SCHOOL-AGE CONSEQUENCES OF <750 GM BIRTHWEIGHT

在我们最初的资助期间，我们比较了82个地区样本， 极低出生体重（ELBW，<750克）儿童， 匹配的极低出生体重（VLBW，750-1499 g）和足月组 (FT)孩子 根据对这些儿童的评估结果， 在学龄早期，ELBW组的表现不如其他两组 在神经心理学和成就测试方面， 和社会问题，更经常被安排在特殊教育中， 程序. ELBW儿童的父母报告了更高水平的痛苦 出生体重较高的孩子的父母。 健康和 发育问题在ELBW组中更为常见， 与父母中较高的心理症状率有关。 这一延续建议的目的是遵循这三个群体 孩子们在学校的成长过程中。 最近的出生队列 将被添加到我们的样本中，以调查晚出生儿童的结果 并将样本量增加到每组约100名儿童。 一 计划连续进行四次年度评估，每次评估涉及 儿童和家长的评估类似于我们最初的评估， study. 儿童的健康状况也将在每个 评估，教师将提供年底的教育状况 报道 将检验三个假设。 假设1：ELBW儿童将 以较慢的速度获得技能，并表现出越来越多的脆弱性 行为和学习问题。 假设2是不利的 孩子的变化将伴随着父母的痛苦增加， 家庭功能失调 假设3是，除了 出生体重将预测儿童结局中与年龄相关的变化，包括 神经感觉和健康状况，发育和行为状况. 随访的开始和社会家庭变量。 这些测试 假设将增强对长期后果的认识， 早熟和过程的稳定性或随时间的变化 在个别孩子身上。 调查结果还将导致改善 确定高危儿童，并将阐明 干预

During our initial grant period, we compared a regional sample of 82 extremely low birthweight (ELBW, <750 gram) children to demographically matched groups of very low birthweight (VLBW, 750-1499 gram) and full-term (FT) children. According to the results of assessments of these children at early school age, the ELBW group performed less well than the other two groups on neuropsychological and achievement testing, had more behavior and social problems, and were more often placed in special education programs. Parents of the ELBW children reported higher levels of distress than parents of children in the higher birthweight groups. Health and developmental problems, which are more common in the ELBW group, were also associated with higher rates of psychological symptoms n parents. The purpose of this continuation proposal is to follow these three groups of children as they progress through school. A more recent birth cohort will be added to our sample to investigate outcomes in later-born children and to increase sample size to approximately 100 children per group. A series of four consecutive annual assessments is planned, each involving child and parent assessments similar to those employed in our initial study. The child's health status also will be monitored at each evaluation, and teachers will provide end of year educational status reports. Three hypotheses will be tested. Hypothesis 1 is that ELBW children will acquire skills at a slower rate and show increasing vulnerability to behavior and learning problems with age. Hypothesis 2 is that adverse changes in the child will be accompanied by increasing parent distress and family dysfunction. Hypothesis 3 is that several factors in addition to birthweight will predict age-related changes in child outcomes, including neurosensory and health conditions, developmental and behavioral status at the onset of follow-up, and social-familial variables. Tests of these hypotheses will enhance knowledge of the longer-term consequences of prematurity and of processes accounting for stability or change over time in individual children. Findings also will lead to improved identification of high risk children and will clarify needs for intervention.