News Release

Testing gives glimpse of future learning problems, study says

Peer-Reviewed Publication

Ohio State University

COLUMBUS, Ohio - Health problems aside, it's a parent's greatest fear: that their prematurely born baby will have some sort of serious learning or behavioral problem down the road. Yet a recent study suggests that a specific test used to gauge developmental abilities -- sometimes given to children before they enter school -- can give parents a good idea of whether or not their child is at risk for future problems.

In fact, the study found that 4-year-old children who were unable to finish the test because of behavioral-related problems were twice as likely to receive help when they entered school than were those children who had completed the test successfully. Some children didn't complete the test because they were shy or refused to talk, and others became uncooperative during testing.

"Some studies have estimated that as many as 40 to 50 percent of children born prematurely will have some sort of learning disability," said Diane Langkamp, co-author of the study and an assistant professor of pediatrics at Ohio State University. "Our work confirms this and shows that signs of disability appear before children enter school."

The research appears in a recent issue of The Journal of Pediatrics. Langkamp co-wrote the study with Jane Brazy, a pediatric physician at the University of Wisconsin. None of the children in the current study suffered from the major health problems that sometimes affect premature babies, such as cerebral palsy, chromosomal abnormalities, hearing loss or mental retardation.

"In a sense, the children in our study represented a kind of 'sleeper phenomenon' -- none had noticeable disabilities," Langkamp said. "There's no way to pick up on some of these developmental problems in the first two years of life, so many of these children showed no outward signs of disabilities." The researchers assessed the social and emotional development of 105 children aged 7 to 10. Each child had been born prematurely. In this study, that was defined as being born during or before the thirty-second week of pregnancy. All children had been patients in the University of Wisconsin neonatal intensive care unit.

At 3 to 4 years old, each child had returned to the neonatal follow-up clinic for developmental testing. Using the McCarthy Scales of Children's Abilities, the researchers measured each child's cognitive, verbal, spatial, memory and motor abilities. The researchers came up with a score for each child, called the General Cognitive Index (GCI). Children were classified as untestable if a GCI score could not be calculated.

Twenty-four of the 105 children were considered untestable, because of shyness or lack of cooperation. On average, these children were born a week earlier (28.8 weeks) than the children who had fully cooperated with developmental testing (29.9 weeks).

When all the children reached school age -- between 7 and 10 years old -- the researchers sent each family three questionnaires. Two were for the parents, and the third was for the child's teacher. The parents received the Child's Behavior Checklist, which focused on the child's behavior, as well as a two-page questionnaire which asked about the child's use of special educational services, overall health, and demographic information. The teachers were asked to assess each child's behavior in the classroom.

According to the parents' reports, the children who were in the untestable group were more likely to have received special educational services in school. Twice as many children in the untestable group had received such help (45 percent vs. 20 percent). The teachers reported that the untestable children had more behavioral problems overall.

"A low score on the McCarthy test and failing to cooperate during testing were both highly associated with school problems," Langkamp said.

Concerned parents can request that the school test their child. "Parents of prematurely born children should make sure that their child receives a good pre-kindergarten evaluation," Langkamp said. "If their 3- or 4-year-old has not cooperated for developmental testing, it might be worthwhile to look into educational testing right before that child enters kindergarten."

The research was supported by a grant from the Meriter Foundation.

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Contact: Diane Langkamp, (614) 722-4953; dlangkam@chi.osu.edu
Written by Holly Wagner, (614) 292-8310; wagner.235@osu.edu


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