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Background: Feeding impairment is prevalent in children with neurodevelopmental issues. Neuroimaging and neurobehavioral outcomes at term are predictive of later neuromotor impairment, but it is unknown whether they predict feeding impairment.Aims: To determine whether neurobehavior and brain magnetic resonance imaging (MRI) at term predict oromotor feeding at 12 months in preterm and term-born children.Study Design: Prospective cohort study.Subjects: 248 infants (97 born <30 weeks and 151 born at term) recruited at birth.Outcome Measures: Neurobehavioral assessments (General Movements (GMA), Hammersmith Neonatal Neurological Examination (HNNE), Neonatal Intensive Care Unit Network Neurobehavioral Scale (NNNS)); and brain MRI were administered at term-equivalent age. Oromotor feeding was assessed at 12 months corrected age using the Schedule for Oral Motor Assessment.Results: 49/227 children had oromotor feeding impairment. Neurobehavior associated with later feeding impairment was: suboptimal NNNS stress (odds ratio [OR] 2.68; 95% confidence interval [CI] 1.20–6.01), non-optimal reflexes (OR 3.33; 95% CI 1.37–8.11) and arousal scales (OR 2.54; 95% CI 1.03–6.27); suboptimal HNNE total (OR 4.69; 95% CI 2.20–10.00), reflexes (OR 2.62; 95% CI 1.06–6.49), and tone scores (OR 3.87; 95% CI 1.45–10.35); and abnormal GMA (OR 2.60; 95% CI 1.21–5.57). Smaller biparietal diameter also predicted feeding impairment (OR 0.88; 95% CI 0.79–0.97). There was little evidence that relationships differed between birth groups.Conclusions: Neurobehavior and biparietal diameter at term are associated with oromotor feeding at 12 months. These results may identify children at greatest risk of oromotor feeding impairment. [ABSTRACT FROM AUTHOR]

Background: General movements (GMs) is an assessment with good predictive validity for neurodevelopmental outcomes in preterm infants. However, there is limited information describing the early GMs of very preterm infants, particularly prior to term.Aims: To describe the early GMs trajectory of very preterm infants (born <30weeks' gestation) from birth to term-equivalent age, and to assess the influence of known perinatal risk factors on GMs.Study Design: Prospective cohort study.Subjects: 149 very preterm infants born <30weeks' gestation.Outcome Measures: GMs were recorded weekly from birth until 32weeks' postmenstrual age, and then fortnightly until 38weeks' postmenstrual age. GMs were also assessed at term-equivalent age. Detailed perinatal data were collected.Results: Of 669 GMs assessed, 551 were preterm and 118 were at term-equivalent age. Prior to term, 15% (n=82) of GMs were normal and 85% (n=469) were abnormal, with the proportion of abnormal GMs decreasing with increasing postmenstrual age (p for trend <0.001). By term-equivalent 30% (n=35) of GMs were normal. On univariable analysis, lower gestational age (p<0.001), postnatal infection (p<0.001) and bronchopulmonary dysplasia (p=0.001) were associated with abnormal GMs. Postnatal infection was the only independent perinatal association with abnormal GMs on multivariable analysis. All four infants with grade III/IV intraventricular haemorrhage (IVH) had persistently abnormal GMs.Conclusions: GMs were predominantly abnormal in very preterm infants, with a higher proportion of normal GMs at term-equivalent age than prior to term. Abnormal GMs were associated with postnatal infection and IVH. [ABSTRACT FROM AUTHOR]

Background: Very preterm (VPT) children have different sensory profiles than term-born controls, but how the sensory profiles in VPT children relate to development has not been reported., Aim: The aim of this study was to examine the relationship between VPT infant sensory profiles and concurrent developmental outcomes at 2 years' corrected age., Study Design: Cohort study., Subjects: 243 children <30 weeks' gestation., Outcome Measures: Primary caregivers completed the Infant/Toddler Sensory Profile Questionnaire to obtain information on sensory processing at 2 years of age. Independent observers assessed the child's neurodevelopment with either the Mental Developmental Index (MDI) and Psychomotor Developmental Index (PDI) of the Bayley Scales of Infant Development version 2 (Bayley 2) or the Cognition, Language and Motor Composites of the Bayley Scales of Infant and Toddler Development version 3 (Bayley 3)., Results: A stronger Low Registration pattern correlated with lower MDI and PDI scores and a stronger Sensation Avoiding pattern correlated with a lower PDI score. A stronger Low Registration pattern correlated with a lower Language Composite score. More frequent visual and oral sensory processing behaviours were associated with higher performance on the MDI and PDI, with more frequent auditory sensory processing behaviours also associated with higher PDI scores. More frequent auditory, touch and oral sensory processing behaviours were associated with improved outcomes on the Language Composite and more frequent auditory, touch and vestibular processing behaviours correlated with improved outcomes on the Cognition Composite. A secondary analysis using a computed MDI score derived from the Bayley 3 scores did not substantially alter any conclusions., Conclusion(s): Different sensory profile patterns obtained from parental reports of VPT children are associated with various aspects of neurodevelopment at 2 years of age, obtained from independent assessment., (© 2013.)

Background: Sensory profiles are increasingly used by therapists to assess children. There is limited information on how sensory profiles differ between very preterm (VPT) children and term controls, or on the predictors of sensory profiles in VPT children., Aims: The aim of this study was to examine sensory profiles of children born <30 weeks' gestation at 2 years and their environmental and biological influences., Study Design: Cohort study., Subjects: 253 VPT children born <30 weeks' gestation and 65 term-born controls (>36 weeks' gestation)., Outcome Measures: Sensory profiles were examined with the Infant/Toddler Sensory Profile Questionnaire, which measures the child's responsiveness in four sensory quadrants and in five sensory processing sections. Standardised z scores for the VPT sample were compared with the controls, and predictors of VPT infant sensory profiles were determined., Results: VPT children had scores consistent with stronger patterns across all four sensory quadrants compared with controls, indicating a stronger interaction between neurological thresholds to elicit a response and self-regulation strategies. In addition they also exhibited more of the behaviours in all sensory processing sections compared with controls. Male sex, higher social risk, increasing length of stay, and moderate to severe white matter abnormality on MRI at term-equivalent age were associated with stronger sensory profile patterns in some quadrants, and more behaviours in some sensory processing sections., Conclusions: Sensory profiles differed between VPT children and term-born controls, with stronger sensory profile patterns associated with male sex, higher social risk, longer hospital stay, and moderate to severe white matter abnormality., (Copyright © 2013 Elsevier Ltd. All rights reserved.)

Background: It is unclear whether developmental assessment later or earlier in childhood is the better predictor of intelligence at 8years of age. This is an important distinction as many clinical trials assess their final outcomes only in early childhood, assuming the results are valid for later childhood cognitive functioning., Aims: To compare the ability of developmental assessment at 18 months with 24 months in predicting general intellectual functioning at 8-9 years of age in extremely low birth weight (ELBW, birthweight<1000 g) children., Study Design: Cohort study., Subjects: 58 ELBW survivors born during 1997 at the Royal Women's Hospital, Melbourne, Australia., Outcome Measures: Cognitive assessments at each of 18 months, 24 months (Mental Developmental Index [MDI]) and 8-9 years (Full Scale IQ) of age, corrected for prematurity were compared by regression analysis and by the κ statistic (agreement beyond chance)., Results: Both the 18-month and the 24-month MDI were significantly predictive of Full Scale IQ at 8-9 years, but more so for the 24-month MDI, with 38% of variance explained compared with 34% of variance explained by the 18-month MDI. The 24-month MDI, expressed as categories of severe, moderate, mild or no developmental delay, was more predictive of categories of severe, moderate, mild or no intellectual impairment at 8-9 years (weighted κ=0.43, P<0.001) than was the 18-month MDI (weighted κ=0.35, P=0.001)., Conclusions: Cognitive assessment at 24 months is superior to cognitive assessment at 18 months in predicting IQ and intellectual impairment at 8-9 years of age in ELBW children., (Copyright © 2011 Elsevier Ltd. All rights reserved.)

Background: Examining rates of difficulties in family functioning following very preterm birth has been a relatively neglected area of research., Aims: To examine family functioning, burden and parenting stress in families with very preterm compared with term born children, and investigate influences of parental mental health problems and child neurodevelopmental disability on family outcomes in families with preterm children., Study Design: Participants were 184 very preterm and 71 term children and their parents. Parents completed the Family Assessment Device, Parenting Stress Index and Impact on Family questionnaires when their children were 2 years old (corrected for prematurity). Parental mental health and social risk information were also collected. Children were assessed for neurodevelopmental disability., Results: Families with very preterm children reported poorer family functioning (p=.03) compared with families with term born children, with less evidence for differences between families with very preterm and term born children in parenting stress and family burden. Within very preterm families, parental mental health problems were associated with higher levels of parenting stress (p=.001), and parents of children with a neurodevelopmental disability were more likely to report higher family burden (p=.04)., Conclusions: For families with very preterm children, parental mental health symptoms and child neurodevelopmental disability may identify families at risk of greater stress and burden who may benefit from additional support., (Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.)