More Support Needed For Children Born Very Pre-term

There is a need for the health and education system to adopt a more proactive approach in addressing the developmental needs of children born very pre-term, a University of Canterbury (UC) child health development expert says.

Professor Lianne Woodward’s latest study, published in high profile American journal Pediatrics, but conducted in New Zealand, suggests almost half of babies born very pre-term (VPT), or between 28 and 32 weeks, will develop cognitive impairments ranging from mild to severe.

Even mild impairments can have significant impacts on educational and social opportunities over the child’s lifetime. However, given current criteria for early intervention services, many children with impairments could remain undetected, because they are not always being monitored beyond the first few years of life.

“In New Zealand our early intervention services are variable,” Professor Woodward says. “Some children will have access but others won’t and assessments stop when they are too young. It is not enough to assess VPT children at two or four years old. We’ve got to extend into school so we don’t miss children with early mild problems that could develop into more serious problems later, needing more comprehensive and expensive educational remediation and behavioural support.”

The study, Predicting School-Age Cognitive Impairment in Children Born Very Preterm, found that between 40-50% children born VPT meet criteria for either mild or severe cognitive or intellectual impairment. The authors (from UC, Harvard Medical School and Brigham and Women’s Hospital, USA) concluded that for children born VPT to reach their best long-term potential, they need to be monitored until age six with interventions introduced early for children found to have early mild cognitive delay. This was especially important for children growing up in socially disadvantaged families. The study also acknowledged that other factors such as parental mental health, family stability, and parenting are likely to play a further role in shaping cognitive outcomes for VPT children.

Cognitive difficulties are associated with high rates of special education service use, longer term educational underachievement, social and mental health difficulties, and reduced earning and employment potential in adulthood.

Professor Woodward returned to Christchurch last year to lead UC’s School of Health Sciences following roles at Harvard Medical School as Professor of Psychology in Pediatrics and at Brigham and Women’s Hospital as Director of Research, Department of Pediatric Newborn Medicine.

Complete List of Authors:

· Carmina Erdei; Brigham and Women's Hospital, Pediatric Newborn Medicine; Harvard Medical School, Pediatrics

· Nicola Austin; University of Otago, Pediatrics

· Sara Cherkerzian; Brigham and Women's Hospital, Pediatric Newborn Medicine; Harvard Medical School, Pediatrics (Biostatistician)

· Alyssa Morris; University of Southern California, PhD student Clinical Psychology

· Lianne Woodward; University of Canterbury, School of Health Sciences

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