Academic journal article The Journal of Special Education and Rehabilitation

Psychomotor Development in Premature Infants until the End of Their Third Year of Life

Academic journal article The Journal of Special Education and Rehabilitation

Psychomotor Development in Premature Infants until the End of Their Third Year of Life

Article excerpt

Received: 20. 04. 2009

Accepted: 18. 05. 2009

Original article

Abstract

Psychomotor development in premature infants has specific characteristics with increased tendency towards neuro-developmental difficulties, such as the fact that certain percent of the developmentally challenged people belongs in this category of children.

Many factors contribute to the neuro-developmental difficulties in premature infants. A large number of studies have shown that the birth weight (BW) and gestational age (GA) have strong correlation with the neuro-developmental outcome.

In order to establish the general developmental outcome and the developmental outcome in specific areas of early development, that is the first three years of life in preemies, we have conducted a research on our own population. We conducted a longitudinal study on 20 premature newborns with very low birth weight (VLBW), with a follow-up period from 4 weeks CGA until 36 weeks GA.

The research results showed that the largest difference in developmental areas between the group of premature infants with VLBW and the control group is present at the end of the 36th month of life and the general development quotient (GDQ) in the premature group was significantly lower during the whole follow-up period, except at the end of month 4 - in different developmental areas. We also concluded that 20% of the premature infants with VLBW have developmental difficulties and severe difficulties in their motor development.

Key words: premature infants with VLBW, Griffiths Mental Development Scales, GDQ, developmental areas.

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Introduction

Neuro-developmental Characteristics of Premature Newborns

The neurological system of the preemie, as a result of its immaturity, is exposed to constant danger in an anatomical, chemical and physical manner. The uncompleted maturity of its organism accounts for the difficult adaptation to the outer environmental stress, which, on the other hand, contributes to bleeding and PVL malations in the CNS - the biggest issue of neuro-developmental difficulties in this group of high-risk infants. The white brain matter is especially sensitive to this kind of problems. These afflictions are strongly associated with motor problems. Preemies are a vulnerable group of children and their development in large extent depends on their maturity, the birth conditions and the support given during the early developmental period. The baby's adaptive ability is underdeveloped in the new environment as a result of its immature organism. Since its birth the baby is exposed to plenty of tactile stimuli, many of which are painful.

During the last three decades, neonatal mortality notes dramatic fall, especially in preemies with GA lower than 32 GW and in extreme preemies (GA lower than 28 GW). This condition raises another issue: Does the mortality decrease or increase the number of developmentally challenged persons? The answer should be looked in the longitudinal research.

Prematurity is often related to longer periods of hospitalization, separation from the parents, and deprivation of parental touch. It is also related to fear for life and consequences on the development, which results in anxiety at parents and taking protective attitude towards the child.

In early diagnostics, 40-80% of premature infants are diagnosed with transitory neurological difficulties accompanied by hypotonic or hypertonic signs that should disappear in the first 3-9 months of life. In two thirds of the preemies with very low birth weight (VLBW) the transitory neurological difficulties should disappear with continuous development of the infant. Some of these children have motor balance and coordination difficulties for a longer period of time. Studies show that premature infants with VLBW (.1500gr.) in their early developmental period suffer from severe developmental difficulties such as Cerbral Palsy, mental handicap, etc. …

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