Magda Kalmár

The Course of Intellectual Development in Preterm and Fullterm Children: An 8-year Longitudinal Study

A total of 55 preterm children born at low to moderate risk and a comparison group of 100 healthy fullterm children were studied until they reached 8 years of age. Perinatal biomedical data and environmental data were considered as potential contributors to developmental outcome. The Budapest Binet intelligence quotients (IQs) were used as outcome measures. The mean IQs for both groups fell within the normal range at each measurement point. However, the differential patterns of IQ development in the preterm and term group underscore the significance of the age variable. Instead of a gradually declining impact of prematurity, the age effect resulted in a complex pattern. The considerable intra-group variability within the preterm group and the correlates of outcome suggest that biological hazards related to birth may have subtle long-term influences. Variables tapping the quality of home environment, however, clearly outweighed the perinatal risk factors in their ability to predict long-term outcomes. The results suggest a transaction between the two spheres of contributing factors. Long-term follow-up studies with multiple measurement points are essential if we are to understand the developmental implications of premature birth.

Interplay of Biological and Social-Environmental Factors in the Developmental Outcome of Prematurely Born Children from Infancy to Seven Years.

THE DEVELOPMENT of 58 preterm infants classified as low‐risk was compared over their first 7 years with a control group of 100 full‐term healthy infants. One major conclusion from this ongoing study is the critical need to take account of age when outcomes for prematurely born children are compared with full‐term children. As well as finding “catch up” phenomena at certain ages, the study also found periods during which there were reverses of this favourable tendency. Further, the study provided evidence that perinatal risk conditions may have a differential impact on mental development, depending on social‐environmental factors. It was suggested that advantaged family circumstances may reduce or even fully compensate for the adverse effects of preterm birth whereas a disadvantaged environment may amplify them.

Comparative Network Analysis of Preterm vs. Full-Term Infant-Mother Interactions

Several studies have reported that interactions of mothers with preterm infants show differential characteristics compared to that of mothers with full-term infants. Interaction of preterm dyads is often reported as less harmonious. However, observations and explanations concerning the underlying mechanisms are inconsistent. In this work 30 preterm and 42 full-term mother-infant dyads were observed at one year of age. Free play interactions were videotaped and coded using a micro-analytic coding system. The video records were coded at one second resolution and studied by a novel approach using network analysis tools. The advantage of our approach is that it reveals the patterns of behavioral transitions in the interactions. We found that the most frequent behavioral transitions are the same in the two groups. However, we have identified several high and lower frequency transitions which occur significantly more often in the preterm or full-term group. Our analysis also suggests that the variability of behavioral transitions is significantly higher in the preterm group. This higher variability is mostly resulted from the diversity of transitions involving non-harmonious behaviors. We have identified a maladaptive pattern in the maternal behavior in the preterm group, involving intrusiveness and disengagement. Application of the approach reported in this paper to longitudinal data could elucidate whether these maladaptive maternal behavioral changes place the infant at risk for later emotional, cognitive and behavioral disturbance.

Az intelligencia alakulása gyermekkorban:Egy 10 éves longitudinális vizsgálat módszertani tanulságai

Bar az IQ ketsegkivul az egyik leggyakrabban hasznalt merőszam a pszichologiaban, keves az azzal kapcsolatos adat, hogyan valtozik az IQ az eletkor fuggvenyeben. Meg kevesebbet tudunk arrol, hogyan alakul az atipikus gyermekek intelligenciaja. Kutatasunkban egy 55 fős koraszulott gyermekcsoport fejlődeset tanulmanyoztuk. A koraszulottseg perinatalis veszelyeztetettsegnek tekinthető. A kontrollcsoportot 100 fős, időre szuletett gyermek kepezte. A meresek eredmenyei szerint mindket csoport atlagos intelligenciaja a normal ovezetbe tartozott. A koraszulott es az időre szuletett csoport IQ-janak elterő longitudinalis mintazata alahuzza az eletkor mint valtozo jelentőseget. Az eletkorral nem csokkent egyenletesen a koraszulottseg negativ hatasa, hanem komplex mintazatot kovetett. A koraszulottek jelentős csoporton beluli valtozatossaga es a kesőbbi fejlemenyek arra utalnak, hogy a szuleteskori biologiai rizikonak rejtett hosszu tavu kovetkezmenyei lehetnek. Az otthoni kornyezet feltetelei ugyanakkor bizonyithatoan inkabb alakitjak a hosszu tavu kovetkezmenyeket, mint a perinatalis kockazati tenyezők.

Interplay of Biological and Environmental Factors in the Development of a Pair of Down Syndrome Twins

A pair of female identical twins with trisomy 21, born preterm with very low birth weight, was followed up through their third year of life with regular neuro-motor and developmental assessments (Brunet-Lezine) as well as observations. The fact that one of the twins has a congenital heart defect while the other is physically unimpaired constituted a natural experimental setting for analyzing the potential effects of and interrelationships between biological factors (preterm birth, low birth weight, heart defect) and environmental variables (intervention program, maternal coping and follow through, temporary hospitalization).