Behavioral Deficits at 18-22 Months of Age Are Associated with Early Cerebellar Injury and Cognitive and Language Performance in Children Born Extremely Preterm

Eunice Kennedy Shriver National Institute of Child Health and Development Neonatal Research Network

Research output: Contribution to journalArticle

Abstract

Objective: To investigate associations in toddlers born extremely preterm (<28 weeks) between neonatal neuroimaging and 18- to 22-month developmental and behavioral outcomes. Study design: Cohort analysis from the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network Surfactant Positive Airway Pressure and Pulse Oximetry Trial Neuroimaging and Neurodevelopmental Outcomes Study of infants born extremely preterm. Subjects underwent cranial ultrasonography and near-term magnetic resonance imaging (MRI). At 18-22 months of corrected age, the assessment included the Brief Infant Toddler Social Emotional Assessment (BITSEA) Problem and Competence Scale scores and the Bayley Scales of Infant Development, Third Edition (Bayley-III). The BITSEA Problem Scale assesses dysregulation; the Competence Scale assesses social-emotional competence. We examined associations of Problem and Competence scores and positive screen rates with cranial ultrasonography and near-term MRI. Mean BITSEA and Bayley-III scores were compared using ANOVA and positive screen rates with the χ2 test. We computed correlations between BITSEA and Bayley-III scores. Results: Of the 397 children, positive BITSEA screens were found in 34% for the Problem score and 26% for the Competence score. Presence of lesions on near-term MRI that included cerebellar lesions were significantly associated with lower BITSEA Competence but not with Problem scores; Competence scores were inversely related to the presence/significance of lesions. Positive screens on Competence scores and on both Competence and Problem scores were significantly associated with Bayley-III cognitive and language scores <85 (P <.001). Conclusions: Social–emotional competence contributes to deficits in cognitive and language development. Presence of injury on near-term MRI that includes cerebellar lesions is associated with later social–emotional competence and may be a useful predictor to guide early assessment and intervention. Trial registration: ClinicalTrials.gov: NCT00063063 and NCT00233324.

Original languageEnglish (US)
JournalJournal of Pediatrics
DOIs
StateAccepted/In press - Jan 1 2018

Fingerprint

Mental Competency
Language
Wounds and Injuries
Magnetic Resonance Imaging
Neuroimaging
Ultrasonography
National Institute of Child Health and Human Development (U.S.)
Language Development
Oximetry
Child Development
Surface-Active Agents
Analysis of Variance
Cohort Studies
Outcome Assessment (Health Care)
Pressure
Research

Keywords

  • behavior
  • extremely preterm
  • neuroimaging

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Behavioral Deficits at 18-22 Months of Age Are Associated with Early Cerebellar Injury and Cognitive and Language Performance in Children Born Extremely Preterm. / Eunice Kennedy Shriver National Institute of Child Health and Development Neonatal Research Network.

In: Journal of Pediatrics, 01.01.2018.

Research output: Contribution to journalArticle

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title = "Behavioral Deficits at 18-22 Months of Age Are Associated with Early Cerebellar Injury and Cognitive and Language Performance in Children Born Extremely Preterm",
abstract = "Objective: To investigate associations in toddlers born extremely preterm (<28 weeks) between neonatal neuroimaging and 18- to 22-month developmental and behavioral outcomes. Study design: Cohort analysis from the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network Surfactant Positive Airway Pressure and Pulse Oximetry Trial Neuroimaging and Neurodevelopmental Outcomes Study of infants born extremely preterm. Subjects underwent cranial ultrasonography and near-term magnetic resonance imaging (MRI). At 18-22 months of corrected age, the assessment included the Brief Infant Toddler Social Emotional Assessment (BITSEA) Problem and Competence Scale scores and the Bayley Scales of Infant Development, Third Edition (Bayley-III). The BITSEA Problem Scale assesses dysregulation; the Competence Scale assesses social-emotional competence. We examined associations of Problem and Competence scores and positive screen rates with cranial ultrasonography and near-term MRI. Mean BITSEA and Bayley-III scores were compared using ANOVA and positive screen rates with the χ2 test. We computed correlations between BITSEA and Bayley-III scores. Results: Of the 397 children, positive BITSEA screens were found in 34{\%} for the Problem score and 26{\%} for the Competence score. Presence of lesions on near-term MRI that included cerebellar lesions were significantly associated with lower BITSEA Competence but not with Problem scores; Competence scores were inversely related to the presence/significance of lesions. Positive screens on Competence scores and on both Competence and Problem scores were significantly associated with Bayley-III cognitive and language scores <85 (P <.001). Conclusions: Social–emotional competence contributes to deficits in cognitive and language development. Presence of injury on near-term MRI that includes cerebellar lesions is associated with later social–emotional competence and may be a useful predictor to guide early assessment and intervention. Trial registration: ClinicalTrials.gov: NCT00063063 and NCT00233324.",
keywords = "behavior, extremely preterm, neuroimaging",
author = "{Eunice Kennedy Shriver National Institute of Child Health and Development Neonatal Research Network} and Duncan, {Andrea F.} and Bann, {Carla M.} and Allison Dempsey and Myriam Peralta-Carcelen and Susan Hintz and Jobe, {Alan H.} and Caplan, {Michael S.} and Laptook, {Abbot R.} and Vohr, {Betty R.} and William Oh and Hensman, {Angelita M.} and Barbara Alksninis and Dawn Andrews and Kristen Angela and Susan Barnett and Bill Cashore and Melinda Caskey and Kim Francis and Dan Gingras and Katharine Johnson and Leach, {Theresa M.} and Stephens, {Bonnie E.} and Watson, {Victoria E.} and Walsh, {Michele C.} and Fanaroff, {Avroy A.} and Newman, {Nancy S.} and Wilson-Costello, {Deanne E.} and Siner, {Bonnie S.} and Arlene Zadell and Julie DiFiore and Monika Bhola and Friedman, {Harriet G.} and Gulgun Yalcinkaya and Dorothy Bulas and Goldberg, {Ronald N.} and Cotten, {C. Michael} and Goldstein, {Ricki F.} and Patricia Ashley and Auten, {Kathy J.} and Fisher, {Kimberley A.} and Foy, {Katherine A.} and Freedman, {Sharon F.} and Gustafson, {Kathryn E.} and Lohmeyer, {Melody B.} and Malcolm, {William F.} and Wallace, {David K.} and Carlton, {David P.} and Stoll, {Barbara J.} and Shahnaz Duara and Bauer, {Charles R}",
year = "2018",
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T1 - Behavioral Deficits at 18-22 Months of Age Are Associated with Early Cerebellar Injury and Cognitive and Language Performance in Children Born Extremely Preterm

AU - Eunice Kennedy Shriver National Institute of Child Health and Development Neonatal Research Network

AU - Duncan, Andrea F.

AU - Bann, Carla M.

AU - Dempsey, Allison

AU - Peralta-Carcelen, Myriam

AU - Hintz, Susan

AU - Jobe, Alan H.

AU - Caplan, Michael S.

AU - Laptook, Abbot R.

AU - Vohr, Betty R.

AU - Oh, William

AU - Hensman, Angelita M.

AU - Alksninis, Barbara

AU - Andrews, Dawn

AU - Angela, Kristen

AU - Barnett, Susan

AU - Cashore, Bill

AU - Caskey, Melinda

AU - Francis, Kim

AU - Gingras, Dan

AU - Johnson, Katharine

AU - Leach, Theresa M.

AU - Stephens, Bonnie E.

AU - Watson, Victoria E.

AU - Walsh, Michele C.

AU - Fanaroff, Avroy A.

AU - Newman, Nancy S.

AU - Wilson-Costello, Deanne E.

AU - Siner, Bonnie S.

AU - Zadell, Arlene

AU - DiFiore, Julie

AU - Bhola, Monika

AU - Friedman, Harriet G.

AU - Yalcinkaya, Gulgun

AU - Bulas, Dorothy

AU - Goldberg, Ronald N.

AU - Cotten, C. Michael

AU - Goldstein, Ricki F.

AU - Ashley, Patricia

AU - Auten, Kathy J.

AU - Fisher, Kimberley A.

AU - Foy, Katherine A.

AU - Freedman, Sharon F.

AU - Gustafson, Kathryn E.

AU - Lohmeyer, Melody B.

AU - Malcolm, William F.

AU - Wallace, David K.

AU - Carlton, David P.

AU - Stoll, Barbara J.

AU - Duara, Shahnaz

AU - Bauer, Charles R

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Objective: To investigate associations in toddlers born extremely preterm (<28 weeks) between neonatal neuroimaging and 18- to 22-month developmental and behavioral outcomes. Study design: Cohort analysis from the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network Surfactant Positive Airway Pressure and Pulse Oximetry Trial Neuroimaging and Neurodevelopmental Outcomes Study of infants born extremely preterm. Subjects underwent cranial ultrasonography and near-term magnetic resonance imaging (MRI). At 18-22 months of corrected age, the assessment included the Brief Infant Toddler Social Emotional Assessment (BITSEA) Problem and Competence Scale scores and the Bayley Scales of Infant Development, Third Edition (Bayley-III). The BITSEA Problem Scale assesses dysregulation; the Competence Scale assesses social-emotional competence. We examined associations of Problem and Competence scores and positive screen rates with cranial ultrasonography and near-term MRI. Mean BITSEA and Bayley-III scores were compared using ANOVA and positive screen rates with the χ2 test. We computed correlations between BITSEA and Bayley-III scores. Results: Of the 397 children, positive BITSEA screens were found in 34% for the Problem score and 26% for the Competence score. Presence of lesions on near-term MRI that included cerebellar lesions were significantly associated with lower BITSEA Competence but not with Problem scores; Competence scores were inversely related to the presence/significance of lesions. Positive screens on Competence scores and on both Competence and Problem scores were significantly associated with Bayley-III cognitive and language scores <85 (P <.001). Conclusions: Social–emotional competence contributes to deficits in cognitive and language development. Presence of injury on near-term MRI that includes cerebellar lesions is associated with later social–emotional competence and may be a useful predictor to guide early assessment and intervention. Trial registration: ClinicalTrials.gov: NCT00063063 and NCT00233324.

AB - Objective: To investigate associations in toddlers born extremely preterm (<28 weeks) between neonatal neuroimaging and 18- to 22-month developmental and behavioral outcomes. Study design: Cohort analysis from the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network Surfactant Positive Airway Pressure and Pulse Oximetry Trial Neuroimaging and Neurodevelopmental Outcomes Study of infants born extremely preterm. Subjects underwent cranial ultrasonography and near-term magnetic resonance imaging (MRI). At 18-22 months of corrected age, the assessment included the Brief Infant Toddler Social Emotional Assessment (BITSEA) Problem and Competence Scale scores and the Bayley Scales of Infant Development, Third Edition (Bayley-III). The BITSEA Problem Scale assesses dysregulation; the Competence Scale assesses social-emotional competence. We examined associations of Problem and Competence scores and positive screen rates with cranial ultrasonography and near-term MRI. Mean BITSEA and Bayley-III scores were compared using ANOVA and positive screen rates with the χ2 test. We computed correlations between BITSEA and Bayley-III scores. Results: Of the 397 children, positive BITSEA screens were found in 34% for the Problem score and 26% for the Competence score. Presence of lesions on near-term MRI that included cerebellar lesions were significantly associated with lower BITSEA Competence but not with Problem scores; Competence scores were inversely related to the presence/significance of lesions. Positive screens on Competence scores and on both Competence and Problem scores were significantly associated with Bayley-III cognitive and language scores <85 (P <.001). Conclusions: Social–emotional competence contributes to deficits in cognitive and language development. Presence of injury on near-term MRI that includes cerebellar lesions is associated with later social–emotional competence and may be a useful predictor to guide early assessment and intervention. Trial registration: ClinicalTrials.gov: NCT00063063 and NCT00233324.

KW - behavior

KW - extremely preterm

KW - neuroimaging

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U2 - 10.1016/j.jpeds.2018.08.059

DO - 10.1016/j.jpeds.2018.08.059

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JO - Journal of Pediatrics

JF - Journal of Pediatrics

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