of the 2364 survivors eligible for follow-up evaluation , 1954 ( 83 % ) were assessed at 2 years of age . RESULTS . Among the 1954 children assessed at 2 years , 8.2 % had cerebral palsy . Bilateral spastic cerebral palsy , hemiplegia , and monoplegia accounted for 72 % , 9 % , and 10 % of cases , respectively . Fifty percent of the children with cerebral palsy walked independently at the age of 2 , 31 % were unable to walk but could sit independently , and 19 % could not sit ( unable to maintain head and trunk control ) . The prevalence of cerebral palsy was 20 % at 24 to 26 weeks of gestation , compared with 4 % at 32 weeks . On the basis of ultrasound findings in the neonatal period , we found that 17 % of children with isolated grade III intraventricular hemorrhage and 25 % of children with white matter damage ( ie , ventricular dilation , persistent echodensities , or cystic periventricular leukomalacia ) had cerebral palsy , compared with 4 % of children with normal ultrasound scans . CONCLUSIONS . Despite recent improvements in survival rates , cerebral palsy remains highly prevalent among very preterm children . Severe cranial ultrasound abnormalities predict motor disability strongly , but one third of infants with cerebral palsy had no ultrasound abnormalities ABSTRACT Procedural pain in the neonatal intensive care unit triggers a cascade of physiological , behavioral and hormonal disruptions which may contribute to altered neurodevelopment in infants born very preterm , who undergo prolonged hospitalization at a time of physiological immaturity and rapid brain development . The aim of this study was to examine relationships between cumulative procedural pain ( number of skin‐breaking procedures from birth to term , adjusted for early illness severity and overall intravenous morphine exposure ) , and later cognitive , motor abilities and behavior in very preterm infants at 8 and 18 months corrected chronological age ( CCA ) , and further , to evaluate the extent to which parenting factors modulate these relationships over time . Participants were N = 211 infants ( n = 137 born preterm ⩽32 weeks gestational age [ GA ] and n = 74 full‐term controls ) followed prospect ively since birth . Infants with significant neonatal brain injury ( periventricular leucomalacia , grade 3 or 4 intraventricular hemorrhage ) and /or major sensori‐neural impairments , were excluded .  Poorer cognition and motor function were associated with higher number of skin‐breaking procedures , independent of early illness severity , overall intravenous morphine , and exposure to postnatal steroids . The number of skin‐breaking procedures as a marker of neonatal pain was closely related to days on mechanical ventilation . In general , greater overall exposure to intravenous morphine was associated with poorer motor development at 8 months , but not at 18 months CCA , however , specific protocol s for morphine administration were not evaluated . Lower parenting stress modulated effects of neonatal pain , only on cognitive outcome at 18 months BACKGROUND Infants born very preterm ( <33 weeks ) are at increased risk of neurocognitive deficits . Their neurodevelopmental outcome up to age 8 years can be predicted by neonatal ultrasonography , but little is known of their later function . We investigated the effect of very preterm birth on brain structure and neurocognitive and behavioural functioning in adolescence . METHODS A cohort of 105 infants born before 33 weeks of gestation in 1979 - 80 had ultrasonographic scans at University College Hospital , London , and were prospect ively examined at 1 , 4 , and 8 years . At age 14 - 15 years , 72 of those who remained in UK ( cases ) and 21 age-matched full-term controls underwent brain magnetic resonance imaging ( MRI ) , as well as neurological , cognitive , and behavioural assessment . MRI images were assessed by two neuroradiologists unaware of ultrasonographic findings or case or control status . FINDINGS Of the 72 cases , 40 had unequivocally abnormal MRI and 15 had equivocal scans . Of the 21 controls , one had abnormal and five equivocal MRI . Abnormalities of ventricles , corpus callosum , and white matter were especially common in cases . More brain lesions were identified by MRI than by neonatal ultrasonography . The cases had significantly more reading , adjustment , and neurological impairments than controls , but their behaviour was significantly related to MRI abnormality . INTERPRETATION Individuals born very preterm show an excess of neurocognitive and behavioural problems in adolescence , and more than half have abnormal MRI brain scans The ultimate goal of cognitive enhancement as an intervention for age-related cognitive decline is transfer to everyday cognitive functioning . Development of training methods that transfer broadly to untrained cognitive tasks ( far transfer ) requires underst and ing of the neural bases of training and far transfer effects . We used cognitive training to test the hypothesis that far transfer is associated with altered attentional control dem and s mediated by the dorsal attention network and trained sensory cortex . In an exploratory study , we r and omly assigned 42 healthy older adults to six weeks of training on Brain Fitness ( BF-auditory perception ) , Space Fortress ( SF-visuomotor/working memory ) , or Rise of Nations ( RON-strategic reasoning ) . Before and after training , cognitive performance , diffusion-derived white matter integrity , and functional connectivity of the superior parietal cortex ( SPC ) were assessed . We found the strongest effects from BF training , which transferred to everyday problem solving and reasoning and selectively changed integrity of occipito-temporal white matter associated with improvement on untrained everyday problem solving . These results show that cognitive gain from auditory perception training depends on heightened white matter integrity in the ventral attention network . In BF and SF ( which also transferred positively ) , a decrease in functional connectivity between SPC and inferior temporal lobe ( ITL ) was observed compared to RON-which did not transfer to untrained cognitive function . These findings highlight the importance for cognitive training of top-down control of sensory processing by the dorsal attention network . Altered brain connectivity - observed in the two training tasks that showed far transfer effects - may be a marker for training success BACKGROUND Preterm infants complete their development in Neonatal Intensive Care Unit being exposed to environmental stimuli that lead to the early maturation of the sensory systems . It is known that the fetus perceives sounds and reacts to them with movements since the 26th-28th week of gestational age . Maternal voice represents a source of sensory stimulation for the fetus . AIMS To investigate the effect of the exposure to maternal voice , administered by bone conduction , on preterm infants autonomic and neurobehavioral development . STUDY DESIGN Longitudinal , explorative , case control study . SUBJECTS 71 preterm infants with birth weight < 1500 g , born adequate for gestational age OUTCOME MEASURES vital and neurobehavioral parameters at term , neurofunctional assessment at 3 and 6months of corrected age . RESULTS Infants in the treatment group had lower heart rate values and a higher proportion of stable skin color at each study point as compared to the control group . The scores in the visual attention performance and in the quality of the general movements at term were better in the treatment group than in the control one . Neurofunctional assessment score at 3months of corrected age was higher in the treatment group whereas no difference between the two groups was detected at 6months of corrected age . CONCLUSIONS Early exposure to maternal voice exerts a beneficial effect on preterm infants autonomic and neurobehavioral development BACKGROUND Preterm children have problems with mathematics but knowledge about the predictors of specific mathematic abilities in preterm population s is scarce . AIMS This study investigated neurodevelopmental pathways to children 's general and specific mathematic abilities across the full gestational age range . STUDY DESIGN Prospect i ve geographically defined longitudinal investigation in Germany . SUBJECTS 947 children across the full gestational age range ( 23 - 41 weeks ) . Outcome measures . At 8 years , children 's cognitive and mathematic abilities were measured and residuals of a regression predicting mathematic scores by IQ were used to identify specific mathematic abilities . RESULTS Neurodevelopmental cascade models revealed that adverse effects of preterm birth on mathematic abilities were mediated by neonatal risk . Specific mathematic abilities were uniquely predicted by the duration of hospitalization and ventilation . CONCLUSIONS Prolonged neonatal medical treatment and , in particular , mechanical ventilation may lead to specific impairments in mathematic tasks . These findings have implication s for the mode of respiratory support in neonates , routine follow-up and intervention planning as well as research about brain reorganization after preterm birth OBJECTIVES . Our objective was to determine motor , cognitive , and behavioral outcome at school age in preterm children with periventricular hemorrhagic infa rct ion and to identify cerebral risk factors for adverse outcome . METHODS . This was a prospect i ve cohort study of all preterm infants who were < 37 weeks ' gestation , had periventricular hemorrhagic infa rct ion , and were admitted between 1995 and 2003 .  Ultrasound scans were review ed for characteristics of periventricular hemorrhagic infa rct ion and other cerebral abnormalities . At 4 to 12 years of age , motor outcome was assessed by the Gross Motor Function Classification System and the Manual Ability Classification System , by a neurologic examination ( Touwen ) , an intelligence test ( Wechsler Intelligence Scale III/Wechsler Preschool and Primary Scale of Intelligence-Revised ) , and tests for visual-motor integration , visual perception , and verbal memory . Behavior was assessed by using the Child Behavior Checklist and the Behavior Rating Inventory of Executive Function . RESULTS . Of 38 infants , 15 ( 39 % ) died . Twenty-one of the 23 survivors were included in the follow-up . Four infants were neurologically normal , 1 had minor neurologic dysfunction , 13 had unilateral spastic cerebral palsy , and 3 had bilateral cerebral palsy . Coordination , associated movements , and fine manipulative abilities were affected most according to the neurologic examination . Gross Motor Function Classification System scores were level 1 ( 7 children ) , level 2 ( 7 children ) , level 3 ( 1 child ) , and level 4 ( 2 children ) . Manual Ability Classification System scores were normal ( 4 children ) , level 1 ( 8 children ) , level 2 ( 7 children ) , and level 3 ( 2 children ) . The mean and median total IQ was 83 . Visual perception was normal in 88 % of children , visuomotor integration was normal in 74 % , and verbal memory was normal in 50 % . Behavior was normal in 53 % of children , and executive functions were normal in 65 % and 29 % of children ( by parent and teacher report , respectively ) . Characteristics of the periventricular hemorrhagic infa rct ion were not related to functional motor outcome and intelligence . Posthemorrhagic ventricular dilatation was a risk factor for poorer total and performance intelligence and abnormal fine manipulative abilities . CONCLUSIONS . The majority of surviving preterm children with periventricular hemorrhagic infa rct ion had cerebral palsy with limited functional impairment at school age . Intelligence was within 1 SD of the norm of preterm children without lesions in 60 % to 80 % of the children . Verbal memory , in particular , was affected . Behavioral and executive function problems occurred slightly more than in preterm infants without lesions . The functional outcome at school age of preterm children with periventricular hemorrhagic infa rct ion is better than previously thought BACKGROUND Late-onset sepsis is a relatively common complication particularly of preterm birth that affects approximately a quarter of very low birth weight infants . AIM We aim ed to determine the motor , cognitive , and behavioural outcome at school age of preterm children with late-onset sepsis compared to matched controls . STUDY DESIGN AND SUBJECTS A prospect i ve case-control study that included preterm infants ( gestational age<32weeks and /or birth weight<1500 g ) admitted to our Neonatal Intensive Care Unit in 2000 - 2001 with a culture-proven late-onset sepsis , and controls matched for gestational age . OUTCOME MEASURES At school age we assessed motor skills , intelligence , visual perception , visuomotor integration , verbal memory , attention , executive functioning , and behaviour . RESULTS At 6 - 9years , 21 of 32 children with late-onset sepsis ( 68 % ) had borderline or abnormal motor outcome with most problems in fine motor skills . Their total IQ was 89 compared to 98 in controls . In addition , verbal memory and attention were affected compared to controls ( 0.61 st and ard deviations ( SD ) , 95 % confidence interval ( CI ) 0.04 - 1.17 , p=0.033 and 0.94 SD , 95 % CI 0.32 - 1.62 , p=0.011 , respectively ) . Multiple episodes of sepsis and gram-negative sepsis were risk factors for worse cognitive outcome . CONCLUSIONS At school age , a majority of preterm children with late-onset sepsis had motor problems . Their IQ was considerably lower than matched controls , and memory and attention were specifically impaired . Outcome at school age of preterm children with late-onset sepsis was worse than previously thought The visual function of 42 children with haemorrhagic and /or ischaemic cerebral lesions acquired before a gestational age of 35 weeks was examined and related to cranial ultrasound in the neonatal period and to MRI and neurodevelopmental status at follow-up . All 37 children with abnormal ultrasound scans and one of the five with normal ultrasound scans showed impairment of one or more aspects of visual function . While impaired acuity was more frequent among infants with MRI evidence of visual pathway damage , this was not an invariable finding . Normal or near-normal visual acuity did not preclude the presence of other functional visual deficits . The authors conclude that preterm cerebral insults may produce a variety of visual difficulties , the pattern and severity of which can not be predicted on imaging . Each child therefore requires individual assessment of multiple aspects of visual function Recurrent respiratory symptoms in the first year of life following preterm delivery were documented in two studies . In the first study a question naire was sent to all parents of preterm very low birth weight ( VLBW ) infants who had been admitted during a six-month period to the Neonatal Intensive Care Unit ( NICU ) at King 's College Hospital ( KCH ) and who lived within the local district . Question naires were also sent to parents of a control group of infants who were recruited by r and om selection . All the controls lived locally and were delivered at KCH in the same six-month period as the study group , but were born at 37 - 41 weeks of gestation and had had no neonatal problems . The question naire documented frequency of cough and wheeze , medication and hospital admissions . Recurrent respiratory symptoms ( wheeze or wheeze and cough ) occurred in 65 % of the preterm VLBW infants but only 33 % of the controls p less than 0.001 . Less than 10 % of infants in either group had received bronchodilator therapy . Admission to hospital in both groups was more common amongst children who had recurrent wheeze ( p less than 0.01 ) . In the second study all preterm VLBW infants admitted to the NICU in a six-month period were followed prospect ively over the first year of life . The nature and frequency of respiratory symptoms and frequency and length of re-admission was documented and related to the duration of neonatal ventilation . Twenty-three of the 44 preterm VLBW infants ( 53 % ) followed prospect ively had recurrent wheeze and /or cough . ( ABSTRACT TRUNCATED AT 250 WORDS OBJECTIVES To investigate the prevalence , correlates , and antecedents of autism spectrum disorders ( ASD ) in extremely preterm children . STUDY DESIGN We conducted a prospect i ve study of all births < 26 weeks gestation in the United Kingdom and Irel and in 1995 . Of 307 survivors at 11 years , 219 ( 71 % ) were assessed and compared with 153 term-born classmates . Parents completed the  Social Communication Question naire ( SCQ )  to assess autism spectrum symptoms , and ASD were diagnosed by using a psychiatric evaluation . An IQ test and clinical evaluation were also administered . Longitudinal outcome data were available for extremely preterm children . RESULTS Extremely preterm children had significantly higher SCQ scores than classmates ( mean difference , 4.6 points ; 95 % CI , 3.4 - 5.8 ) . Sixteen extremely preterm children ( 8 % ) were assigned an ASD diagnosis , compared with none of the classmates . By hospital discharge , male sex , lower gestation , vaginal breech delivery , abnormal cerebral ultrasound scanning results , and not having had breast milk were independently associated with autism spectrum symptoms . By 6 years , independent associates were cognitive impairment , inattention and peer problems , withdrawn behavior at 2.5 years , and not having had breast milk . CONCLUSIONS Extremely preterm children are at increased risk for autism spectrum symptoms and ASD in middle childhood . These symptoms and disorders were associated with neurocognitive outcomes , suggesting that ASD may result from abnormal brain development in this population Background : Major neurological h and icaps and neuropsychological disturbances are more common in ex-preterm children than their counterparts born at term . Objective : To establish in a prospect i ve study whether a characteristic neuropsychological profile exists in ex-preterm children who do not exhibit neurodevelopmental deficits on routine clinical examination . Methods : Thirty intellectually normal children born preterm ( 30–34 weeks gestation ) without major neurological disabilities and a control group of term children matched for age , sex , and parental educational and occupational status were assessed at 3–4 years of age to obtain a complete neuropsychological profile . Intellectual ability , language comprehension and expression , perceptual and visual motor function , working memory , and attention and behavioural problems were investigated . Results : Even in the absence of major neurological signs , children born preterm achieved lower mean scores than controls on the Stanford-Binet intelligence scale ( 110.8 v 121 , p<0.001 ) , visual perception test ( 33.8 v 42.7 , p<0.001 ) , visual motor integration test ( 42.6 v 47.4 , p = 0.049 ) , memory for location test ( 8.4 v 9.5 , p = 0.007 ) , sustained attention test ( 41.6 v 51.5 , p = 0.009 ) , and the picture vocabulary test ( 33.3 v 44.7 , p = 0.021 ) . Conclusions : Neuropsychological abnormalities can be detected early in childhood in apparently normal ex-preterm children and are consistent with a growing body of evidence that prematurity may be associated with long term neuropsychological morbidity in childhood and adolescence OBJECTIVE To compare healthy late-preterm infants with their full-term counterparts from age 4 through 15 years for numerous st and ard cognitive , achievement , socioemotional , and behavioral outcomes . DESIGN Prospect i ve cohort study . SETTING National Institute of Child Health and Development Study of Early Child Care and Youth Development , 1991 - 2007 . PARTICIPANTS A total of 1298 children ( 53 born at 34 - 36 weeks ' gestational age ) , and their families , observed from birth through age 15 years . None of the infants had major health problems before or immediately following birth , and all the infants were discharged from the hospital within 7 days . MAIN EXPOSURE Preterm status : children born late preterm ( 34 - 36 weeks ) vs those born full term ( 37 - 41 weeks ) . MAIN OUTCOME MEASURES Eleven st and ard outcomes measuring cognition , achievement , social skills , and behavioral/emotional problems using the Woodcock-Johnson Psycho-Educational Battery-Revised and the Child Behavior Checklist , administered repeatedly through age 15 years . RESULTS No consistent significant differences were found between late-preterm and full-term children for these st and ard measures from ages 4 to 15 years . Through age 15 years , the mean difference of most of these outcomes hovered around 0 , indicating , along with small confidence intervals around these differences , that it is unlikely that healthy late-preterm infants are at any meaningful disadvantage regarding these measures . CONCLUSION Late-preterm infants born otherwise healthy seem to have no real burdens regarding cognition , achievement , behavior , and socioemotional development throughout childhood Problem Current research suggests behavioral and environmental interventions to prevent neonatal pain prior to an invasive procedure are rarely administered and seldom documented . The aim of this study was to systematic ally review findings from published r and omized controlled trials that tested the effects of behavioral and environmental procedural pain management interventions on behavioral pain response in preterm infants . Eligibility Criteria R and omized controlled trials examining the effects of behavioral and environmental pain management interventions on behavioral pain response in preterm infants were identified . Articles accepted for inclusion met the following criteria : English language , original , peer refereed , r and omized controlled clinical trials published within the past 5 years , study sample : preterm infants , setting : neonatal intensive care units , study intervention behavioral and environmental , outcome pain measurement score from valid and reliable pain scale . Sample Fourteen r and omized controlled trials from a literature search of PubMed and Medline data bases were included in this review . Results Across all age groups , facilitated tucking , oral sucrose , and kangaroo care decreased behavioral and physiologic pain response alone and in combination with other behavioral and environmental interventions . Conclusion Among preterm infants , facilitated tucking , oral sucrose , and kangaroo care significantly mitigates biobehavioral pain response associated with acutely painful procedures . Implication s Evidence suggests that behavioral and environmental interventions can decrease biobehavioral pain response associated with acutely painful procedures in preterm infants . This review highlights the need for rigorous studies to help healthcare providers to build a tailored pain treatment plan for preterm infants OBJECTIVE To investigate neurodevelopment at school age in preterm infants treated with hydrocortisone for bronchopulmonary dysplasia ( BPD ) in the neonatal period . STUDY DESIGN Preterm infants ( n = 226 ; gestational age < or = 32 weeks and /or body weight < or = 1500 grams ) performed subtests of the Wechsler Intelligence Scale for Children-Revised , the Visual Motor Integration test , a 15-Word Memory Test and the Movement Assessment Battery for Children at school age . Conventional MRI of the brain was obtained . Sixty-two children who received hydrocortisone for BPD ( starting dose , 5 mg/kg/day ; median duration , 27.5 days ) were compared with 164 nontreated neonates . RESULTS Hydrocortisone-treated infants were younger , lighter , and sicker than their non-steroid-treated counterparts . Adjustments for gestational age , body weight , sex , mechanical ventilation , and small for gestational age were made . Adjusted mean Intelligence Quotient , Visual Motor Integration test , and memory test results were the same in the hydrocortisone-treated group and the non-steroid-treated group ( 99 versus 101 , P = .62 ; 97 versus 99 , P = .49 , 7.9 versus 7.5 , P = .42 , respectively ) . Motor function and incidence of cerebral palsy in both groups was not different ( 11 % versus 7 % , P = .97 ) . Occurrence of brain lesions on MRI was similar for the two groups . CONCLUSIONS Neonatal hydrocortisone treatment for BPD had no long-term effects on neurodevelopment BACKGROUND Preterm children are at risk for developing behavioral and emotional problems , as well as being less socially competent . Premature birth causes chronic distress in the parents . AIMS The aim of the paper is to discover whether parental psychological well-being is associated with the social , behavioral , and functional development of very low birth weight ( VLBW , ≤1500 g ) children at 5years of age . STUDY DESIGN A longitudinal prospect i ve cohort study . SUBJECTS A cohort of 201 VLBW infants ( ≤1500 g , < 37weeks of gestation ) born during 2001 - 2006 in Turku University Hospital , Finl and was studied . OUTCOME MEASURES At 4-year chronological age of their child , parents independently completed vali date d question naires ( Beck Depression Inventory , Parenting Stress Index and Sense of Coherence Scale )  . At 5years , parents and day-care providers evaluated the development of the child by completing the Five to Fifteen question naire . RESULTS The parents of VLBW children reported significantly more problems in child development compared to the Finnish normative data . Depressive symptoms and weaker sense of coherence in mothers , but not in fathers , were associated with more problems in child development . Parenting stress , for both mothers and fathers , was associated with developmental problems in their child at 5years of age . CONCLUSIONS Maternal depressive symptoms and parenting stress of both parents may be risk factors for the social , behavioral , and functional development of 5-year-old preterm children . On the other h and , stronger maternal sense of coherence may be a protective factor
Results of this review support the presence of sensory modulation problems in preterm children .
Sensory modulation problems may play a key role in underst and ing neurocognitive and behavioral sequelae in preterm children .
Some support is found for a dose-response relationship between both white matter brain injury and length of NICU stay and sensory modulation problems
BACKGROUND Neurodevelopmental sequelae in preterm born children are generally considered to result from cerebral white matter damage and noxious effects of environmental factors in the neonatal intensive care unit ( NICU ) .
Cerebral white matter damage is associated with sensory processing problems in terms of registration , integration and modulation .
However , research into sensory processing problems and , in particular , sensory modulation problems , is scarce in preterm children .
AIM This review aims to integrate available evidence on sensory modulation problems in preterm infants and children ( < 37 weeks of gestation ) and their association with neurocognitive and behavioral problems .