Functioning of very preterm born children at preschool age: Follow-up of an early intervention programme

The thesis presents the effects of the multicentre RCT on the Infant Behavioral Assessment and Intervention Program (IBAIP) in children born preterm, with a gestation of less than 32 weeks and/or a birth weight below 1500 grams (VLBW), at the age of school entry. Eighty-six infants were enrolled in post-discharge IBAIP until 6 months corrected age and 90 infants received standard care. Forty-one term born children were assessed for comparison.
At 44 months of corrected age, 3 years after the end of the intervention, 86 % of the original cohort was examined: 76 children of the intervention group and 75 children of the control group. Assessments included motor development, behaviour problems, executive functioning, cognitive skills and daily activities. The intervention group performed significantly better than the control group on motor development: independency in mobility in daily activities was improved. There were no significant differences between the intervention and control group on executive functioning, behaviour problems and cognitive skills.
Compared to term born children the VLBW children performed significantly worse with respect to executive functioning, visual attention, attention problems, figure-ground perception and daily activities. The VLBW children had significantly more multiple developmental difficulties (more than one score below 1 SD) than their term born peers. Having multiple developmental difficulties is associated with less favourable school outcome at 5.5 years. The study found that 19% of the VLBW children, without cerebral palsy, had a disability in daily activities (score < 2 SD) at the age of school entry.
Suggestions to improve the care of VLBW children are given.