Line Nadeau

Measuring participation in children with disabilities using the Assessment of Life Habits

The objectives of this study were: (1) to examine the psychometric properties of the Assessment of Life Habits (LIFE‐H) for children; and (2) to draw a profile of the level of participation among children of 5 to 13 years of age with various impairments. The research team adapted the adult version of the LIFE‐H in order to render it more appropriate for the daily life experiences of children. Content validity was verified by an expert panel of 29 people, made up of parents, paediatric clinicians, and researchers. Reliability and construct validity of the LIFE‐H for children (interview‐administered form) was tested during an experiment that comprised three sessions of interviews with a group of 94 parents of children with disabilities (36 males, 58 females; mean age 8y 10mo [SD 2y 6 mo]; diagnostic groups: cerebral palsy, myelomeningocoele, sensory‐motor neuropathy, traumatic brain injury, and developmental delay). Overall, the LIFE‐H showed high intrarater reliability with intraclass correlation coefficient values of 0.78 or higher for 10 out of 11 categories. The correlations between the LIFE‐H and the tools used in pediatric rehabilitation varied, and categories with similar constructs generally led to higher correlations. The psychometric properties of the LIFE‐H are appropriate and its content allows a complete description of participation among children with disabilities.

Mediators of behavioral problems in 7-year-old children born after 24 to 28 weeks of gestation

We tested the hypothesis that prematurity acts through its association with neuromotor and intellectual functioning to explain behavior problems at school age. Sixty-one extremely preterm (EP) very low birth weight (VLBW) children (< 29 wk and < 1500 g) born in 1987-1990 and 44 normal birth weight children (NBW) (> 37 wk and > 2500 g) were matched for age, sex, and socioeconomic status (SES). Mediator variables were evaluated at a hospital at 5 years and 9 months. Behaviors were evaluated at school at 7 years by peers, teachers, and parents. When compared with NBW children, EP/VLBW children had poorer IQ and neuromotor development. At school, EP/VLBW children were evaluated by peers as more sensitive/isolated, and by teachers and parents as more inattentive and hyperactive than NBW. When mediators were introduced, the previously significant relation between prematurity and behavior problems disappeared. Hyperactive and inattentive behaviors were explained by a specific working memory factor for the latter, and by a general intellectual delay for the former, whereas sensitive/isolated behaviors were best explained by neuromotor delays. Inattentive behaviors were also related to family adversity. At school age, extreme prematurity had thus an indirect effect on behaviors via specific and nonspecific intellectual and neuromotor delays.

Kangaroo Mother Care: A method for protecting high-risk low-birth-weight and premature infants against developmental delay

Aim: The purpose of this study was to examine the relationship between intervention with Kangaroo Mother Care (KMC) and the subsequent mental development of the infants. In this prospective study, 431 low-birth-weight and premature infants (≤1801 g) were assigned randomly to KMC or Traditional Care. Of these, 336 (78%) received the Griffiths test at 12 months of corrected age. Results: After control for the infant’s health at birth, family socioeconomic status and mother labor and delivery characteristics, the KMC infants had a higher IQ than those given traditional care (TC). The difference was most highly significant for infants who were more premature (30–32 weeks of gestational age), had required intensive care, and had a diagnosis of doubtful or abnormal neurological development at 6 months. The main impact of KMC was on the development of personal relations and on planning functions related to brain developmental stage at birth. Discussion: The KMC intervention can be viewed as a developmentally supportive care, in which parents are guided in managing their biological parenting abilities and which provides “brain care” during a highly sensitive period of a preterm infant’s neurological development.

Victimization: a newly recognized outcome of prematurity

Victimization by peers affects 10 to 20% of school children under the age of 12 years. Physical, verbal, and psychological victimization (being pushed, hit, called names, teased, being the target of rumours, theft, extortion) is associated with short‐ and long‐term adjustment problems, such as peer rejection, social withdrawal, low self‐esteem, anxiety, loneliness, and depression, as well as academic problems and school drop‐out. Research on populations of school children (primary and secondary) has associated victimization with personal risk factors (the victims characteristics and behaviour) and interpersonal risk factors (social relationships between peers). Studies on the social adjustment of preterm children at school age show that, even in the absence of a major motor or cognitive disability, this population has several personal risk factors associated with victimization. The objective of this study was to compare the level of victimization experienced by a group of 96 seven‐year‐old children born extremely preterm (EP, <29 weeks of gestation; 49 females) against that experienced by a group of 63 term children (34 females) matched for age and sex, maternal level of education, and family socioeconomic status. The children born EP had a mean gestational age of 27.3 weeks (SD 1.2) and a mean birthweight of 1001.1g (SD 223) and normal birth weight children had a mean gestational age of 39.5 weeks (SD 1.5) and a mean birthweight of 3468.7g (SD 431). Physical and verbal victimization were assessed in a school setting by peers with individual sociometric interviews (Modified Peer Nomination Inventory). After controlling for physical growth (height and weight) at the age of 7 years, the data indicate two independent effects: males were more victimized than females, and children born preterm experienced more verbal victimization by their peers than their term classmates, even when participants with a visible motor, intellectual, or sensory disability were excluded. Several hypotheses are presented to account for the higher incidence of verbal victimization of preterm children.

Extremely Premature and Very Low Birthweight Infants: A Double Hazard Population?

This article evaluates the contributions of birth status (defined by gestational age and birthweight) and family adversity at birth and at age 7 to explaining behavior problems at age 7. The behaviors of 96 extremely preterm and very low birth-weight children and 66 full-term children were assessed in a school setting by peers, teachers and parents. The results show that a significant relationship exists between birth status and isolation and social withdrawal problems as well as between birth status and social immaturity and inattention problems. Family adversity at birth has a significant contribution to aggressive behaviors reported by the three sources whereas, at age 7, this index is associated only with aggressive behaviors and social immaturity problems reported by parents. In conclusion, the results of the present study qualify the findings of studies that suggest that at school age, the effect of prematurity decreases and that behavior problems are explained chiefly by family environment characteristics. Our results indicate that the findings must take into account the cohort studied, the environmental measures used, the type of behaviors assessed as well as the type of informants.

Social participation by children with developmental coordination disorder compared to their peers

Abstract Purpose: Two objectives are being pursued: (1) to describe and compare the level of social participation of children aged 5–13 with developmental coordination disorder (DCD) to children of the same age with typical development (TD) and (2) to describe and compare the level of social participation of two subgroups of youths with DCD, e.g. children with dyspraxia affecting both the motor sphere and the verbal sphere (mixed dyspraxia) and children with developmental dyspraxia. Method: This cross-sectional study was conducted among 27 youngsters with DCD: 9 having developmental dyspraxia and 18 having mixed dyspraxia, compared to 27 same-age peers with TD. Life habits (LIFE-H) for children was used to measure social participation. Results: Levels of lifestyle achievements among youngsters with DCD are significantly lower than those of TD youngsters in all categories. Noteworthy differences were found between subgroups of youngsters with DCD in the categories of life habits related to communication and education. The group with mixed dyspraxia obtained the lowest scores. Conclusions: The achievement of a normal lifestyle by youngsters with DCD is upset in all spheres of life. The impact of DCD on the level of participation of these youngsters is quite significant and affects all lifestyles measured in this study. Children with mixed dyspraxia are particularly affected. These facts must be taken into consideration by anyone involved in the lives of these youngsters. Implications for Rehabilitation It is necessary to encourage social participation of DCD sufferers aged 5–13 in all spheres of life. Special attention should be paid to those who have a speech disorder. Life habits concerning communication and education may be related; greater efforts should be made to limit the negative impact on other lifestyles. Social participation of DCD sufferers should be measured periodically and appropriate resources must be made available to promote training and support for clinicians. It is important to provide tools to measure social participation for both stakeholders and parents.

The Social Behaviour of 11- to 12-year-old Children Born as Low Birthweight and or Premature Infants

Two studies (Study 1 and Study 2) were carried out to compare the social behaviour of school-aged children born as premature and/or low birthweight infants, with that of children born as healthy fullterm infants. Participants in Study 1 were 147 11-year-olds of whom 49 (29 females and 20 males) were reported by their parents to have been born prematurely. Participants in Study 2 were 84 11-year-old boys, 28 of whom were born with a birthweight less than 2000 grams. These at-risk subjects were followed for a period of two years. Subgroups within both study groups were matched with control groups using gender, age, and the school environment as common factors. Children in the target classes of Study 1 were classified using the Revised Class Play (Masten, Morison, & Pelligrini, 1985) and the Peer Nomination Inventory (Perry, Kusel, & Perry, 1988). In Study 2, the children completed the Pupil Evaluation Inventory (PEI) (Pekarik, Prinz, Liebert, Weintraub, & Neale, 1976). Findings suggest that aggressive behaviour is not related to birth status and that birth status is not linked to prosocial behaviour associated with sociability and likeability. However, both studies showed that children (boys and girls alike) born as premature or low birthweight infants, expressed greater levels of internalised social behaviour. These findings suggest that infants born premature and/or with a low birthweight may be less socially competent with their peers during their school-age years.

Social adjustment at school: Are children with cerebral palsy perceived more negatively by their peers than other at-risk children?

Purpose. To compare three dimensions of social adjustment (social status, friendship and victimization) across four groups of children between the ages of nine and 12 who differ by their birth status (premature vs. at term) and the presence or absence of a motor impairment (with and without cerebral palsy [CP]). Method. All premature (n = 72) and term children (n = 118) without CP and all children with CP (premature with CP: n = 49; term with CP: n = 29) are part of a follow-up study. Social adjustment measures were obtained by conducting a classwide sociometric interview in the class of the target child. Results. Irrespective of their birth status, girls with CP have more social adjustment problems than those without a disability. With respect to victimization, the results show that, irrespective of gender, both CP children and premature children (without CP) differ from their term peers (without CP). Conclusions. By comparing the four groups, we are able to qualify the impact of a visible clinical impairment such as CP versus that of extreme prematurity on social adjustment.

Twenty-year Follow-up of Kangaroo Mother Care Versus Traditional Care

BACKGROUND AND OBJECTIVES: Kangaroo mother care (KMC) is a multifaceted intervention for preterm and low birth weight infants and their parents. Short- and mid-term benefits of KMC on survival, neurodevelopment, breastfeeding, and the quality of mother–infant bonding were documented in a randomized controlled trial (RCT) conducted in Colombia from 1993 to 1996. The aim of the present study was to evaluate the persistence of these results in young adulthood. METHODS: From 2012 to 2014, a total of 494 (69%) of the 716 participants of the original RCT known to be alive were identified; 441 (62% of the participants in the original RCT) were re-enrolled, and results for the 264 participants weighing ≤1800 g at birth were analyzed. The KMC and control groups were compared for health status and neurologic, cognitive, and social functioning with the use of neuroimaging, neurophysiological, and behavioral tests. RESULTS: The effects of KMC at 1 year on IQ and home environment were still present 20 years later in the most fragile individuals, and KMC parents were more protective and nurturing, reflected by reduced school absenteeism and reduced hyperactivity, aggressiveness, externalization, and socio-deviant conduct of young adults. Neuroimaging showed larger volume of the left caudate nucleus in the KMC group. CONCLUSIONS: This study indicates that KMC had significant, long-lasting social and behavioral protective effects 20 years after the intervention. Coverage with this efficient and scientifically based health care intervention should be extended to the 18 million infants born each year who are candidates for the method.

The performance profile on the Wisconsin Card Sorting Test of a group of children with cerebral palsy aged between 9 and 12.

Purpose: The aim of this study was to determine the performance profile of a group of children with cerebral palsy (CP) on the Wisconsin Card Sorting Test (WCST). Methods: The sample consisted of 102 children aged between 9–12, divided into two groups: the clinical group consisted of 52 children with CP in mainstream class (37 with hemiplegia and 15 with diplegia), while the comparison group comprised 50 children matched for class, gender, age and socioeconomic status. Results: The findings showed that children with CP make more non-perseverative errors, they completed fewer categories, required more trials to complete the first category and gave fewer conceptual responses than control children. Children with diplegia are distinguished more from comparison children than children with hemiplegia. Conclusion: The results suggest a difficulty in initial conceptualization that could be attributable to a slow rate of information processing. Delayed maturation of the nervous system is likely to be implied. Propésito: La puntería de este estudio era determinar el perfil del funcionamiento de niños con la parálisis cerebral (CP) en Wisconsin Card Sorting Test (WCST). Métodos: La muestra consistió en 102 niños (9-12 años), dividido en dos grupos: el grupo clínico consistió en 52 niños con el CP incluidos en clase regular (37 con hemiplegia y 15 con diplegia) y el grupo de la comparación consistió en 50 niños emparejados para la clase, el género, la edad y el estado socioeconómico. Resultados: Los resultados demostraron que los niños con el CP hacen no-más errores con perseverancia, terminaron pocas categorías, requirieron más ensayos para terminar la primera categoría y dieron pocas respuestas conceptuales que niños del control. Los niños con diplegia se distinguen más del niños del grupo de comparación que los niños con hemiplegia. Conclusión: Los resultados sugieren una dificultad en la conceptualización inicial que podría ser atribuible a un índice lento de tratamiento de la información. Un plazo de la maduración del sistema nervioso central es problablement implicado Palabras clave : Parálisis cerebral, función ejecutiva, ajuste social