Home Screening Questionnaire Research Articles

Diathesis-stress or differential susceptibility? Comparing the theories when determining the outcomes for children born before 33 weeks' gestation

Infants born preterm (less than 37 weeks completed gestation) have a higher risk of suboptimal cognitive and behavioral outcomes when compared with their term-born counterparts. The risk and severity of poor outcome increases as gestational age at birth decreases; however, not all children born preterm will develop deficits, and environmental influences post birth may have a role in shaping developmental outcomes. Whilst early preterm birth is not preventable, it may be possible to intervene after birth via the environment in order to improve outcomes. The diathesis-stress theory hypothesizes that vulnerable individuals will have worse outcomes after a negative environmental exposure, whereas the differential susceptibility theory posits that vulnerable (or plastic) individuals can be both adversely and positively affected by environmental factors. These two theories were compared in 535 children born <33 weeks' gestation. The interaction between the degree of prematurity and the home environment (as measured by the Home Screening Questionnaire) at 18 months on cognition (Intelligence Quotient from the Wechsler Abbreviated Scale of Intelligence) and behavior (Total Difficulties Score from the Strengths and Difficulties Questionnaire) at 7 years was explored. Evidence was not found for either theory, although a supportive/stimulating home environment appeared to contribute to a decrease in the risk or severity of suboptimal scores. Future research is needed to establish stronger evidence in order to inform interventions to improve the home environment of children born preterm.

Oral Motor and Gesture Abilities Independently Associated With Preschool Language Skill: Longitudinal and Concurrent Relationships at 21 Months and 3-4 Years.

Purpose Early motor abilities (gesture, oral motor, and gross/fine skills) are related to language abilities, and this is not due to an association with cognitive or symbolic abilities: Oral motor skills are uniquely associated with language abilities at 21 months of age. It is important to determine whether this motor-language relationship continues beyond the earliest stage of language development to understand language acquisition better and better predict which children may have lasting language difficulties. Method In this longitudinal study, we assessed language comprehension and production, oral motor skill, gross/fine motor skill, and meaningless manual gesture at ages 3 years (N = 89) and 4 years (N = 71), comparing the contribution of motor skill and earlier (at 21 months of age) language ability. We also examined covariates: nonverbal cognitive ability, socioeconomic status, and stimulation in the home as measured on the Home Screening Questionnaire. Results Motor abilities continue to have a significant relationship with language abilities independent of other factors in the preschool years. Meaningless manual gesture ability, gross/fine motor skill, and oral motor skill were still associated with language skill at 3 years of age; these relationships are not explained by the contribution of cognitive abilities or earlier language abilities. Conclusions Relationships between early motor skill and language development persist into preschool years and are not explained by other cognitive or home factors, nor by a relationship with earlier language ability. This finding should lead to a better understanding of the origins of language abilities.

Exploring the relationship between creative thinking and scientific process skills of preschool children

The aim of this study was to explore the relationship between creative thinking and scientific process skills of preschool children. Possible relations were also sought between home environment quality, preschool education duration, gender, and parents’ educational backgrounds and the children’s creative thinking and scientific process skills. The study was carried out based on a correlational research model, one of the quantitative methods. The participants included 70 children aged between 60 and 66 months who were attending preschool. The data collection tools included a demographic information form, Torrance Tests of Creative Thinking Figural Form A, the Scientific Concepts and Scientific Process Skills Instrument for Preschool Students, and the Home Screening Questionnaire for children of 3–6 years of age. It was determined in this study that there was a moderately positive significant relationship between the children’s creative thinking and scientific process skills scores. Additionally, the creativity indicator scores of the children with high home environment quality were found to be higher. It was also determined that the fluency and elaboration scores of the girls were higher than those of the boys and the creative thinking skills scores of the children differed in favor of the children with fathers with higher education levels.

Özel Gereksinimli Küçük Çocukların Ev Ortamlarının Niteliği

This study aimed to analyze the home environment of young children with disabilities. Data related to overall home environment was collected from 145 mothers by using the Turkish Form of the Home Screening Questionnaire (HSQ-T), while the home learning environment including the involvement of the mothers and the learning materials available in the home was assessed through individual interviews with mothers. The finding revealed that the 50.35 percent of the children live in low-quality homes and whereas the remainders live in high-quality homes based on the cut-off points of the HSQ-T score. The HSQ-T scores were found to be significantly related to parental involvement, education level and income of the mothers, and the developmental functions of the children measured by the Abilities Index. The mothers who live in less crowded homes participated in activities with their children more than those in the other group. Additionally, a comparison of the home quality of CWDs with and without access to home-made toys revealed a significant difference in the HSQ- T scores of the two groups of children, and finally, the maternal involvement was found to be the main predictor of the home environment of children.

Ev Ortamı Tarama Aracı: Küçük Çocukların Ev Ortamlarının Değerlendirilmesi

In this study, firstly, the psychometric properties of the Turkish version of the Home Screening Questionnaire (3-6 years form), which is used to evaluate the quality of the home environment of young children, was examined, and then the relationship between the quality of the home environment and the variables related to parents and children were examined. Data was collected from 306 mothers of young children by using Demographic Information Form, Home Screening Questionnaire and Abilities Index. The psychometric properties of the instrument were investigated by exploratory and confirmatory factor analyses, item analysis, and internal consistency coefficient. According to the results of the analysis, the questionnaire is a single factor instrument consisting of 12 items and its psychometric properties are at an acceptable level. There was a moderate and significant relationship between the quality of the home environment and the level of education and income of the mothers and the level of education and income of the parents living in low-quality home environments were found to be significantly lower than the other group. In addition, there is a significant and negative relationship between the developmental functions of children and the quality of the home environment. The home environment of children with lower developmental functions was found to be less favorable than the home environment of children with higher functions. The findings of the study were discussed in terms of the psychometric properties of the 12 items Turkish version of the instrument and the utility of the instrument in both the medical and educational fields .

The Association of Home Environment and Caregiver Factors With Neurocognitive Function in Pre-school- and School-Aged Perinatally Acquired HIV-Positive Children on cART in South Africa.

Background: Children with perinatally acquired HIV in low resource settings are at risk for neurocognitive impairments not only due to the direct effects of HIV on the brain and in utero ART exposure but also due to factors associated with their environment. Thus, the aim of this study was to examine the association between home environment and caregiver factors and the neurocognitive function of pre-school- and-school-aged HIV-positive South African children from low resource rural communities.Materials and Methods: The Wechsler Preschool and Primary Scale of Intelligence-III was administered to assess the neurocognitive functioning of 152 purposively sampled perinatally acquired HIV-positive children on cART, aged 3 years to 7 years 6 months (mean age 63.13 months). The primary caregivers (n = 152) completed the Home Screening Questionnaire to assess the quality of the home-environment of the children.Results :The results showed that unfavorable environment, caregiver type, and quality of stimulation in the home were negatively associated with the neurocognitive development of perinatally HIV-positive children on cART. Most of the HIV-positive children (n = 95) were under the care of an extended relative. Older HIV-positive boys, reared by biological mothers, who also lived in suboptimal and poor quality home-environments had poorer neurocognitive function when compared to HIV-positive children reared by non-biological (extended relatives) caregivers, [F(2,149) = 14.42, p < 0.001].Conclusion: The child's early home environment is associated with general neurocognitive development, which highlights the need for early psychosocial interventions that can promote better cognitive outcomes among children living with HIV.

Prevalence and Risk Factors of Speech and Language Delay in Children Less Than Three Years of Age

Background: There is a large amount of data on the prevalence and risk factors of speech and language delay from the West, but relatively scanty data from India. Objectives: The aim of this study was to assess the prevalence and risk factors of speech and language delay in children less than three years old, using the Langauge Evaluation Scale Trivandrum (LEST 0-3). Materials and Methods: A descriptive, cross sectional study was conducted in the under-five clinic of our institute, on a sample of 200 children, less than three years old. Language was assessed using Language Evaluation Scale Trivandrum (LEST 0-3) and development in other domains was assessed using the Trivandrum Development Screening Chart (TDSC). The Home Screening Questionnaire (HSQ) was used to assess the home environment. Various biological and environmental risk factors were analyzed. Results: The prevalence of speech and language delay was found to be 27%. In univariate analysis, parameters found to be significantly associated with speech and language delay were male gender, poor home environment (score ≤ 19 in the Home Screening Questionnaire) and family history of speech and language delay. In multivariate analysis, poor home environment (CI = 0.20 - 0.80, P = 0.01) and positive family history (CI = 0.09 - 0.72, P = 0.01) were significant risk factors. There was a significant association between delay in TDSC and speech delay. However, TDSC alone had a low sensitivity of 33% in detecting speech and language delay. Conclusions: Prevalence of speech and language delay is high (27%) in children less than three years of age attending the Under-Five clinic for at-risk children. Negative home environment and family history of speech and language disorders are significant risk factors for speech and language delay. The strong association of speech delay with delay in TDSC reemphasizes the need for a complete developmental assessment in any child with speech delay. The TDCS alone fails to detect significant number of cases of speech delay, showing the need to perform a separate speech screening test.

How Did They Grow: An Intervention to Reduce Stunted Growth in Low-Income Mexican-American Children.

Growth stunting is a complex phenomenon related to undernutrition that can contribute to developmental delay, cognitive deficits, and small size and obesity in adulthood. Stunted growth, defined as height for age below the 5th percentile, is primarily caused by chronic malnutrition. In this study, a community-based intervention to reduce undernutrition was tested in a quasi-experimental design with 174 low-income, Mexican-American mothers and children recruited from a Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) clinic in a major southwestern city. The intervention was based on the public health nursing practice of collaborating with mothers of young children on appropriate nutrition and parenting, and was tailored by the author and community informants for mothers of children with stunted growth. Data were collected on child height and weight, dietary intake, maternal acculturation, maternal perceived stress as measured by the Perceived Stress Scale (PSS), home environment as measured by the home screening questionnaire (HSQ), and maternal-child interaction as measured by the Nursing Child Assessment Teaching Scale (NCATS). Intervention children had higher growth velocity than the children in the comparison group. These findings were especially prominent for children of women who were older and less acculturated. Results suggest that a nursing intervention delivered in collaboration with WIC can make a significant improvement in growth of low-income children with growth stunting.

PP02.12 – 2719: Assessment of speech and language delay among 0–3 year old children attending well baby clinics using Language Evaluation Scale Trivandrum (LEST 0–3)

Objective 0–3 years children seem to be at increased risk for speech and language disorders. Methods Parents of 202 children within age 0–3 years (141 male, 61 female) completed screening questionnaires and the child was evaluated on the language scale. The screening battery included the Risk Factor Assessment Questionnaire for socio demographic profile, Home Screening Questionnaire (HSQ) and LEST. Children with disabilities were excluded. Results Twelve children (5.9%) screened positive for LEST delay. Among them 10 children (83.3%) had negative home environment while 2 children (16.7%) had positive environment on Home Screening Questionnaires. Of the 12 children who showed LEST delay 8 (66.7%) were boys and 4 (33.3%) were girls. LEST total delay showed a similar trend on the basis of religion as 8 (66.7%) were Hindus and 4 (33.3%) were Muslims. The overall socio economic status of majority of families was 73 (38.4%) lower middle class with 7 (58.3%) showing LEST delay. The mean age of mother in case of LEST delay was 23.42 (SD 2.234) and mean age of father in case of LEST delay was 26.42 (SD 2.644). The average birth weight noticed was 3158.33 grams (SD 511.163) with P value 0.047. There was no significant relation with gestational age and the LEST delay as 11 (91.7%) of the children were born at term and 1 (8.3%) was born preterm. There was relation in LEST delay and place of residence as 10 (83.3%) were urban dwellers and 2 (18.7%) were from rural background. Conclusion Our results indicate a higher prevalence of speech and language delay in children with negative home environment compared to the general population prevalence. The speech and language delay was associated with male child. There was more so prevalence in urban children without any relation to the preterm gestation. Our findings support the simultaneous use of more than one screening tests in order to increase screening sensitivity

Can the home environment promote resilience for children born very preterm in the context of social and medical risk?

Relationships between the home environment and early developmental outcomes were examined in 166 children born very preterm in one tertiary maternity hospital to explore whether a more optimal home environment could promote resilience. In particular, we explored whether this effect was apparent over and above social risk and children’s biological risk, as measured by cerebral white matter abnormality (WMA) evaluated using magnetic resonance imaging (MRI) at term-corrected age and length of hospital stay (LOS), and whether the effect of the home environment differed according to WMA. The home environment and social–emotional outcomes were assessed at 2years’ corrected age using the Home Screening Questionnaire (HSQ) and the Infant–Toddler Social and Emotional Assessment (ITSEA). Children’s cognitive and motor development was assessed using the Bayley Scales of Infant Development II. A more optimal home environment was associated with better cognitive and social–emotional development after adjusting for social risk, WMA, and LOS. Neonatal cerebral WMA moderated the relationship between the home environment and dysregulation problems only, such that the home environment had less effect on dysregulation for children with mild or moderate to severe WMA. The need to support parents to create an optimal home environment is discussed.

Does maternal depression predict developmental outcome in 18 month old infants?

AimOur aim was to examine the associations between maternal depression in the first 6months postpartum, home environment and cognitive, language and motor development in infants at 18months of age. Study design and methodsThis article reports results from the control group (n=312 full term; n=48 preterm) of the prospective Docosahexaenoic acid (DHA) to Optimise Maternal Infant Outcome (DOMInO) Randomised Controlled Trial. Mothers in South Australia completed the Edinburgh Postnatal Depression Scale (EPDS) at 6weeks and 6months postpartum. Infant development was assessed when children were 18months old with the Bayley Scales of Infant and Toddler Development Version III and mothers completed the Home Screening Questionnaire at this assessment. ResultsThere were no significant associations between maternal depression in the first 6months postpartum and cognitive, language or motor development after controlling for infant prematurity, breastfeeding status and socio-economic level. Home environment remained a significant predictor of development after controlling for potential confounding variables. Using mediation models, we did not find an association between maternal depression and developmental outcome through home environment. ConclusionsMaternal depression in the first 6months postpartum was not associated with infant development at 18months of age. Further studies should focus on women with chronic depression.

Cognitive Function after Fetal Exposure to Antiepileptic Drugs

To the Editor: Meador et al. (April 16 issue)1 suggest that children who had been exposed to valproate in utero had significantly lower IQ scores than those who had been exposed to other antiepileptic drugs. However, the results of their study should be interpreted with caution. Many factors have a role in the neuropsychological development of children, apart from fetal exposure to antiepileptic drugs. We are not given details of the quality of the home environment, which has been recognized as a key environmental influence on child development.2 The Home Screening Questionnaire (HSQ) is a widely used tool to assess the qualities of the home environment that may influence the development of children,3 such as emotional and verbal responses of the mother and avoidance of restriction and punishment. Although the study by Meador and colleagues included detailed monitoring of multiple potential confounding factors relating to child IQ, the HSQ may be helpful for obtaining more detailed and appropriate assessments of and conclusions about the children at the age of 6 years.

The Home Environments of Young Children With and Without Disabilities

This study was designed to investigate the differences between the home environments of children with and without disabilities in relation to certain child and family variables. The participants were mothers of children (aged 0–72 months) with and without disabilities living in Ankara, Turkey. The Home Screening Questionnaire was used to gather data on the home environments of the children. The t tests showed that home measures were related to disability status only for the 3- to 6-year age group, with the families of children with disabilities having lower scores. The home environment was also found to be closely linked to maternal age, educational level, work status, and the family's monthly income. Results are discussed in terms of the importance of maternal characteristics on the home environments of children with and without disabilities and in terms of implications regarding early intervention programs.

Home environment, not duration of breast-feeding, predicts intelligence quotient of children at four years

Objective We investigated the relation between duration of breast-feeding in infancy and the intelligence quotient (IQ) of children at 4 y of age in a well-nourished population of an industrialized country. Methods Data on duration of breast-feeding were collected prospectively from a cohort of 302 children born between 1998 and 1999 in Adelaide, Australia. The IQ of the children was assessed at 4 y of age using the Stanford-Binet Intelligence Scale. Information on important predictors of childhood IQ including the quality of the home environment was also collected prospectively. Regression analyses were conducted to examine the effect of duration of breast-feeding on IQ with adjustment for potential confounders. Results There was no association between the duration of breast-feeding and IQ of the children. The expected IQ of a child at 4 y of age who was breast-fed for 6 mo was only 0.2 point (95% confidence interval −0.8 to 1.2) higher than that of a child who had never been breast-fed after adjustments for the quality of the home environment and socioeconomic characteristics of families using multivariable regression analysis. The quality of the home environment, as assessed by the Home Screening Questionnaire, was the strongest predictor of IQ at 4 y. Conclusion There was no association between duration of breast-feeding and childhood IQ in this relatively well-nourished cohort from an industrialized society. In such settings, the apparent benefit of breast-feeding on cognitive function is most likely attributable to sociodemographic factors.

Cord Serum Ferritin Concentrations and Mental and Psychomotor Development of Children at Five Years of Age

There is clear evidence that iron deficiency in early life can lead to enduring delay in mental and psychomotor development. Trials of iron supplementation have, however, failed to consistently demonstrate benefit. The authors assessed fetal iron status by determining the umbilical-cord serum ferritin concentration by radioimmunoassay in 278 children and related the findings to full-scale intelligence quotient (FSIQ), language ability, fine and gross motor skills, attention, and tractability at age 5 years. Participants took part in a study designed to identify risk factors for small-for-gestational-age (SGA) infants. Mothers completed the Home Screening Questionnaire, a measure of the home environment for children, as well as the Peabody Picture Vocabulary Test, a measure of cognitive function. In addition to the FSIQ, children completed the Test for Auditory Comprehension of Language (TACL), the Peabody Developmental Motor Scales, and the Yale Children's Inventory for attention and tractability (the ability to obey rules of decorum). The mothers were predominantly African-American and had scores typical of a resource-poor inner city population. The prevalence of preterm birth before 37 weeks' gestation was 13%, and that of SGA infants was 22%. Birth weights were lower for those in the lowest quartile of serum ferritin. After adjusting for gender, birth weight, and smoking, cord ferritin levels correlated significantly but weakly with maternal serum ferritin levels at 36 weeks' gestation. Children in the lowest quartile of cord blood ferritin scored the lowest in all tests, and had significantly lower scores on the TACL and the test of fine motor function than did those in the two median quartiles. There were no such differences in FSIQ or gross motor function scores. In no respect did the children in the highest ferritin quartile differ from those in the median quartiles. Analyzing test scores below the 15th percentile, the chance of a low score on any of the tests was increased by at least 60% for children in the lowest ferritin quartile. Children in the highest ferritin quartile were more than 3 times as likely as those in the two median quartiles to have a FSIQ score lower than 70 (the 15th percentile cutoff score). These findings suggest that poor iron status at birth is associated with impaired performance on mental and psychomotor evaluation at age 5 years. The finding that high ferritin levels correlate with low FSIQ scores remains unexplained.

A Lurian-Piagetian Approach to Assessment of Historically Disadvantaged Black Scholars in English Medium Schools

Piagetian and Lurian assessment procedures were employed to evaluate the neurocognitive processes of seven-year-old historically disadvantaged children (n=27), residents of traditionally Black areas who were identified as experiencing learning problems (LP group) in English medium schools. Comparisons were made with a reference group of Black children in the same schools (n=23) currently not experiencing learning problems (NLP). No significant differences were found between factors such as maternal education, occupational status, Home Screening Questionnaire or the amount of English spoken in the homes of the two groups. On Piagetian tasks of conservation and seriation, it was observed that the performances of the NLP group were age appropriate, while the LP children showed a developmental lag, despite the fact that no significant difference was observed on classification tasks. Using Majovski et als (1978) adaptation of Luria's tests, significant differences were noted on all tasks with the exception of Acoustic-Motor organisation and Higher Visual Functions. The results of the Lurian tasks indicated difficulties with basic skills but especially with the regulatory and directional aspects of language which manifested in lower level dysfunctions regarded as prerequisites for gaining higher level skills. The occurrence of different maturation rates and skills for the two groups as shown by Piagetian and Lurian tasks, was also supported by differences obtained on Goodenough's (1929) DAP test (p&lt;.001). Significant correlations were found between conservation and seriation tasks with Lurian functions of motor, acoustic-motor, expressive language, arithmetic and reading /writing skills. The possibility is raised that Piagetian and Lurian approaches can offer greater insight into children's cognitive levels and task performance.

Management of otitis media and functional outcomes related to language, behavior, and attention: is it time to change our approach?

Outcomes research assesses the end results of health care from the perspective of those who receive the care, those who provide it, and those who pay for it. The article by Karin Minter and her colleagues1 at the Frank Porter Graham Child Development Center in Chapel Hill, North Carolina, provides important new information related to the functional outcomes of otitis media (OM) in early childhood. Their study documenting the relationship of otitis media with effusion (OME) and hearing loss with functional measures of attention and behavior obtained from parents, teachers, and clinicians appears in this issue of Pediatrics. 1 They conducted this prospective cohort study in 85 children whose middle ear and hearing status had been closely monitored from 6 months to 4 years of age. The diagnosis of OME was based on both pneumatic otoscopy and tympanometry. Audiologists who were unaware of the middle ear findings performed hearing assessments. The validated measures used to assess outcomes included the behavior rating scale of the Bayley Scales of Infant Development, the Parenting Stress Index, the Social Skills rating system, and the Conners' Teacher/Parent Rating Scale. Children's attention and behavior were assessed during infancy, preschool, and first grade. Mother's education, socioeconomic status, child gender, child care quality, and a measure of the home environment (home screening questionnaire) were included as covariates in all analyses. When these covariates were considered, there were no significant correlations between OME or hearing loss with any of the measures of attention and behavior at any age during the first 6 years of life. In a previous publication, the investigators failed to document an association between otitis or hearing loss and the acquisition of language skills in this population.2 The availability of this new data as well as the recent publication of several prospective cohort studies …

Predicting IQ of Biologically “At Risk” Children from Age 3 to School Entry

Predictive validity of the Stanford-Binet Intelligence Scale Fourth Edition (S-B IV) from age 3 years to ages 4-5 years was evaluated with biologically "at risk" children without major sensory or motor impairments (n = 236). Using the standard scoring, children with full scale IQ < or = 84 on the Wechsler Preschool and Primary Scale of Intelligence at age 4-5 years were poorly identified (sensitivity 54%) from the composite S-B IV score at age 3. However, sensitivity improved greatly to 78% by including as a predictor the number of subtests the child was actually able to perform at age 3 years. Measures from the Home Screening Questionnaire and ratings of mother-child interaction further improved sensitivity to 83%. The standard method for calculating the composite score on the S-B IV excludes subtests with a raw score of 0, which overestimates cognitive functioning in young biologically high risk children. Accuracy of early identification was improved significantly by considering the number of subtests the child did not perform at age 3 years.

Gender and its contribution to the prediction of cognitive abilities at 5 years.

Gender-related differences in the prediction of five year-olds' cognitive abilities from measures of distal environment, proximal environment and infant test scores were examined in a random sample of 93 boys and 90 girls. Distal environmental data included maternal IQ, maternal and paternal education. Proximal environmental data included two variables derived from the Home Screening Questionnaire: the Home Questions and the Toy Checklist. The Bayley MDI was administered at age 13 months, whereas WPPSI-R was used as cognitive outcome measure at age 5 years. The relationship between paternal education and child IQ, and between proximal environmental variables and child IQ was significantly stronger for boys than for girls. The associations between proximal environment and IQ in boys, were accounted for by the distal environmental variables. Bayley MDI correlated significantly higher with girls' IQ compared to boys' IQ. Findings are discussed in terms of parental gender-differentiated socialization processes.

OUTCOME OF ECMO VS NEAR MISS ECMO PATIENTS AT FIVE YEARS OF AGE:† 1640

A total of one hundred and sixteen ECMO patients have been evaluated in our center at five years of age. Excluding the patients with primary diagnosis of congenital diaphragmatic hernia and sepsis, allowed us to compare 76 of five-year-old ECMO patients with 20, five-year-old Near Miss ECMO patients with similar primary diagnosis. Both groups were similar in gestational age, sex, Apgar scores and their primary diagnosis of pulmonary disease. Mean birth weight of ECMO patients (3.40 ± 0.60 Kg) was significantly higher than Near Miss group (3.02 ± 0.68 Kg) (p 40 was similar in both groups (22 ± 26 vs 26± 42), the Near Miss group spent longer time on PIP over 30 (75± 81 vs 42 ± 31), FiO2>0.70 (121 ± 81 vs 51± 34) and FiO2 of 1.00 (55 ± 71 vs 38 ± 23), and had longer duration of PCO2<30 (93 ± 64 vs 32 ± 35) respectively. Both groups had similar ethnic distribution and socioeconomic status as it was assessed by number of patients living in a single parent family, level of maternal education and home screening questionnaire. All 76 ECMO patients and 10 of the 20 Near Miss patients had neuroimaging studies. Total of 9 ECMO patients and 2 of the Near Miss patients that were studied had major neuroimaging abnormalities. Mean Full Scale IQ in ECMO patients was 96.88 ± 20.09 vs 91.50 ± 22.34 in Near Miss ECMO (p=.32). Academic screening for reading, writing, and arithmetic was similar in both groups with 46% of ECMO and 56% of Near Miss patients being at risk for school failure (p=.47). Parental reporting of psychosocial problems was similar for behavior adjustment and level of maternal stress, although parents of Near Miss patients reported an increased rate of child immaturity compared to ECMO patients (p=.005).