Elsevier

Brain and Development

Volume 22, Issue 3, 24 May 2000, Pages 163-168
Brain and Development

Original article
Perceptual-motor, visual and cognitive ability in very low birthweight preschool children without neonatal ultrasound abnormalities

https://doi.org/10.1016/S0387-7604(00)00098-XGet rights and content

Abstract

Thirty-six children born preterm with very low birth weight without neonatal brain disorders and normal cerebral ultrasound findings were examined at pre-school age: visual, perceptual motor, attention, behaviour and cognitive assessments were performed in the study group as well as in a control group of term children matched for age, sex and parental educational and occupational status. The results showed a significant lower scoring in perceptual motor skills in the study group, associated with a defect of accuracy in spatial attention and a higher incidence of stereopsis impairment related with perceptual motor disabilities. Behavioural disorders, in terms of emotional maturation and hyperactivity, were significantly more frequent in the study group. To prevent behavioural and learning problems at school, a complete longitudinal assessment including visual functions and perceptual motor abilities seems mandatory in preterm born children, even in the absence of neonatal brain disorders including abnormal cerebral ultrasound findings.

Introduction

There is enough evidence that children with very low birth weight (VLBW), even when not severely disabled, frequently present minor perceptual-motor, behavioural and cognitive disorders [1], [2], [3], [4], [5], [6], [7], [8], [9]. A visual impairment has also been [10] reported and its relationship with coexistent perceptual-motor disorders was emphasized [11].

The relevance of detecting minor deficits at preschool age is obvious in order to try to prevent learning and behaviour problems whose risk in these cases is high [12], [13].

The aim of our study was to provide additional information on perceptual-motor and cognitive development as well as behavioural patterns at preschool age in children with VLBW and without evident neonatal brain disorders, based on normal sonography findings. The following parameters were considered:

  • (a) visual functions and perceptual-motor abilities, and later intelligence;

  • (b) attention abilities and their possible impact on other skills;

  • (c) the presence of behavioural disorders, and their relationship with perceptual-motor, visual and cognitive problems;

  • (d) the possible role of some neonatal features, as weight and gestational age, on the development of the assessed abilities.

Section snippets

Patients and methods

Between 1991 and 1993, 85 infants with birthweight lower than 1500 g were discharged from the NICU of Policlinico Gemelli (UCSC, School of Medicine). We excluded all children affected by frankly disabling conditions like cerebral palsy, mental retardation, blindness or deafness, and those born with specific diseases such as infectious and metabolic diseases, central nervous system (CNS) malformations and known genetic syndromes; furthermore, all the newborns with abnormal ultrasound findings,

WPPSI (Table 1)

The mean full I.Q. scale was in the normal range: 99.9 with SD of 16.0. We did not find any significant difference between performance quotient (100.82; SD: 16.92) and verbal quotient (99.4; SD: 17.4); furthermore, there was no specific failure in any of the ten WPPSI subscales.

Movement assessment battery for children

In the 34 VLBW children examined, the majority (24 cases, 70.6%) had abnormal or borderline scores and were, therefore, considered as having perceptual-motor problems. The comparison with the control group performed by

Discussion

There is evidence that children with VLBW are at major risk of severe motor, perceptual, cognitive and behavioural disorders due to frequent perinatal brain damage. Furthermore, also in the other surviving infants with VLBW, minor neurological problems are found in a proportion significantly higher than in the general population; there can be minor either motor [5], [21] perceptual [22] or cognitive [23] disorders. Yet, there is a lack of consistency in literature data both in the reported

Acknowledgements

This study was supported by a grant of Italian MURST 40% 1997/98.

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