The behavioral and developmental outcome of extremely low birth weight infants: a focus on emotional regulation

This study investigated the developmental outcome of children born with extremely low birth weight ( < 1000 grams) as compared to those children born at full term. Descriptive statistics for behavioral outcome, focusing on aspects of emotional regulation were also used to explore the long-term behavioral functioning of children born with extreme prematurity. Retrospective data from The Low Birth Weight Clinic at Children's Medical Center of Dallas was collected and compared to normative data from The Psychological Corporation used during the 1993 standardization of the Bayley Scales of Infant Development- Second Edition (BSID-II). The Mental Development Index (MDI), Psychomotor Development Index (PDI) and behavioral percentiles for five factors (Orientation, Emotional Regulation, Motor Quality and Total Behavior Score) were collected for 140 children between the ages of 18 and 25 months. Although The Psychological Corporation could not provide comparison data for the behavioral percentiles for children born at full term, descriptive data was explored with respect to frequency of questionable and non-optimal ratings in children born with extremely low birth weight (ELBW). These children were matched in terms of gender, age, race, ethnicity and maternal education. Results of this study indicated significant differences between the ELBW group and those children born at full term with respect to mental and psychomotor development. This appears consistent with previous research investigating the long-term outcome of children born prematurely. Seventeen percent of the children within the ELBW group performed within a Questionable or Non-Optimal range on the behavioral factor, Emotional Regulation. Emotional regulation has been linked to the neuropsychological construct of executive functioning. Children with executive function difficulties are often diagnosed with Attention-Deficit/Hyperactivity Disorder (ADHD). ADHD is estimated to occur in approximately 3-5% of the general population, so a percentage of 17% appears noteworthy. When considering the Total Behavior Score on the BSID-II, 21% of the children within the ELBW group performed within a Questionable or Non-Optimal range. Again, this appears exceptional when compared to previous research investigating the incidence of behavioral disturbance within the general population. Further study in the area of behavioral outcome for children born with ELBW would be advantageous.