According to a latest study, published in American journal ‘Pediatrics’ but conducted in New Zealand by leading Professor Lianne Woodward, there is a real need for the health and education system to adopt a more proactive approach in addressing the developmental needs of children born very pre-term.
Almost half of very pre-term (babies born between 28 and 32 weeks) will develop cognitive impairments ranging from mild to severe, according to the findings from Woodward’s latest study.
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 (very pre-term) 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.”
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. 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. 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.