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This study estimated ASD prevalence in a cohort of 3-year-old very preterm children (N = 55) and investigated the usefulness of parent-reported ASD screeners and the ADOS-2. 12.7% received an ASD diagnosis by clinical judgment based on DSM-5 criteria. An additional 14.5% were classified as having a broader-autism-phenotype outcome. Sensitivity values for the screeners were poor, whereas specificity values ranged from poor to excellent. The ADOS-2 identified all children with ASD and had a fair specificity. These findings confirm the elevated ASD prevalence made by previous studies with preterm children but also highlight the challenges of successfully identifying ASD in this at-risk group. Caution is warranted when interpreting results of ASD instruments with the currently available cut-off scores and algorithms, especially when developmental challenges are present., Author(s): Julie Vermeirsch [sup.1] , Liedewij Verhaeghe [sup.2] , Alexandra Casaer [sup.3] , Fran Faes [sup.4] , Ann Oostra [sup.4] , Herbert Roeyers [sup.1] Author Affiliations: (1) grid.5342.0, 0000 0001 [...]

The incidence and risk factors for psychiatric disorders in extremely preterm children are examined by observing babies born less than 26 weeks gestation in the UK and Ireland from March through December 1995. Extremely preterm children are shown to have higher risk for condition such as attention deficit hyperactivity disorder and autism spectrum disorders at 11 years of age.

Parent assessment of infants who were born very preterm reveal that these children at two years of age demonstrate significantly higher internalizing and dysregulation scores than peers born at term.

A randomized controlled trial was conducted to determine the benefits of dietary docosahexaenoic acid (DHA) on the neurodevelopmental outcomes of preterm infants. The results indicated that a dosage of 1% did not affect the neurodevelopment of preterm infants born earlier than 33 weeks, but did positively impact the neurodevelopment of girls.

Glutamine may be a conditionally essential amino acid in low-birth-weight (LBW) preterm neonates. Exogenously administered amino acids, by providing anaplerotic carbon into the tricarboxylic acid cycle, could result in greater cataplerotic efflux and glutamine de novo synthesis. The effect of dose and duration of amino acid infusion on glutamine and nitrogen (N) kinetics was examined in LBW infants in the period immediately after birth. Preterm neonates ( stable isotope tracers; glutamine metabolism; protein metabolism; very low birth weight; neonates

OBJECTIVE. To assess whether improvements in cognitive and behavioral development seen in preschool educational programs persist, we compared those in a multisite randomized trial of such a program over the first 3 years of life (INT) to those with follow-up only (FUO) at 18 months of age. METHODS. This was a prospective follow-up of the Infant Health and Development Program at 8 sites heterogeneous for sociodemographic characteristics. Originally 985 children were randomized to the INT (n = 377) or FUO (n = 608) groups within 2 birth weight strata: heavier low birth weight (HLBW; 2001-2499 g) and lighter low birth weight (LLBW; [less than or equal to] 2000 g). Primary outcome measures were the Peabody Picture Vocabulary Test (PPVT-III), reading and mathematics subscales of the Woodcock-Johnson Tests of Achievement, youth self-report on the Total Behavior Problem Index, and high-risk behaviors on the Youth Risk Behavior Surveillance System (YRBSS). Secondary outcomes included Weschler full-scale IQ, caregiver report on the Total Behavior Problem Index, and caregiver and youth self-reported physical health using the Medical Outcome Study measure. Assessors were masked as to study status. RESULTS. We assessed 636 youths at 18 years (64.6% of the 985, 72% of whom had not died or refused at prior assessments). After adjusting for cohort attrition, differences favoring the INT group were seen on the Woodcock-Johnson Tests of Achievement in math (5.1 points), YRBSS (-0.7 points), and the PPVT-III (3.8 points) in the HLBW youth. In the LLBW youth, the Woodcock-Johnson Tests of Achievement in reading was higher in the FUO than INT group (4.2). CONCLUSIONS. The findings in the HLBW INT group provide support for preschool education to make long-term changes in a diverse group of children who are at developmental risk. The lack of observable benefit in the LLBW group raises questions about the biological and educational factors that foster or inhibit sustained effects of early educational intervention. Key Words early intervention, long-term results, low birth weight, randomized controlled trial Abbreviations IHDP--Infant Health and Development Program LLBW--lighter low birth weight HLBW--heavier low birth weight INT--intervention FUO--follow-up only YRBSS--Youth Risk Behavior Surveillance System BPI--Behavior Problem Index WASI--Weschler Abbreviated Scale of Intelligence PPVT-III--Peabody Picture Vocabulary Test-Version III HSG--high school graduate CI--confidence interval LSW--low birth weight, INTENSIVE EARLY EDUCATIONAL interventions have been documented to improve the cognitive outcomes (1) and, in some cases, reduce antisocial behavior early in the school experience. (2) In several single-site, randomized [...]

Four puzzle boxes were used to investigate localized stimulus enhancement and object movement reenactment (OMR) in 13 pig-tailed macaques (Macaca nemestrina) and 30 human infants (Homo sapiens). Participants received contrasting demonstrations on each box. A circular lid was gripped by its rim or handle and swiveled to the left or right. A flap door was pushed or flipped. A sliding lid was pushed to the left or right. A pin bolt was demonstrated being pushed down, or the participants were left to solve the puzzle for themselves. Despite the fact that the monkeys watched the demonstrations about 60% of the time, only a weak OMR effect was found on the sliding lid. In contrast, the children watched significantly more, and there was clear evidence of socially mediated learning on all of the boxes.

Objective. Abnormalities in brain structure, cognition, and behavior have been described in children born prematurely. However, no direct in vivo evidence has yet demonstrated abnormal neural processing in these children. Our aim was to compare brain activity associated with phonologic and semantic processing of language between term and preterm children using functional magnetic resonance imaging (fMRI). Methods. fMRI scans were acquired during a passive language comprehension task in 26 preterm children at 8 years of age and in 13 term community control children who were comparable in age, sex, maternal education, and minority status. IQ was assessed using a standard measure of intelligence. Results. The pattern of brain activity identified in a semantic processing task in the preterm children closely resembled the pattern of brain activity identified in a phonologic processing task in term controls. The greater this resemblance in the preterm children, the lower their verbal comprehension IQ scores and the poorer their language comprehension during the scanning task. Conclusions. Preterm children with the poorest language comprehension seemed not to fully engage normal semantic processing pathways in a language comprehension task. These children instead engaged pathways that normal term children used to process meaningless phonologic sounds. Aberrant processing of semantic content in these preterm children may account in part for their lower verbal IQ scores. Pediatrics 2002;110:1153-1162; functional MRI, children, prematurity, cognition, outcome., Children born prematurely are known to be at risk for cognitive and behavioral problems, including lower IQ, learning disorder, thought disturbance, and excessive distractibility and hyperactivity. (1-6) Anatomic abnormalities in [...]

The effect of mother-infant skin-to-skin contact (kangaroo care, or KC) on self-regulatory processes of premature infants was studied. Seventy-three infants who received KC were compared with 73 infants matched for birth weight, gestational age, medical risk, and family demographics. State organization was measured in 10-s epochs over 4 hr before KC and again at term. No differences between KC infants and controls were found before KC. At term, KC infants showed more mature state distribution and more organized sleep-wake cyclicity. At 3 months, KC infants had higher thresholds to negative emotionality and more efficient arousal modulation while attending to increasingly complex stimuli. At 6 months, longer duration of and shorter latencies to mother-infant shared attention and infant sustained exploration in a toy session were found for KC infants. The results underscore the importance of maternal body contact for infants' physiological, emotional, and cognitive regulatory capacities.

Premature infants exposed to visual pattern displays in their incubators may derive benefits not matched by infants with no pattern displays. These benefits include reduced number of state changes, periods of quiet alertness, decreased heart rate and stronger visual skills. Such benefits may indicate that incubator displays foster behavioral organization development.

Calming by sucrose and glucose was evaluated in premature, preterm, and term infants. In Experiment 1, 9 preterm and 9 term infants each received 0.5 ml (0.1 ml/min) sucrose (12% w/v) solution; 9 age-matched preterm and 9 other term infants received water. In Experiment 2, 9 premature and 9 term infants received a 10% glucose solution. Sucrose reduced crying in preterm and term infants by 91% and 93%, respectively. Glucose reduced crying in premature and term infants by 86% and 81%, respectively. Water was ineffective in both preterm and term infants. Thus, reduced crying cannot be attributed to fluid ingestion per se. Calm induced by either sugar persisted longest in term infants after conclusion of sugar delivery. Accordingly, sensory systems that detect sweet taste and central mechanisms that transduce this change to calm crying infants are functional before normal term and may be engaged during the initial suckling bouts.

Infants of very low birth weight (VLBW) (n = 34) and a comparison group of 40 full-term infants were observed in Ainsworth's Strange Situation at 14 and 19 months and observed in the home at 14 months of age, using Waters's Attachment Q-set. Results indicated that at 14 months VLBW infants were more likely than the full-term infants to be insecurely attached when rated using the Q-set but not when using the Strange Situation. However, at 19 months VLBW infants were also more likely than full-term infants to be insecurely attached in the Strange Situation assessment. There were no associations between the Q-set and Strange Situation measures of attachment security. These results are discussed in terms of the social-emotional development of VLBW infants.

Multiple aspects of speech and language performance of 29 four- to five-year-old preterm children (10 neurologically suspect) were assessed. Data were collected using a variety of measures including standardized tests and analysis of language samples. Each child's performance was compared with reference data on the various outcomes which yielded an over-all pass score and individual profiles of performance. Neurologically normal children had significantly higher passing scores than suspect children but appeared to be at risk for mild language delays, particularly in morphosyntactic development. Neurologically suspect children appeared to be at risk for moderate and more generalized language delays, including morphosyntactic and phonological development.