Predicting the future of premature babies

Testing previews future learning problems

Health problems aside, it's a parent's greatest fear: that their prematurely born baby will have some sort of serious learning or behavioral problem down the road.

Yet a recent study suggests that a specific test used to gauge developmental abilities -- sometimes given to children before they enter school -- can give parents a good idea of whether or not their child is at risk for future problems.

In fact, the study found that 4-year-old children who were unable to finish the test because of behavioral-related problems were twice as likely to receive help when they entered school than were those children who had completed the test successfully. Some children didn't complete the test because they were shy or refused to talk, and others became uncooperative during testing.

By Kevin Fitzsimons

Diane Langkamp in her office at Children's Hospital.

"Some studies have estimated that as many as 40 to 50 percent of children born prematurely will have some sort of learning disability," said Diane Langkamp, co-author of the study and an assistant professor of pediatrics at Ohio State. "Our work confirms this and shows that signs of disability appear before children enter school."

The research appears in a recent issue of The Journal of Pediatrics. Langkamp co-wrote the study with Jane Brazy, a pediatric physician at the University of Wisconsin. None of the children in the current study suffered from the major health problems that sometimes affect premature babies, such as cerebral palsy, chromosomal abnormalities, hearing loss or mental retardation.

"In a sense, the children in our study represented a kind of 'sleeper phenomenon' -- none had noticeable disabilities," Langkamp said. "There's no way to pick up on some of these developmental problems in the first two years of life, so many of these children showed no outward signs of disabilities."

The researchers assessed the social and emotional development of 105 children aged 7 to 10. Each child had been born prematurely. In this study, that was defined as being born during or before the 32nd week of pregnancy. All children had been patients in the University of Wisconsin neonatal intensive care unit.

At 3 to 4 years old, each child had returned to the neonatal follow-up clinic for developmental testing. Using the McCarthy Scales of Children's Abilities, the researchers measured each child's cognitive, verbal, spatial, memory and motor abilities. The researchers came up with a score for each child, called the General Cognitive Index (GCI). Children were classified as untestable if a GCI score could not be calculated.

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