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 人口统计学上的极低出生体重(ELBW，&lt；750克)儿童 配对的极低出生体重(VLBW，750-1499克)和足月儿 (FT)子女。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 接受神经心理和成就测试的小组有更多的行为 和社会问题，更多地被安排在特殊教育中 程序。ELBW儿童的父母报告说他们的痛苦程度更高 而不是出生体重较高组的孩子的父母。健康和 发育问题，这在ELBW组中更常见，也是 与父母的心理症状发生率较高有关。 这一延续提案的目的是遵循这三个群体 随着孩子们在学校的进步。一个较新的出生队列 将被添加到我们的样本中，以调查较晚出生的儿童的结果 并将样本量增加到每组约100名儿童。一个 计划进行一系列连续四次的年度评估，每次评估涉及 儿童和家长评估与我们最初使用的评估类似 学习。孩子的健康状况也将在每个月监测 评估，教师将提供年终教育状况 报告。 三个假说将被检验。假设1是ELBW儿童将 获得技能的速度较慢，并表现出越来越容易受到 随年龄增长而出现的行为和学习问题。假设2是相反的 孩子的变化将伴随着越来越多的父母痛苦和 家庭功能障碍。假设3是除了几个因素 出生体重将预测与年龄相关的儿童结局变化，包括 神经感觉和健康状况、发育和行为状况 随访的开始，以及社会-家庭变量。对这些的测试 假说将增强对以下物质长期后果的认识 考虑到稳定性或随时间变化的过程的早熟性 在个别的孩子身上。调查结果也将带来改进 识别高危儿童，并将澄清以下需求 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.