In the current study, a strong correlation was found between MDI measured at 2 years of age and FSIQ measured at the age of 5 years, suggesting that early assessment of cognitive development is significantly associated with cognitive development at least up to the age of 5 years. The stability of the classification of cognitive outcome was high in normally developing and in significantly delayed groups. This finding implies that early assessment of cognitive development is clinically important. Children with significant developmental problems should be addressed to appropriate diagnostic, etiologic, and rehabilitation services as early as possible in their development.
Di penelitian ini, ada hub yg kuat ditemukan antara pengukuran mdi pada uia 2 tahun dan pengukuran fsiq pada umur tahun. Ass di awal awal pada prkembangan kognitif adalah scr signifikan dhubungkan dg perkembangan kognitif setidaknya pada usia 5 tahun. Kestabilan pada klasifikasi dampak kognitif adalah tinggi dalam perkembangan normal dan scr sig masuk kat terlambat.
Penemuan ini scr tdk langsung menunjukan bahwa ass pada awal thdp perkembangan kognitif scr clinically penting. Anak2 yg memunyai masalah perkembangn scr sig shrusnya diberikan penanganan yg tepat sejak awal sebisa mungkin pd perkembangnnya.
Conversely, parents of children with milder problems should also be provided with counseling to support their child’s possible specific needs.
Sebaliknya ortu anak anak dg permsalah yg lebih menengah shrusnya juga di berikan konseling untuk men support kebtuhan spesifik yg mungkin dibuthkan si anak
Cognitive development of the currentstudy population has been shown to berelatively good, as the meanvalue of MDIhas been at the level of BSID-II norms atthe age of 2 years.Our study confirmed this developmental pattern because VLBW children performed at the level of WPPSI-R norms. Despite thisfinding, the difference to control groupwas almost 1 SD also at the age of 5years. Our control group was, however, selected because it included only healthy-born infants excluding all pretermand small for gestational age infants, those requiring NICU admission for any reason, and those who wereexposed antenatally to alcohol or illicitdrugs. In addition, the average education level in Finnish society is high, free health care is provided to all, and the variation in socioeconomic background is smaller than in many other countries.
Therefore, these findings may not be directly generalized to other populations. Importantly, however, the socioeconomic background factors (level of parental education, which correlates strongly with socioeconomic status) did not differ between VLBW and term infants, which served to differentiate the VLBW population in the current study from those of many other countries. This condition makes it possible to study the impact of prematurity without the confounding effects of socioeconomic factors. Children did not take part in any structured intervention programin this study. However, all of the infants who had a significant motor delay received physiotherapy. If there were any concerns about the development or the behavior of the child either at the age of 2 or 5 years, he or she was referred to appropriate local rehabilitation services. In Finland, most children enter the communal day care system. This system provides appropriate support for all children with developmental or behavioral concerns, and no IQ discrepancy is required for inclusion. Trained nursery school teachers support their development in daily play situations.
Oleh krn itu, penemuan ini tdk bs langsung di generalisasikan pada populasi. Faktor sosial ekonomi pada populasidi sudiini dibuat sama, sehingga menurunkan biasdr faktor sosial eonomi.
Di finlandia sbgian besar anak anak menerima psikoterapi terutama anak anak yg eaami keerlmabatan perkembangan.
The strengths of this study include high coverage of the VLBW children with a long follow-up period. Standardized methods were used for follow-up, and a regional control group was used in addition to the normative data of the BSID-II and WPPSI-R. Different psychologists conducted the assessment in 2 different time-points to avoid the bias of the previous assessment. Strong correlation was found despite the fact that different methods had to be used to measure cognitive development at different age point, as both methods cover only limited age-span. However, both methods provide information about the individual development compared with age-appropriate normative data, and they use the same scaling. An additional strength was that all children participated in the assessment within a very strict time limit. Timing of theassessment was chosen to be both developmentally and clinically relevant. From the developmental point of view, 2 years is an interesting time window as motor development is less dominant and language development is in a very active phase. Clinically, it is important to identify those children who have developmental problems as early and as accurately as possible to provide them with appropriate services. Five years is a more reliable age of assessment considering the later academic performance at school age, but there is still time for preventive interventions if child is at risk for academic failure.
Kekuatan stud ini adalah mengcover anak anak vlbw dg fllow up yg lama. Metode standar yg digunakan untuk mem follow up adalah data data normatif dr bsid edisi 2 dan wppsi-r. Perbedaan psikologis dihubungkan dg ass dalam 2wkt yg berbeda untuk menghindari bias dr ass sebelumnya. Hub yg kuat ditemukan meskipun faktanya metode yg berbeda hanya mng cover masa usia yg terbatas. Bgmnpun kedua metode menyediakan info ttg individual perkembangan dg membandingkan kesesuaian usia dan mereka menggunakan skala yg sama.
meneydiakan mereka peleyanan yg sesuai. Tahun adalah usia yg mampu untuk meg ass demi mempertimbangakn performa akademik di usia usia sekolah, namun masih ada waktu untuk mencegahnya
Study limitations include that the BSID-II and WPPSI-R were used instead of the new versions (the Bayley Scales of Infant and Toddler Development, Third Edition, and the third edition of the WPPSI), as these tests were not available in Finland at the time of the study. It is also important to stress that measures of cognitive development, such as used here, do not allow inferences about neuropsychological deficits that can be found with more specificmeasures or that may become evident only later in the child’s development. Low cognitive capacity is usually accompanied
with neuropsychological difficulties, but average cognition does not imply that one would be free from more specific neuropsychological problems. Therefore, other methods are also needed to complement follow-up of at-risk preterm children. Long-term follow-up is needed to identify specific problems that may become evident only later in the development. However, it is important to offer families with as accurate information as it is possible to gain at the child’s different developmental stages.
Meskiun daam studi ini tdk menark kesiulan terkait kekurangan neuropsychological yg dpt ditemukan dg pengukuran yg lebih spesifik atau y mungin menjadi bukti pada perkembangan anak. Kapasitas kognitif yg rendah biasanya disertai dg kesulitan neuropsychological, namun rata rata kognitif tdk menyaakan tdk scr implisit (gamblang)....
Bgmnpun metode lain juga dibutuhkan untuk melengkapi follow up pada masasblm anak anak yg beresiko. Masa yg ama untuk mem follow up dibutuhkan untuk menidentifikasi masalah spesifik yg mungkin enajdi bukti dr perkembnagan. Bgmnpun penting bg keluarga dalam berperan di erkembangan anak
CONCLUSIONS
The current study revealed that the cognitive outcome of a regional VLBW cohort measured at the age of 2 years was significantly associated with cognitive outcome at the age of 5 years. We suggest that a well-conducted assessment is relevant and valuable also at the early age, making it possible to support those children with developmental problems. However, at the same time, we stress the importance to followup these at-risk children longitudinally and with methods covering both cognitive and neuropsychological development.
