Nina Sajaniemi

Cognitive performance and attachment patterns at four years of age in extremely low birth weight infants after early intervention

Abstract This study aims at assessing the effects of an early occupational therapy intervention on the cognitive development and the development of attachment patterns in ELBW infants. The intervention, given weekly at home from six months to 12 months, aimed at supporting parent-child interaction and enhancing motor control and coordination. The study population consisted of 100 ELBW infants matched in pairs in accordance to their pre-perinatal risk scores and allocated successively to intervention or non-intervention groups. Cognitive development was assessed with the Bayley Scales at age two and with the WPPSI at age four. Attachment to primary caregiver was assessed with the Preschool Assessment of Attachment (PAA). Cognitive performance was within age norms in both groups at both ages. Intervention did not show any effect on cognitive performance at the age of two years. At the age of four years, cognitive level was overall, and most notably for verbal performance, higher in the intervention group than in the control group. There was an over-representation of the so-called atypical attachment patterns (those not fitting the normative A, B, or C categories) in the control group. The results are discussed in terms of finding more global ways to support the development of at risk pre-term children.

Cognitive development, temperament and behavior at 2 years as indicative of language development at 4 years in pre-term infants.

This study focuses on the early temperamental (TTQ = toddler temperament questionnaire), behavioral (IBR = infant behavior record), and cognitive precursors of impaired language functioning in preschool-age pre-terms infants. The study group consisted of 63 pre-term infants with a mean birth weight of 1246 ± 437 g born in 1989–1991 in the University Central Hospital of Helsinki. Children with major disabilities (CP or mental retardation) were excluded. At the age of 4 years, 22% showed impaired language function. Logistic regression analysis showed that the Bayley MDI score was the best predictor in identifying an increased risk for language impairment. Behavioral characteristics were more strongly associated with subsequent language impairment than temperament.

Early numeracy in low‐performing young children

The aim of this study was to explore the early numeracy of low‐performing young children. The mean age of the children was six years and four months. The 511 participants belonged to three groups: multi‐language children, children with special educational needs and children with average performance. The results showed that there were significant group differences in early numeracy: the children in the reference group had better relational and counting skills than those with a multi‐language background and those with special educational needs. Some differences were found in counting skills between the children with multi‐language background and those with special educational needs. Finally, (special) educational support for low‐performing children is discussed.

Early Cognitive and Behavioral Predictors of Later Performance: A Follow-up Study of ELBW Children from Ages 2 to 4.

Abstract The aim of this study was to examine whether behavioral style and cognitive performance predict cognitive development in ELBW children. The children were assessed at age 2 (40 girls, 41 boys) with the Bayley Scales of Infant Development. At age 4 they were assessed with the WPPSI-R, and with the word fluency, visual attention and recognition of incomplete figures subsets of the Finnish Neuropsychological Investigation for Children (NEPSY-R; Korkman et al. 1997 ). The results indicated that there was stability in cognitive performance from 2 to 4 years of age. Along with cognitive performance, behavioral style, especially orientation-engagement at age 2, was an important predictor of subsequent cognitive performance (WPPSI-R). Significant gender differences were also found. For boys, orientation-engagement factor at time one was the best predictor of subsequent nonverbal cognitive performance, arithmetical abilities and word fluency at time two. In contrast, girls’ cognitive performance measured at the 2-year assessment was the most powerful predictor of nonverbal performance and word fluency at 4 years. As a whole, it seems that behavioral factors merit more consideration in understanding cognitive development than has been thought before.

Neurodevelopment until the adjusted age of 2 years in extremely low birth weight infants after early intervention--a case-control study.

A total of 104 infants with birth weights of less than 1000 grams were enrolled in this prospective case-control study in order to examine the effect of occupational therapy based on sensory integration (SI) and neurodevelopmental therapy (NDT) on neurological development. The children were grouped as matched pairs on the basis of a set of developmental risks assessed at the age of 3 months. The intervention children had a weekly session of 60 minutes of occupational therapy from the corrected age of 6 months up to 12 months. All the children were examined at the corrected age of 3, 6, 9, 12, 18 and 24 months. The neurodevelopment of the cases and the controls did not differ essentially and the only significant difference was found in the social development of the children at the age of 12 months to the advantage of the intervention group. It is concluded that this amount of occupational therapy in at-risk children does not have a relevant effect on neurological development.

Increased health and well-being in preschools (DAGIS): rationale and design for a randomized controlled trial

BackgroundEffective interventions that target socioeconomic status (SES) differences to avoid the potential widening of inequalities in health are needed. Children at preschool age is a valuable intervention target since sedentary behaviors, physical activity (PA), dietary behaviors, and sleep habits, jointly called the energy balance-related behaviors (EBRBs), are established in early childhood and tend to persist later in life. The interventions are most effective, when they focus on evidence-based factors. One potential factor associated with EBRBs and SES is children’s stress regulation, which receives special attention in this study. Based on the socioecological approach, the combinations of multiple levels (e.g. individual, environmental, societal) of analysis and diverse methodologies (e.g. surveys, observations, biological measurements) are used to assess the healthfulness of environments (e.g. social, physical, learning, policy) in preschool and family settings. The intervention aimed to diminish SES differences in EBRBs is then conducted in the preschool setting.Methods/designThe DAGIS study is divided into two phases. The first phase comprises focus group interviews and a cross-sectional survey. Parents and preschool personnel in low SES neighborhoods participated in interviews about children’s sedentary behaviors, dietary behaviors, and PA in 2014. In the cross-sectional survey beginning in autumn 2015, preschools will be recruited from a random sample of preschools in 3–5 municipalities in Southern Finland. A total of 800 children will wear an accelerometer for seven days. Children’s hair and saliva samples will be taken. Parents and preschool personnel will complete questionnaires on EBRBs, social and physical environments and SES factors. The quality of preschool environment is also observed. In the second phase, an intervention targeting to narrowing SES differences in EBRBs is conducted. The effects of the intervention will be evaluated in randomised controlled trial. The implementation of the intervention will also be evaluated.ConclusionIf effective, this unique preschool-based study will be able to narrow the SES differences in preschool children’s EBRBs. This study is anticipated to identify the most important modifiable factors in preschool and family environmental settings associated with children’s EBRBs, especially in children from low SES backgrounds.Trial registrationISRCTN57165350 (January, 8th, 2015).

Bystanders’ roles and children with special educational needs in bullying situations among preschool-aged children

Despite the growing body of evidence that the origins of bullying lie in early childhood, very little is known about the nature of the phenomenon in preschool groups. The current understanding among studies conducted in the school environment is that bullying prevention can only be effective if training with individual children takes place parallel to broader interventions in the classroom. The aim of this study was to examine how bullying prevention should be focused among under school-aged children. Since we know that children with special educational needs (SEN) have been found to be extremely vulnerable to bullying and victimization, we examined the role of three- to six-year olds with SEN in bullying situations. In addition, we examined whether the peripheral roles of other children in bullying situations can already be observed in preschool groups. The data were collected from a survey of day care staff in the city of Vantaa (n = 771). According to staff reports, 18% of bullying took place in situations in which children with SEN were present. Bullies with SEN used more physical forms of bullying and bullies without SEN used more psychological forms of bullying. The findings also showed that the multiple, peripheral roles of the bystanders in bullying situations are already occurring in preschool groups, especially among boys. It is important to target intervention programs in preschools both on individual children and at group level.

Pedagogical Work, Stress Regulation and Work-Related Well-Being among Early Childhood Professionals in Integrated Special Day-Care Groups.

Abstract The aim of this study was to investigate the relationship between early childhood professionals’ (ECPs) stress regulation (using salivary cortisol and alpha-amylase [AA] measurements), work engagement and the quality of their pedagogical work in integrated special day-care groups. Participants were 89 ECPs from 21 integrated special day-care groups located in Helsinki, Finland. The special educational needs of children (who were between 3 and 6 years of age) in these groups varied from language disorders and self-regulation difficulties to severe disabilities. Data was collected by using work engagement surveys, salivary cortisol and AA measurements and observational assessments of pedagogical work. This study is novel, in that it combines approaches from different disciplines to investigate work-related well-being among ECPs. Our findings demonstrate the close relationship between ECPs’ stress regulation and the quality of pedagogical work in teams. Whilst ECPs’ high work engagement was associated with better-quality pedagogical work, we did not find any associations between different biomarkers and work engagement. Our study highlights the importance of teamwork, not only as fundamental to high-quality early childhood special education, but also in supporting the well-being of ECE professionals. The findings can be applied in future studies and can be used to inform intervention aiming to enhance working conditions in day-care centres.

Demographic Factors, Temperament and the Quality of the Preschool Environment as Predictors of Daily Cortisol Changes among Finnish Six-Year-Old Children.

A young childs stress-sensitive neurobiological system is immature and open to being shaped by experience. When children enter preschool, external demands on them to adjust are different from the demands they experience at day care. In Finland, the last year before children transfer to the comprehensive school is called preschool. The preschool year is far more academically demanding than earlier day care years, emphasizing school-like activities along with age-appropriate social and cognitive challenges. The first aim of the present study was to study whether the preschool year (six-year-old children) has an effect on the childrens cortisol reactivity. To examine the changes in stress regulation, cortisol reactivity was investigated both in the autumn and in the spring. The second aim of the study was to explore whether demographic factors, temperament and the quality of preschool environment have an effect on the daily variation of the cortisol level among the participants of the study. Five day care centres in metropolitan Helsinki, Finland, participated in this study and 91 six-year-old preschool children served as participants. Our results showed that the children displayed typical cortisol reactivity during the autumn as expected, whereas their cortisol values were significantly higher in the spring. The autumn measurements revealed a significant relationship between the cortisol effects and the temperament characteristics of sadness, anger/frustration and perceptual sensitivity. These characteristics were not as evident when measured during the spring. Additionally, the results indicated that quality of learning environment affects changes in childrens cortisol reactivity.

Verbal and non‐verbal development in SLI children after early intervention

Of all the developmental difficulties that may be present in childhood, language impairment is probably the most common. It is of vast importance to prevent cumulative negative consequences of these impairments. The present study evaluates the effects of a language and activity‐based intervention programme on verbal and non‐verbal performance and play behaviour in children diagnosed as having specific language impairment. Children with the same diagnosis and conventional early special education were used as controls. Verbal and non‐verbal abilities and play behaviour were evaluated before and after intervention in both groups. The intervention sessions, aimed to develop the children’s functional use of language and communication, were held in community day care centres. The sessions took place twice a week in groups of two to four children. The intervention had a positive influence on non‐verbal performance and play behaviour. However, the intervention did not have any significant effect on language measurements. The results are discussed in the context of language development as a dynamic process with circular causation between different aspects of development.