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Resilience in Extremely Preterm/Extremely Low Birth Weight Kindergarten Children

Published online by Cambridge University Press:  03 May 2019

H. Gerry Taylor ,
Nori Minich ,
Mark Schluchter ,
Kimberly Andrews Espy  and
Nancy Klein
H. Gerry Taylor*
Affiliation:
The Research Institute at Nationwide Children’s Hospital, Center for Biobehavioral Health, and Department of Pediatrics, The Ohio State University, Columbus, Ohio Department of Pediatrics, Case Western Reserve University, and Rainbow Babies & Children’s Hospital, University Hospitals Cleveland Medical Center, Cleveland, Ohio
Nori Minich
Affiliation:
Department of Pediatrics, Case Western Reserve University, and Rainbow Babies & Children’s Hospital, University Hospitals Cleveland Medical Center, Cleveland, Ohio
Mark Schluchter
Affiliation:
Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, Ohio
Kimberly Andrews Espy
Affiliation:
University of Texas at San Antonio, San Antonio, Texas
Nancy Klein
Affiliation:
Department of Teacher Education, Cleveland State University, Cleveland, Ohio
*
Correspondence and reprint requests to: H. Gerry Taylor, Nationwide Children’s Hospital, 700 Children’s Drive FB3355, Columbus, OH 43205-2696. E-mail: [email protected]
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Abstract

Objectives: Research on developmental outcomes of preterm birth has traditionally focused on adverse effects. This study investigated the prevalence and correlates of resilience in 146 extremely preterm/extremely low birth weight (EPT/ELBW) children (gestational age <28 weeks and/or birth weight <1000 g) attending kindergarten and 111 term-born normal birth weight (NBW) controls. Methods: Adaptive competence (i.e., “resilience” in the EPT/ELBW group) was defined by scores within grade expectations on achievement tests and the absence of clinically elevated parent ratings of child behavior problems. The “adaptive” children who met these criteria were compared to the “maladaptive” children who did not on child and family characteristics. Additional analyses were conducted to assess the conjoint effects of group (ELBW vs. NBW) and family factors on adaptive competence. Results: A substantial minority of the EPT/ELBW group (45%) were competent compared to a majority of NBW controls (73%), odds ratio (95% confidence interval)=0.26 (0.15, 0.45), p<.001. Adaptive competence was associated with higher cognitive skills, more favorable ratings of behavior and learning not used to define adaptive competence, and more advantaged family environments in both groups, as well as with a lower rate of earlier neurodevelopmental impairment in the EPT/ELBW group. Higher socioeconomic status and more favorable proximal home environments were associated with competence independent of group, and group differences in competence persisted across the next two school years. Conclusions: The findings document resilience in kindergarten children with extreme prematurity and highlight the role of environmental factors as potential influences on outcome. (JINS, 2019, 25, 362–374)

Keywords

Premature birthCompetenceFamilyEnvironmental impactCognitive functionDevelopment
Type
Regular Research
Information
Journal of the International Neuropsychological Society , Volume 25 , Issue 4 , April 2019 , pp. 362 - 374
Copyright
Copyright © The International Neuropsychological Society, 2019. 

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