Predictor Of Developmental Outcomes Research Articles

Predictors of developmental outcomes in children with complete transposition.

Cognitive, functional, educational achievement and behavioural measures were employed to assess neurobehavioral status in 57 of 60 participants who were initially enrolled in the Baltimore-Washington Infant Study, and who survived surgical correction of complete transposition (concordant atrioventricular and discordant ventriculo-arterial connections). Charts were reviewed to investigate the relationship between birth variables, surgical strategy and developmental outcomes. Higher preoperative weight was associated with better outcomes on the Stanford-Binet Short-term Memory subtest, while lower preoperative oxygen tension was associated with better outcomes on the Abstract/Visual Reasoning subtest and a test of Visual-Motor Integration. Longer total bypass time was associated with poor outcomes on the Short-term Memory subtests. Higher average flow rates during cooling and rewarming were associated with higher scores in the test of short term memory but poorer outcomes on a test for visual motor integration. Longer cooling times were associated with higher scores on the test for Visual-Motor Integration. Patients suffering seizures scored lower on the Stanford-Binet Composite, as well as in their tests of achievement. The data indicate that non-verbal skills may be particularly sensitive to variations in surgical strategies employed to correct complete transposition. Overt neurological events, such as seizures, were related to global deficits in intellectual functioning. Prospective studies evaluating systemic variations in surgical procedures and attempts to prevent and manage perioperative neurological events are important for further investigation of neurodevelopmental outcomes in children surviving surgical correction.

Predictors of Developmental Outcomes for Medically Fragile Early Intervention Participants

Little is documented about the determinants of developmental outcomes for medically fragile infants who receive early intervention. In this controlled longitudinal study 65 premature infants with intraventricular hemorrhage (IVH) were randomly assigned to intervention groups beginning at 3 months adjusted age (Early) or 12 months adjusted age (Delayed). The sample was 65% African American and 35% Caucasian, and over half the youngsters were being raised by single mothers. Although cost analyses revealed that it was almost twice as expensive to begin sensorimotor intervention at the earlier age, annual comprehensive assessments revealed no significant differences in developmental outcomes based on age at start. Stepwise multiple regression analyses revealed that Maternal Education and Neonatal Medical Problems were significant predictors of outcomes at years 1, 3, 5, and 7 regardless of age at start. Related findings from other studies are discussed along with implications for policy and future research.

Predictors Of Developmental Outcomes For Infants Who Are Medically Fragile

Smith, Timothy B.; Boyce, Glenna C. Predictors of Developmental Outcomes for Infants Who Are Medically Fragile. Utah State Univ., Logan. Early Intervention Research Inst. Department of Education, Washington, DC. 26 Mar 93 HS90010001 20p.; Paper presented at Society for Research in Child Development Conference (New Orleans, LA, March 25-28, 1993). Speeches/Conference Papers (150) Reports Research/Technical (143)

Measuring Illness Severity in Newborn Intensive Care

Measurement of illness severity has found increasing use in adult and pediatric intensive care research over the past decade. The development of illness severity indices for neonatal intensive care has lagged because birth weight has served as an excellent proxy for illness severity. However, a number of recent studies have shown marked variation in survival and morbidity among neonatal intensive care units (NICUs) despite birth weight adjustment, making clear the need for neonatal illness severity scoring. We discuss advantages and disadvantages of the 4 types of scoring systems used in adult intensive care—diagnosis, risk-factor, therapeutic, and physiological—and review their applications in adult and pediatric ICU research. Criteria for score design, as well as standards for validation and performance, are enumerated. The 30 neonatal scores fall in 5 major categories: obstetric risk, general use pediatric scores, predictors of developmental outcome, bronchopulmonary dysplasia risk, and acute mortality risk. Few have been adequately validated on large, concurrent independent samples. The most promising scores are those that measure acute physiological derangement on admission. Potential applications for these new illness severity scores are discussed.

Prediction of Developmental Outcome Using a Perinatal Risk Inventory

Prediction of Developmental Outcome Using a Perinatal Risk Inventory

Prediction of Developmental Outcome Using a Perinatal Risk Inventory

An effective perinatal developmental screening that predicts developmental outcome of high-risk neonates is currently not available. One hundred twenty-five high-risk infants were evaluated prior to discharge from the neonatal intensive care unit using a newly developed perinatal risk inventory, family status index, and abbreviated neurobehavioral assessment scale. All infants had been evaluated using the Bayley Mental and Motor Scales of the Stanford-Binet. They were also evaluated by a pediatrician, audiologist, and ophthalmologist. Fifteen infants had been evaluated using 9-month Bayley Scales of Infant Development, 74 had been evaluated using the Bayley at 9 and 18 months, and 36 children had been assessed using the Stanford-Binet at 36 months. The total score of the perinatal risk inventory demonstrated a significant correlation with the infants' last score on the Bayley and Stanford-Binet (r = .55, P less than .001). The abbreviated neurobehavioral assessment scale correlated with the infants' IQ and developmental quotient score (r = .3, P less than .001); the family status index did not correlate well with the developmental outcome. Using a score of 10 on the perinatal risk inventory provided a sensitivity of 0.76, specificity of 0.79, positive predictive value of 0.475, and negative predictive value of 0.929. Twelve of the 13 infants with cerebral palsy were identified as being potentially developmentally abnormal prior to discharge. It appears that it is possible to predict the developmental outcome of high-risk neonates using a perinatal risk inventory.

Newborn Auditory Brainstem Evoked Responses (ABRs): Prenatal and Contemporary Correlates

A literature review and new data on correlates of newborn auditory brainstem evoked responses (ABRs) are presented. Although there has been documentation of the importance of maturation, pathology, postnatal complications, and sex as determinants of the ABR, few investigators have adopted a multivariate approach, resulting in a confounding of maturation with pathological and other factors. In the present study, the ABR was recorded and the I-V interwave latency at 80 dB was computed for 88 newborns (60 neonatal intensive care unit survivors and 28 low-risk babies). 29 variables describing background characteristics, age, pregnancy and delivery complications, and postnatal illnesses were factor analyzed, and the obtained factors were entered into a stepwise regression. Conceptual age was the strongest predictor of the I-V interwave latency, followed by sex and prenatal obstetric complications, although the correlations obtained were low. We concluded that disorders of the central components of the ABR may be more of prenatal than of postnatal origin. In addition, the I-V interval had low but reliable correlations with 4 of 11 Brazelton scale variables. These data show the usefulness of the ABR for monitoring neurologic function in high-risk neonates and foreshadow its potential usefulness as a predictor of developmental outcome.

Developmental Outcome in Children Exposed to Chloride-Deficient Formula

The developmental outcome of 2- and 4-year-old children who had been exposed as infants to chloride-deficient formula was studied. A negative dose-response relationship was demonstrated between use of the formula without additional nutritional supplementation and cognitive outcome as measured by the Bayley Scales of Infant Development (Pearson r = -.55, P = .01) at 2 years of age. A similar negative relationship was demonstrated between this exclusive use of the defective formula and perceptual (Pearson r = -.51, P less than .05), motor (Pearson r = -.52, P less than .05), and fine motor (Pearson r = -.75, P less than .002) ability as measured by the McCarthy Scales of Children's Abilities at 4 years of age. When other know predictors of developmental outcome were taken into account by means of multiple linear regression analyses, exclusive formula use emerged as an important predictor of the children's cognitive functioning at 2 years (model R2 = .59, P less than .005) and of quantitative (model R2 = .58, P less than .006), perceptual (model R2 = .63, P less than .009), and fine motor ability (model R2 = .74, P less than .003) at 4 years of age. These data raise concern about the developmental outcome of the children exposed to chloride-deficient formula.

Maternal risk factors as predictors of developmental outcome in early childhood

This paper describes the rationale, procedures, and initial validation of an instrument which assesses distal environmental factors thought to negatively influence maternal caregiving ability. A sample of 36 lower class, single, black mothers (ranging in age from 14 to 19 years) of first born, full-term infants were included in an educational intervention program carried out during infants' first 12 months of life. The development of the maternal risk score (MRS) instrument was centered around four areas: maturity of mother, degree of planning of the mother, family support system and level of poverty. Initial, Year 1, Year 2, and Year 3 MRS scores were compared with infant development at one and two years as measured by the Bayley Scales, and at three years with the McCarthy Scales, using Pearson product-moment correlations. The initial MRS correlated negatively with the Bayley Mental Development Index (MDI) at Year 1 and also at Year 2 (N=−.38 and −.40 respectively, both significant at p<.05). The MRS for Year 1 showed significant negative correlations with the two Bayley MDIs: two and three year MRS scores were significantly related to three year McCarthy test scores. This screening instrument, which assesses qualitative aspects of the caretaking environment, appears to be a promising approach for identifying lower class mothers of infants who might be at risk for developmental disabilities.

Prediction of Developmental Outcome at Seven Years from Prenatal, Perinatal, and Postnatal Events

Prediction of Developmental Outcome at Seven Years from Prenatal, Perinatal, and Postnatal Events

PREDICTION OF DEVELOPMENTAL OUTCOME AT SEVEN YEARS FROM PRENATAL, PERINATAL, AND POSTNATAL EVENTS

SMITH, A. C.; FLICK, GRAD L.; FERRISS, GREGORY S.; and SELLMANN, ADOLPH H. Prediction of Developmental Outcome at Seven Years from Prenatal, Perinatal, and Postnatal Events. CHILD DEVELOPMENT, 1972, 43, 495-507. Although the present research was exploratory in nature, the results suggest that long-range prediction of ability performance using information from prenatal, perinatal, and postnatal developmental periods was feasible. Additionally, it was found that the use of sequential prediction stages, not only allowed for more accurate classification of Ss as normal or abnormal, but also indicated some optimal interval of time beyond which increments in predictive accuracy were negligible. While the predictor variables were listed for inspection, no attempt was made to interpret which variables were good or poor predictors. Discernment of the adequacy of the predictor variables will be the major focus of a future, more elaborate study involving a much larger number of CCDP Ss. This study will require a refinement of the developmental outcome criterion to include performance on both psychological and neurological tests and a more comprehensive coverage of the wide range of available predictor variables.