The Relationship Between Behavior Ratings and Concurrent and Subsequent Mental and Motor Performance in Toddlers Born at Extremely Low Birth Weight

Abstract

When predicting child developmental outcomes, reliance on children's scores on measures of developmental functioning alone might mask more subtle behavioral difficulties especially in children with developmental risk factors. The current study examined predictors and stability of examiner behavior ratings and their association with concurrent and subsequent mental and motor performance in toddlers born at extremely low birth weight. Toddlers were evaluated using the Behavior Rating scale (BRS) and the mental and psychomotor indexes of the Bayley-II at 18 and 30 months corrected age. BRS total and factor scores showed moderate stability between 18 and 30 months. These scores also predicted 30-month Mental Scale and Psychomotor Scale scores above and beyond prior mental and motor performance. Our findings suggest that early behavior ratings are associated with child mental and motor performance; therefore, behavior ratings might be useful in identifying toddlers at developmental risk and who might benefit from early intervention. Keywordsextremely low birth weight; Bayley; behavior ratings; performance Child performance on standardized measures of developmental functioning is a relatively consistent predictor of subsequent performance in similar domains within the first three years of life. Among typically developing children, behavior observations made by trained examiners are associated with developmental test performance (Banergee & Tamis-LeMonda, 2007;Cardon & Fulker, 1991;DiLalla et al., 1990;Field, Dempsey, & Shuman, 1979;Glutting, Youngstrom, Oakland, & Watkins, 1996;Matheny, 1980;Yarrow, Morgan, Jennings, Harmon, & Gaiter, 1982). Less is known, however, about the extent to which early ratings of child behavior during testing situations predict subsequent developmental functioning. In this study, we examined the relationship between ratings of toddler behavior and subsequent performance in a sample of children born at extremely low birth weight (ELBW).Children born at lower birth weight are at higher risk for behavioral and other impairments than other children (Anderson et al., 2003;Aylward, 2002;Constantinou et al., 2005;Lowe et al., 2005;Saigal et al., 2001;Sajaniemi, Hakamies-Blomqvist, Katainen, & von Wendt, 2001;Whitfield et al., 1997 18-and 30-month old toddlers who had been born at extremely low birth weight (≤ 1000g). These toddlers exhibited lower mean scores than their higher birth weight peers on standardized measures of mental and motor functioning (Aylward, 2002;Constantinou, Adamson-Macedo, Mirmiran, Ariagno, & Fleisher, 2005;Dezoete, MacArthur, & Tuck, 2003;Shankaran et al., 2004;Vohr et al., 2000;Vohr, Wright, Poole, & McDonald, 2005;Walsh et al., 2005). Recent studies have suggested that poor performance on these measures might be predicted by early deficits in behavior regulation including difficulty adapting to change, difficulty sustaining attention, increased activity level, increased need for examiner support, and decreased persistence in attempting to complete tasks (Anderson...

Prognostic factors for cerebral palsy and motor impairment in children born very preterm or very low birthweight: a systematic review

“…The main study design was prospective cohort ( n =26); there was also one case‐control study and one randomized controlled trial population . Of the 26 prospective cohorts, 12 were ascertained from all live births in a geographically defined region and nine were recruited from a single centre neonatal intensive care unit .…”

“…Six studies presented a risk factor analysis for motor impairment in children of all levels of disability and 10 studies in children free of major disability (Table ). The most common assessment used before 5 years was the Psychomotor Development Index from the Bayley Scales of Infant Development version II (BSID‐II) .…”

“…The risk factors emerging from the four studies reporting outcomes before 5 years for children of all levels of disability are summarized in Figure a. There were only two low to moderate risk of bias studies in this grouping and the results are dominated by the largest study .…”

Genetic and environmental influences on individual differences in emotion regulation and its relation to working memory in toddlerhood.

“…Although not a measure of elicited emotion regulation, the BRS emotion regulation factor has been successfully used in several prior studies of observed emotion regulation within a standard situation (e.g., Bocknek, Brophy-Herb, & Banerjee, 2009; Clark, Woodward, Horwood,& Moor, 2008; Halligan et al, in press; Lowe, Woodward, & Papile, 2005; Messinger et al, 2010; Porter, Wouden-Miller, Silva, & Porter, 2003; Raikes, Robinson, Bradley, Raikes, & Ayoub, 2007; Sylva et al, 2011). In contrast to typical emotion regulation episodes that are designed to artificially elicit frustration, in the present study both the play and test situations provided a more naturalistic measure of emotion regulation as reflected by their abilities to: modulate frustration with difficult tasks and with the removal of attractive test materials (i.e., expressed negative affect and frustration as the outcomes of their emotional modulation); to sustain attention to tasks so as to distract their attention away from their negative feelings (i.e., controlling their attentional processes); to maintain motivation in a series of tasks (i.e., persistence, and lower hypersensitivity) and socially adapt to the tester (i.e., more cooperation), both of which serve as the means of maintaining an appropriate emotional state during the sessions with the goal of completing various tasks; and to manage their high level of excitement when presented with attractive test materials (i.e., lower level of hyperactivity and frenetic movement).…”

Neurobehavior Related to Epigenetic Differences in Preterm Infants

“…Rates of cognitive impairment alone at 24 months in preterm infants, especially those born less than 32 weeks gestational age, range from 23 to 47% [2][3][4]. Behavior problems are also associated with lower cognitive scores [5]. Although improvements in cognitive scores have been seen by 8 years, preterm infants continued to score -0.5 to -1 standard deviations (SD) below their full-term peers.…”