Academic journal article The Spanish Journal of Psychology

Neuropsychological Evaluation of High-Risk Children from Birth to Seven Years of Age

Academic journal article The Spanish Journal of Psychology

Neuropsychological Evaluation of High-Risk Children from Birth to Seven Years of Age

Article excerpt

High Risk Children (HRC) are those with an increased risk of abnormal development due to any factor affecting neurological growth. Those factors have been the focus of most studies in this area. However, little is known about their long-term consequences over the course of child development. Objectives: the goal was to study the cognitive, emotional and academic outcomes of 7-year-old children diagnosed as HRC at birth. Method: We compared 14 HRC and 20 healthy children using the WISC-IV, BASC and Brunet-Lezine tests. Results: HRC showed cognitive, emotional and academic deficits compared with healthy children. However, Brunet-Lezine scores obtained over the course of development (6, 12, 18 and 24 months) were not predictive of the children's' current psychological status. Conclusions: long-term follow-up with HRC should be maintained until 7 years of age, at which point an appropriate treatment should be implemented.

Keywords: cognitive, emotional, academic and behavioral assessment, high-risk children, follow-up.

Los niños de alto riesgo (NAR) tienen un mayor riesgo de desarrollo anormal debido a factores relacionados con el crecimiento neurológico. Aunque se han investigado la influencia de muchos de estos factores, se conoce muy poco sobre su efecto a largo plazo en el desarrollo del niño. Objetivo: el objetivo fue investigar el estado cognitivo, emocional y académico de niños de 7 años diagnosticados como NAR en el momento del nacimiento. Metodología: Se compararon 14 niños diagnosticados como NAR con 20 niños sanos en los tests WISC-IV, el BASC y el Brunet-Lezine. Resultados: Los niños NAR mostraron deterioro cognitivo, emocional y académico comparados con los niños sanos. Por otro lado, las puntuaciones del Brunet-Lezine obtenidas a los 6, 12, 18 y 24 meses no fueron predictivas del estado psicológico de los niños a los 7 años. Conclusiones: el seguimiento a niños diagnosticados con NAR debería mantenerse, al menos, hasta los 7 años y deberían recibir un tratamiento adecuado.

Palabras clave: evaluación cognitiva, emocional, académica, niños de alto riesgo, seguimiento.

Children labeled high-risk are those that, due to pre, peri or postnatal antecedents, have a higher probability of presenting with either transitory or permanent alterations during development. Specifically, these alterations have to do with adverse situations in the socio-familial sphere and/or certain genetic and biological predispositions, such as intrauterine infections, premature birth, neonatal interventions, the occurrence and severity of peri or neonatal illnesses, malformations, hypoxia, cerebral hemorrhages and postnatal infections (Grupo de Atención Temprana [GAT], 2000; Kumar et al., 2008).

The number of at-risk births seems to increase with each year, first and foremost those involving babies born before the 37th week of gestation, and those with asphyxia; Hamilton, Martin & Ventura, 2006; Revage et al., 2008). At-risk birth may be associated with complications in central nervous system development, and with permanent lesions that make for a higher risk and frequency of intracranial hemorrhages, which for premature babies are associated with organic immaturity and consequently, difficulty regulating arterial pressure (Roze et al., 2009. The more immature a child's brain is, the more vulnerable it is to possible lesions, bearing consequences that may stay with him or her for the rest of their life (de Haan & Johnson 2003; Johnston, 2009; Stiles, 2008).

Recent research on children who are high-risk from birth indicates that though at the time of hospitalization, they appear to have achieved normal development, close to half later present with delayed cognitive abilities compared to children of the same age up to six years of age (Delobel-Ayoub et al., 2009 Johnson et al., 2009; Pharoah, Stevenson, & West, 2003). Survivors of premature birth experience a greater number of medical afflictions and a greater number of neuromotor, neurocognitive and behavioral problems (Aylward, 2005; Ashton, Lawrence, Adams, & Fleischman, 2009; Boardman et al. …

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