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The study objective was to assess acceptability, feasibility, likeability, and applicability of interactive virtual reality with feedback loops (VR) to teach and assess veterinary anesthesia machine operation. Data from 60 students were analyzed. Students learned and trained how to use the anesthesia machine components and connections and performed safety checks (such as the pressure check) using real and VR machines. Competency was assessed with oral/practical and VR exams. A questionnaire survey gathered student affective skill perception toward VR for education. Students perceived VR for veterinary education as positive, useful, likeable, and helpful to learn the anesthesia machine. VR appeared to increase cognitive load, inducing lower VR exam scores of 100 (92.4-97.9) when compared to oral/practical exams of 100 (98-99.8) with p = .018. Training times with either real or VR anesthesia machines were similar ( p = .71). A positive correlation was found between VR training times and VR exam scores (Spearman's correlation coefficient 0.5; p < .001). No correlations were identified between oral/practical exam scores and training times. Seventy two percent of the students ( n = 43) had never used VR before. Prior VR experience was not necessary to train using VR. Computer glitches and cybersickness are important drawbacks to consider when using VR for education. The study demonstrated that interactive, immersive VR received favorable reactions from students. The VR incorporated educational feedback loops can be utilized as a simulation trainer for veterinary education. However, inherent limitations should be considered.

The purpose of this study was to determine the respiratory symptoms, pulmonary function, and airway reactivity in school-age survivors of very-low-birth-weight and to describe the influence of birth weight and perinatal illness on their pulmonary function. Thirty (of 39) 10- to 11-year-old survivors of very-low-birth-weight (VLBW) recruited at birth into a prospective longitudinal study of development; 30 (of 32) normal-birth-weight peers recruited from the same school or census tract as the VLBW group at age 5; and 15 normal-birth-weight siblings of the VLBW group participated in the study. Outcome measures were mother's reports of respiratory health; forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1); FEV1/FVC; forced expiratory flow, midexpiratory phase (FEF25-75); peak expiratory flow rate (PEFR); and tolerance to methacholine. There were no differences between groups in mothers' reports of current respiratory health. Pulmonary function values were lower for the VLBW survivors but significant only for FEF25-75 (F = 4.13; P = 0.02). Number of days in the intensive care nursery correlated significantly with decreased FEV1 (r = -.40, df = 28, P = 0.03), FEV1/FVC (r = -.37, df = 28, P = 0.04, and FEF25-75 (r = -.39, df = 28, P = 0.03). Only the relationship between length of nursery stay and FEV1/FVC was independent of birth weight. Number of days on mechanical ventilation was significantly correlated with decreased FEV1 (-.44, df = 28, P = 0.01), FEV1/FVC (r = -.38, df = 28, P = 0.04), FEF25-75 (r = -.44, df = 28, P = 0.01, and PEFR (r = -.40, df = 28, P = 0.03). All of these relationships were independent of birth weight. There were no significant associations between perinatal risk factors and methacholine responsiveness. Differences between VLBW children and normal-birth-weight children in pulmonary function are modest even when statistically significant. Severity of perinatal illness influences pulmonary function parameters into late childhood.

Thirty-nine very low birth weight (VLBW) and 32 normal birth weight (NBW) elementary school children were studied prospectively to determine patterns of academic achievement and special education resource use during the elementary school years. Reading, spelling, and mathematical abilities were evaluated. Mean scores for the VLBW children were significantly lower on the mathematic subtests. VLBW study participants experienced more grade retention (43% vs. 23%) and required 2.8 times more special academic assistance than their NBW peers. Thus, providing special educational resources for VLBW children is essential.

The contributions of early medical risk and the early and contemporary home environment on cognitive and academic outcomes of 35 nine-year-old survivors of very low birth weight (VLBW) who were followed prospectively were investigated. There were no significant relationships between the measures of early medical risk and outcome. The quality of the home environment accounted for half of the variance in outcome. Five themes that showed consistent associations over time with positive outcomes were: parental responsivity, parent support for learning, parent involvement with the child, exposure to a variety of experiences, and the presence of a father figure.

The purpose of this article is to provide the clinician with a comprehensive review of the influence of temperament on the social and cognitive development of children with disabilities. Research concerning the interaction of temperament and cognition and the temperament characteristics of children with disabilities is reviewed. Also discussed are issues relevant to clinical practice, including assessment of temperament characteristics and interventions with parents.

The ability of three preschool risk detection tools to accurately identify apparently healthy very-low-birth-weight children (VLBW < 1500 g) who would subsequently experience school failure was studied. The sample of 35 children included 20 girls and 15 boys, 15 African-American children and 20 white children, who were 4 years old when assessed. The tool based on the information processing model had a significantly higher degree of specificity than the readiness or development based tools. None of the tools were sensitive enough to identify more than two thirds of the children who subsequently experienced school failure in grades K through 2.

Factors that influence school achievement in very-low-birth-weight (< 1,500 g) children were investigated at the completion of first grade. The subjects were 71 children and their primary caregivers. Thirty-nine children were very low birth weight (VLBW) and 32 were normal birth weight (NBW). After controlling for birth weight status, over one third of the variance in children's school achievement was accounted for by the age of the child's mother when she began childbearing. Birth weight status accounted for significant amounts of variance in information processing skills. Significantly more children in the VLBW group required special services and fewer were promoted to second grade, although the difference was not significant.

The purpose of this study was to investigate parental perception of vulnerability, parental subjective stress concerning children's premature birth, and child temperament in families of very low birth weight (VLBW) and normal birth weight (NBW) children. The subjects were 39 VLBW children and 30 NBW 7-year-old children and their caregivers. Data on child temperament and parental perception of vulnerability was provided by the 69 families. Families of the VLBW group rated their degree of current stress concerning their children's premature birth. There were no differences between the NBW and VLBW caregivers in their perceptions of their child's vulnerability status. Caregivers of VLBW children had significantly lower scores on degree of subjective stress specific to the premature birth than the value reported on the standardization population. Child temperament made a significant contribution to parental perception of child vulnerability status in both VLBW and NBW parents.

This paper describes factors that have influenced how investigators have conceptualized studies of low-birth-weight children and provides information on critically evaluating and interpreting results of research studies. Major findings concerning personality, temperament, and cognitive development during the preschool years of the low-birth-weight infants and their school achievement and behavior are summarized. Suggestions also are made for strengthening future studies.

Thirty-four very low birth weight (VLBW) 6-year olds and 31 normal birth weight (NBW) 6-year olds were assessed for visual acuity, binocular vision, and ocular muscle balance. Significantly more of the children in the VLBW group failed the tests of binocular vision and ocular muscle balance. Failure in tests of binocular vision was associated with higher numbers of days on mechanical ventilation and higher number of days in the intensive care nursery during the first months of life.

Demographic, medical risk variables and information obtained during early home assessments of very low birth weight infants and their families were compared in their ability to identify subsequent risk in 4-year-old children who were very low birth weight. The home assessment data were equal or better than the demographic risk variables in efficacy and efficiency.

The impact of caretaker daily stress and life strain on the behavioral adjustment of very low birth weight (VLBW less than or equal to 1,500 grams) preschool children was investigated; the degree to which the caregiving environment contributes to the effects of caretaker stress on child outcome was also explored. Subjects were 39 VLBW children (mean birth weight = 1,208 grams) and their primary caretakers, the majority of whom were their biological mothers. Data on caretaker stress and life strain, the caregiving environment, and child behavior were gathered when the children were 60 months of age. The impact of caretaker daily stress and life strain on VLBW child adjustment was moderate and similar to that of normal birth weight (NBW) children. The impact of caretaker stress appeared to be affected by the quality of the caregiving environment. Analysis showed that more behavior problems were found in VLBW 5-year-olds than expected in the general preschool population. Caretakers of VLBW 5-year-olds experienced more intense daily stress than those of NBW children.

The relationship between temperament, behavior problems, and learning skill abilities in preschool children who were born with very low birth weight (VLBW) is described. Subjects were 37 4-year-olds who weighed less than 1,500 grams at birth, were appropriate for gestational age, and free from congenital anomalies (M birth weight = 1,201 grams). Data were gathered when the children were 48 months chronological age and analyzed using point biserial and Pearson product moment correlation, chi square, and MANOVA. Temperament characteristics of rhythmicity, intensity, and persistence were related to behavior problems and learning skill abilities. Mothers reported more children with behavior problems than expected in the general population. Children with four or more behavior problems had significantly lower skill achievement scores than children with fewer behavior problems.

A multivariate study investigated developmental progress in very low birth weight infants (VLBW less than or equal to 1,500 grams) during the first year of life. The subjects were 41 VLBW infants (M birth weight = 1,203 grams) who were free from congenital anomalies and appropriate for gestational age. Eighteen infants were male, 23 were female. Data were gathered from the infants' charts and during home visits when the subjects were 6 and 12 months corrected gestational age. Birth weight, intraventricular hemorrhage status, number of days supported by mechanical ventilation, number of days in the intensive care nursery, socioeconomic status, and characteristics of the childrearing environment were examined in relation to developmental progress. Data were analyzed using multiple regression analysis and cross-lagged panel analysis. Environmental factors were powerful influences accounting for 67% of the variance in development at 1 year. Cross-lagged panel analysis suggested a causal relationship between the quality of the home environment and developmental achievement at 1 year.

The purpose of this study was to gather information about the characteristics of the very low birth weight baby. Twenty-six infants were involved in the study. Their mean gestational age was 29 weeks; mean gestational age was 29 weeks; mean birthweight was 1,170 grams. At the time of the study, the chronological age when corrected for prematurity was 7.9 months. During a home visit, the Denver Developmental Screening Test, the Infant Temperament Questionnaire, and the Home Observation Measurement Evaluation Inventory were completed. Pearson product moment correlation, chi square, and t-tests were used to analyze the data. Of the infants, 42 percent were at risk for developmental delays when assessed at the corrected gestational age. The infants were significantly more difficult as measured by the Infant Temperament Questionnaire. There was a moderate relationship between difficultness and childrearing environments. The findings of this study suggested that very low birth weight infants have an increased risk for developmental delays and are apt to have difficult behavioral styles. There was a negative relationship between infants with difficult behavioral styles and maternal involvement and responsivity.

This longitudinal study examined the toddler and preschool behavioral characteristics of children who were born with very low birth weights (VLBW; less than or equal to 1,500 grams). The subjects were 40 VLBW children (average birth weight, 1,203 grams) who at birth were appropriate for gestational age and free from congenital anomalies. Data were gathered during home visits when the children were 12, 24, 36 and 48 months and were analyzed using Pearson product moment correlation and z tests. Arrhythmicity, low adaptability, and low persistence during the toddler and preschool years characterized the behavioral styles of VLBW children. The temperament dimensions of rhythmicity, adaptability, intensity, mood, and threshold were related to the quality of the child's environment. Clinicians need to be alert to the impact of temperament on the interpersonal milieu of VLBW children and their families.

This article reports findings from the second year of a two-year longitudinal study designed to assess the VLBW infant in the areas of temperament, development, and the home environment. Data were obtained from 20 of the original 26 infants who participated in the study. During a home visit the Denver Developmental Screening Test (DDST), the Toddler Temperament Questionnaire (TTQ), and the Home Observation Measurement for Evaluation Inventory (HOME) were completed. Twenty percent of the toddlers were at-risk for developmental delay when assessed at the corrected gestational age. This compares to 42% who were deemed to be at-risk during the first year of life. No relationship was found between developmental-risk status and the quality of the home environment. The VLBW toddlers' temperaments were not significantly different from the standardization population. However, there were fewer easy toddlers than would be expected. During the second year the percentage of difficult children decreased from 38% to 10%. The VLBW toddler's behavioral style was characterized by arrhythmicity and low persistence. There was a moderate correlation between home environment and the toddler's activity level. High activity was negatively correlated with maternal involvement and provision of appropriate play things. The families of the 20 toddlers scored on the upper 25th percentile on the HOME Inventory. The high quality of the childrearing environment was stable over the two years.