Validation of prediction of kindergarten-age school-readiness scores of nondisabled survivors of moderate neonatal encephalopathy in term infants.
Outcome studies of nonmalformed term infants with neonatal encephalopathy associated with late fetal and/or early neonatal distress show those in the severe category die or become disabled; 18% in the moderate category become disabled and of the nondisabled, greater than 40% have school-readiness delay. Predictive indices for kindergarten-age learning ability obtained from obstetrical/neonatal and family/social data were developed for 71 nondisabled survivors of moderate neonatal encephalopathy born in 1974-79 (Cohort I). Predicted outcome was compared to actual outcome of a second cohort of neonates with the same diagnosis, born in 1982-86 (Cohort II); comparison groups for both cohorts were tested. School-readiness scores from Cohort II were similar to Cohort I and both were below respective comparison groups. Prediction for the nondelayed was 68% to 95%; for the delayed 7% to 29%, affected by the lower sample size available for this category. Predicted scores were within 0.5 SD of actual scores for 80% of not delayed children. Nondisabled survivors predicted to do very well can be discharged from follow-up; others with moderate or severe neonatal encephalopathy should receive ongoing assessment.
Robertson
C M
CM
Department of Pediatrics, University of Alberta, Glenrose Rehabilitation Hospital, Edmonton, Canada.
Grace
M G
MG
D001925:Brain Damage, Chronic / Q000523:psychology; D001927:Brain Diseases / Q000523:psychology*; D002675:Child, Preschool; D015331:Cohort Studies; D006801:Humans; D007231:Infant, Newborn; D007858:Learning; D009483:Neuropsychological Tests; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012578:Schools, Nursery; D012718:Set, Psychology; D012931:Social Environment