Cognitive and neuropsychological outcomes: more than IQ scores.
Improved survival in preterm infants has broadened interest in cognitive and neuropsychological outcomes. The incidence of major disabilities (moderate/severe mental retardation, neurosensory disorders, epilepsy, cerebral palsy) has remained consistent, but high prevalence/low severity dysfunctions (learning disabilities, ADHD, borderline mental retardation, specific neuropsychological deficits, behavioral disorders) have increased. The follow-up literature contains methodologic problems that make generalizations regarding outcome difficult, and these are discussed. Although mean IQs of former VLBW infants generally are in the low average range and are 3-9 points below normal birth weight peers, these scores mask subtle deficits in: visual-motor and visual-perceptual abilities, complex language functions, academics (reading, mathematics, spelling and writing), and attentional skills. There is an increased incidence of non-verbal learning disabilities, need for special educational assistance, and behavioral disorders in children born prematurely. Males have more problems, and there is a trend for worsening outcome over time, due to emergence of more subtle deficits in response to increased performance demands. In addition to IQ and achievement testing in follow-up, there should be evaluation of executive functions and attention, language, sensorimotor functions, visuospatial processes, memory and learning, and behavioral adjustment.
Aylward
Glen P
GP
Division of Developmental and Behavioral Pediatrics, Department of Pediatrics, Southern Illinois University School of Medicine, Springfield, Illinois 62794-9658, USA. Gaylward@siumed.edu
D003072:Cognition Disorders / Q000175:diagnosis* / Q000453:epidemiology; D002658:Developmental Disabilities / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D007806:Language Disorders / Q000453:epidemiology; D007859:Learning Disabilities / Q000453:epidemiology; D008297:Male; D009483:Neuropsychological Tests; D010468:Perceptual Disorders / Q000453:epidemiology; D011596:Psychomotor Disorders / Q000453:epidemiology; D012720:Severity of Illness Index