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Glen P. Aylward, Commentary: Environmental Influences: Issues of Timing and Type, Journal of Pediatric Psychology, Volume 35, Issue 3, April 2010, Pages 284–285, https://doi.org/10.1093/jpepsy/jsp079
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Long-term neurodevelopmental outcome is frequently considered the benchmark in determining the natural sequelae of biologic risks, or the efficacy of various medical interventions in infants born at extremely low birth weight (ELBW; Aylward, 2005). Initially, primary emphasis in outcome studies was placed on major disabilities: moderate/severe intellectual disabilities, sensorineural hearing loss/blindness, cerebral palsy, and epilepsy. However, increasing numbers of “non-disabled” survivors subsequently were found to display problems at later ages. These high prevalence/low severity dysfunctions include learning disabilities (written expression, math, reading), borderline/low average IQ scores, neuropsychological deficits (e.g., visual motor integration, executive function) and behavior problems (Aylward, 2002, 2005). These dysfunctions occur in 50–70% of those born at ELBW, and 70% of these children require special education services (Taylor, Klein, & Hack, 2000). High prevalence/low severity dysfunctions tend to aggregate and work synergistically (Aylward, 2002, 2005).
While major disabilities can be identified early, high prevalence/low severity dysfunctions often become more obvious as the child grows older. Therefore, the social, ethnic, and educational backgrounds of parents have a greater likelihood of influencing these problems in longitudinal follow-up. This situation has an impact on casual inferences by introducing risk and protective factors as mediators and moderators of ELBW and later outcomes (Rose, Holmbeck, Millstein Coakley, & Franks, 2004).
- epilepsy
- blindness
- outcomes research
- environmental factors
- benchmarking
- cerebral palsy
- child psychology
- disabled persons
- special education
- educational status
- environmental exposure
- sensorineural hearing loss
- learning disorder
- mathematics
- outcome assessment
- peer group
- socioeconomic factors
- survivors
- child care
- child care service
- genetics
- science of nutrition
- poverty
- cognitive impairment
- protective factors
- executive functioning
- learning disabilities
- disability
- mental retardation, severe
- behavioral problems
- extremely low birth weight infant
- toxicant
- therapeutic intervention
- cognitive ability
- inference
- academic achievement
- neighborhood
- high schools
- written expression
- visual motor coordination
