Psychomotor development in very and extremely low-birth-weight preterm children: Could it be predicted by early motor milestones and perinatal complications?

Preterm-born children are at risk of slower psychomotor development. This risk may be associated with low birth weight and other perinatal factors and morbidities. We aimed to assess psychomotor development in school-aged preterm children, and to determine whether some early motor and perinatal variables could be related to and/or predict the later motor achievements. Parents of 54 very low-birth-weight preterm, 24 extremely low-birth-weight preterm and 96 control children completed the Movement Assessment Battery for Children (MABC-2-C) checklist and were interviewed about the motor milestones of their children. Significant differences were found between the preterm and control groups in the MABC-2-C results. MABC-2-C outcomes were significantly predicted by the age of crawling, the use of steroids, mechanical ventilation and intraventricular hemorrhage (IVH). The use of screening tools may allow the rapid identification of psychomotor development delays. The presence of some perinatal risk factors and some motor milestone attainments could be related to motor development in the later childhood of preterm children.

Functional near-infrared spectroscopy in the neuropsychological assessment of spatial memory: A systematic review.

Functional near-infrared spectroscopy (fNIRS) is a non-invasive optical imaging technique that employs near-infrared light to measure cortical brain oxygenation. The use of fNIRS has increased exponentially in recent years. Spatial memory is defined as the ability to learn and use spatial information. This neuropsychological process is constantly used in our daily lives and can be measured by fNIRS but no research has reviewed whether this technique can be useful in the neuropsychological assessment of spatial memory. This study aimed to review empirical work on the use of fNIRS in the neuropsychological assessment of human spatial memory. We used four databases: PubMed, PsycINFO, Scopus and Web of Science, and a total of 18 articles were found to be eligible. Most of the articles assessed spatial or visuospatial working memory with a predominance in computer-based tasks, used fNIRS equipment of 16 channels and mainly measured the prefrontal cortex (PFC). The studies analysed found linear or quadratic relationships between working memory load and PFC activity, greater activation of PFC activity and worse behavioural results in healthy older people in comparison with healthy adults, and hyperactivation of PFC as a form of compensation in clinical samples. We conclude that fNIRS is compatible with the standard neuropsychological assessment of spatial memory, making it possible to complement behavioural results with data of cortical functional activity.

Neuropsychological Development and New Criteria for Extrauterine Growth Restriction in Very Low-Birth-Weight Children.

BACKGROUND: Controversy between short-term neonatal growth of very low birth-weight preterm (VLBW) and neurodevelopment may be affected by criteria changes of extrauterine growth restriction (EUGR). OBJECTIVE: to determine if new EUGR criteria imply modifications in the relationship between old criteria and results of neuropsychological tests in preterm children. PATIENTS AND METHODS: 87 VLBW at 5-7 years of age were studied. Neuropsychological assessment included RIST test (Reynolds Intellectual Sctreening Test) and NEPSY-II (NE neuro, PSY psycolgy assessment) tests. The relationships between these tests and the different growth parameters were analyzed. RESULTS: RIST index was correlated with z-score Fenton's weight (p = 0.004) and length (p = 0.003) and with z-score IGW-21's (INTERGRWTH-21 Project) weight (p = 0.004) and length (p = 0.003) at neonatal discharge, but not with z-score difference between birth and neonatal discharge in weight, length, and HC for both. We did not find a statistically significant correlation between Fenton or IGW-21 z-scores and scalar data of NEPSY-II subtasks. CONCLUSION: In our series, neonatal growth influence on neuropsychological tests at the beginning of primary school does not seem robust, except for RIST test. New EUGR criteria do not improve the predictive ability of the old ones.

The association between perinatal and neonatal variables and neuropsychological development in very and extremely low-birth-weight preterm children at the beginning of primary school.

Preterm children with very low birth weight (<1,500 g) and extremely low birth weight (<1,000 g) have an increased risk of experiencing neuropsychological delays. The purpose of this study is to characterize the neuropsychological profile of very and extremely low birth weight preterm children and discover what maternal conditions, diseases, procedures, and alterations in preterm newborns could be related to their later neuropsychological development. Eighty-nine preterm children (aged from 5 to 7 years) were assessed on their intelligence quotient (IQ), executive function, memory, and visuospatial memory in a single session, using the RIST and NEPSY-II test. Parents provided sociodemographic data. Preterm children showed lower scores than normative values on impulsivity, visual short-term memory, and spatial relation abilities. Extremely-low-birth weight preterm children also showed less inhibitory control and worse mental rotation skills. Neonatal surgical procedures, late-onset sepsis, and periventricular hemorrhages had the greatest impact on neurodevelopment. When one or more of these conditions are present, memory is the most affected neuropsychological function, followed by visuospatial skills, inhibitory control, and IQ. It is important to take into account the presence of maternal conditions, diseases, interventions, and neonatal alterations in preterm newborns in order to determine the risk of neuropsychological delays in later development.

Spatial orientation assessment in preschool children: Egocentric and allocentric frameworks.

Spatial orientation is an important function in daily life because it allows us to reach a target place when moving through our environment, using self-centered (egocentric) or environmental information (allocentric). Compared to other cognitive functions, spatial orientation has been studied less in preschool ages. Some brain areas, such as the hippocampus and the temporal as well as the parietal and frontal cortices, are involved in spatial orientation. Therefore, when these brain regions are altered in neurological conditions or in atypical development in children, we would expect impairment of spatial abilities. The aim of this study is to review studies, published in recent years, that use egocentric and allocentric spatial orientation tasks for assessing spatial memory in preschool children, with the final goal of finding out which tests could be included in a clinical neuropsychological evaluation. We observed that although egocentric spatial orientation emerges first during development, allocentric spatial orientation tasks are employed at very early ages. Most of these tasks are performed in real environments, allowing children's self-movements and using environmental modifications, but technologies such as virtual or augmented reality are increasingly used. Other aspects are discussed, such as the lack of consensus in the nomenclature, the difficulty of tracing the course of development of spatial orientation, or the ecological validity of the tests used. We finally observed that there is greater interest in studying the allocentric framework than the egocentric one, which makes it difficult to compare the use of the two frames of reference during a neuropsychological evaluation in preschool-aged children.

Patients with Parkinson's Disease Show Alteration in their Visuospatial Abilities and in their Egocentric and Allocentric Spatial Orientation Measured by Card Placing Tests.

BACKGROUND: Visuospatial skills are impaired in Parkinson's disease (PD). Other related skills exist, such as spatial orientation have been poorly studied. The egocentric (based on internal cues) and allocentric frameworks (based on external cues) are used in daily spatial orientation. Depending on PD onset, the allocentric framework may have a higher level of impairment in tremor-dominant and the egocentric one in akinetic-rigid. OBJECTIVE: To evaluate spatial orientation and visuospatial functions in PD patients and controls, and to assess whether their performance is related to disease duration and the PD subtype (tremor-dominant and akinetic-rigid). METHODS: We evaluated egocentric and allocentric spatial orientation (Egocentric and Allocentric Spatial Memory Tasks) and visuospatial abilities, span and working memory in 59 PD patients and 51 healthy controls. RESULTS: Visuospatial skills, visuospatial span, and egocentric and allocentric orientation are affected in PD. Visuospatial skills and allocentric orientation undergo deterioration during the first 5 years of the disease progression, while egocentric orientation and visuospatial span do so at later stages (9-11 years). The akinetic-rigid subtype presents worse results in all the spatial abilities that were measured when compared to controls, and worse scores in visuospatial working memory, visuospatial abilities and allocentric orientation when compared to the tremor-dominant group. The tremor-dominant group performed worse than controls in egocentric and allocentric orientation. CONCLUSION: PD patients show deficits in their visuospatial abilities and in their egocentric and allocentric spatial orientation compared to controls, specifically in akinetic-rigid PD. Only spatial orientation are affected in tremor-dominant PD patients. Allocentric orientation is affected earlier in the progression of the disease.

Spatial memory assessment reveals age-related differences in egocentric and allocentric memory performance.

Humans move through the environment to reach a place mainly using two strategies: egocentric, taking the viewer's position as a point of reference, and allocentric, employing external landmarks in order to create a mental map of the environment. Aging seems to be associated with a deterioration in these functions, and although participants are evaluated with both virtual and real-environment tasks, performance on these two strategies is not frequently compared. Our objective was to evaluate egocentric and allocentric spatial memory in young and older adult populations using three tasks performed in real environments that allow the perception of 3-D information present in our daily orientation and make it possible to analyse each strategy separately. Twenty-eight young adults and 27 older adults performed Egocentric and Allocentric Spatial Memory Tasks, the Spatial Span task from CANTAB to assess visuospatial span and visuospatial working memory, and Benton's Judge of Line Orientation Test to measure the ability to establish judgments of spatial relations. Young adults outperformed older adults on spatial memory tasks. The older group improved across allocentric blocks. Young men outperformed older men on both the egocentric and allocentric tasks, whereas young women only achieved better scores than older women on the allocentric task. Our findings support the existence of age-related differences in spatial memory performance.

Egocentric and allocentric spatial memory in typically developed children: Is spatial memory associated with visuospatial skills, behavior, and cortisol?

INTRODUCTION: Spatial orientation relies mainly on two frameworks. The egocentric depends on our own position and point of view. The allocentric relies on remembering, recalling, and recognizing environmental stimuli called landmarks. The aim of this study was to analyze the egocentric and allocentric spatial memory performance in children of different ages using two experimental memory card-placing tasks. We also aimed to examine relationships between spatial memory and other cognitive, physiological, and behavioral factors that, potentially, could be associated with spatial memory performance. Those were other visuospatial functions, the regular behavior of the child, cortisol levels, and daily life spatial memory. METHODS: We assessed 62 children (5, 6, and 7 years) using card-placing tasks. We used RIST for IQ evaluation and subtest from NEPSY-II for visuospatial ability assessment. Collection of saliva sample was carried out for cortisol analysis. Parents completed BASC questionnaire for behavioral evaluation and ECM-Q questionnaire for daily life spatial memory evaluation. RESULTS: Our results showed that older children performed better on mental rotation. Directionality, map interpretation, and daily memory were directly associated with both egocentric and allocentric orientation. Egocentric performance was positively related to leadership abilities but negatively to depression and atypicality, while allocentric performance was directly associated with adaptive behavior but inversely with hyperactivity. Finally, cortisol values were positively associated with allocentric performance. CONCLUSIONS: Our study shows the development of different spatial abilities between 5 and 7 years, as well as the relationship between orientation performance, visuospatial skills, behavior, and cortisol.

Identificación de problemas de conducta y emocionales en niños prematuros en el ámbito de atención primaria / Identification of behavioural and emotional problems in premature children in the primary care setting

OBJETIVOS: Evidenciar la utilidad, para su uso por el pediatra de atención primaria, del cuestionario BASC (Behavior Assessment System for Children) para la detección precoz de los problemas psicológicos y comportamentales en los prematuros. DISEÑO: Estudio transversal y descriptivo. Emplazamiento: Centro de atención primaria (Área Sanitaria IV del Principado de Asturias) y centro hospitalario (Hospital Universitario Central de Asturias), España. PARTICIPANTES: Padres de 87 niños prematuros con peso menor de 1.500g al nacimiento y de 43 controles nacidos a término, ambos grupos con edad de 5 a 7 años. Mediciones principales: Se aplicó el cuestionario BASC (versión para padres). RESULTADOS: Los niños prematuros presentan diferencias respecto a los controles, muestran mayores niveles de inatención (Z = -4,125; p < 0,001), ansiedad (Z = -2,801; p = 0,005) e interiorización de conductas (Z = -2,148; p = 0,032), conductas que son más evidentes a los 5 años. Los niños prematuros presentan mayores niveles de hiperactividad (Z = -2,082; p = 0,037) y problemas de conducta (Z = -2.354; p = 0,019) que las niñas, que destacan en problemas de atención (Z = -2.345; p = 0,019). CONCLUSIONES: El BASC permite la detección y diagnóstico precoz en atención primaria de los problemas de conducta y emocionales de los niños prematuros

OBJECTIVE: To demonstrate the usefulness, for use by the primary care pediatrician, of the BASC questionnaire (Behavior Assessment System for Children) for the early detection of psychological and behavioral problems in premature infants. DESIGN: Cross-sectional and descriptive study. SETTING: Primary care (Health Area IV of the Principado of Asturias) and Hospital Universitario Central de Asturias, Spain. PARTICIPANTS: Parents of 87 premature children with birth weight less than 1500g and 43 full-term controls, both aged 5-7 years. MAIN MEASUREMENTS: The BASC questionnaire (parent version) was applied. RESULTS: Preterm children presented a high rate of inactivity (Z = -4.125, P < 0.001), anxiety (Z = -2.801, P = 0.005) and internalization problems (Z = -2.148, P = 0.032), being more evident at 5 years of age. Preterm boys show higher levels of hyperactivity (Z = -2.082, P = 0.037) and behavioural problems (Z = -2.354, P = 0.019) than girls, who presented more attentional problems (Z = -2.345; P = 0.019). CONCLUSIONS: The BASC questionnaire is useful for the detection and early diagnosis at the primary care level of the behavioral and emotional problems of premature children

Development of egocentric and allocentric spatial orientation abilities in children born preterm with very low birth weight.

BACKGROUND: Very low birth weight preterm infants show neuropsychological alterations in functions such as memory or visuospatial skills, although certain related functions, such as spatial orientation, have not been studied. OBJECTIVES: To compare children born preterm and at term between the ages of 5 and 7 years on egocentric and allocentric spatial orientation, and relate their performance to visuospatial skills, behavior, memory in daily environments, and perinatal risk factors. STUDY DESIGN: Observational cross-sectional study. SUBJECTS: 88 very low birth weight children born preterm and 59 controls. OUTCOME MEASURES: IQ (RIST), visuospatial skills (NEPSY II: Route Finding and Geometric Puzzles), spatial orientation (Egocentric and Allocentric Spatial Memory Test - Children's Version), behavior (BASC questionnaire for parents), memory in everyday environments (ECM-Q questionnaire for parents), and perinatal risk factors (collected from medical records). RESULTS: Children born preterm obtain significantly lower scores than controls on the RIST, Route Finding, and Allocentric Spatial Memory Tests. Although spatial orientation is related to other neuropsychological variables in both premature and control children, there is no meaningful association with behavior or daily memory in children born preterm. The perinatal risk factors that are associated the most with visuospatial and orientation problems are surgical procedures and peri- and intraventricular hemorrhages. CONCLUSIONS: Children born preterm with low birth weight present difficulties in their spatial orientation, and for this reason, we propose including these types of tasks in the usual neuropsychological evaluation.

[Identification of behavioural and emotional problems in premature children in the primary care setting]. / Identificación de problemas de conducta y emocionales en niños prematuros en el ámbito de atención primaria.

OBJECTIVE: To demonstrate the usefulness, for use by the primary care pediatrician, of the BASC questionnaire (Behavior Assessment System for Children) for the early detection of psychological and behavioral problems in premature infants. DESIGN: Cross-sectional and descriptive study. SETTING: Primary care (Health Area IV of the Principado of Asturias) and Hospital Universitario Central de Asturias, Spain. PARTICIPANTS: Parents of 87 premature children with birth weight less than 1500g and 43 full-term controls, both aged 5-7 years. MAIN MEASUREMENTS: The BASC questionnaire (parent version) was applied. RESULTS: Preterm children presented a high rate of inactivity (Z = -4.125, P < 0.001), anxiety (Z = -2.801, P = 0.005) and internalization problems (Z = -2.148, P = 0.032), being more evident at 5 years of age. Preterm boys show higher levels of hyperactivity (Z = -2.082, P = 0.037) and behavioural problems (Z = -2.354, P = 0.019) than girls, who presented more attentional problems (Z = -2.345; P = 0.019). CONCLUSIONS: The BASC questionnaire is useful for the detection and early diagnosis at the primary care level of the behavioral and emotional problems of premature children.

Calidad de vida de los padres de escolares nacidos prematuros con peso menor de 1.500 gramos / Quality of life of parents of school age children with a birth weight less than 1500 grams

Introducción: El nacimiento de un hijo prematuro conlleva un alto coste emocional familiar. El objetivo es valorar la calidad de vida de los progenitores de una cohorte de niños prematuros nacidos con peso menor de 1.500g, cuando estos contaban entre los 5 y los 7 años de edad. Pacientes y métodos: Estudio transversal de encuestas personales a progenitores de niños de entre 5 y 7 años de edad que estuvieron ingresados en un hospital terciario de España entre 2009 y 2011, siendo neonatos, por un peso al nacimiento menor de 1.500g. Se aplicó la escala del estrés parental, test de Apgar familiar, escala de sobrecarga del cuidador de Zarit y cuestionario Graffar. Se analizan 94 casos (40 niñas y 54 niños). Resultados: Todas las escalas muestran puntuaciones de normalidad. Con la escala de Zarit, del estrés parental y el cuestionario Graffar-Méndez Castellano, los resultados no reflejan diferencias por sexo, peso ni edad gestacional. Encontramos diferencias estadísticamente significativas con el test de Apgar familiar por sexo y entre la puntuación de Graffar y el grado de disfunción familiar. En el momento del estudio, los padres de niños con problemas en el desarrollo presentaban diferencias estadísticamente significativas con los padres de niños sin alteraciones, reflejadas en el test de Apgar familiar y en la escala de Zarit. Conclusión: La posible repercusión del nacimiento de un hijo con un peso menor de 1.500 g no se aprecia con los test estudiados cuando el niño tiene entre los 5 y 7 años de edad, salvo por las diferencias que se observan en la percepción de la funcionalidad familiar y en la sobrecarga de cuidadores entre los padres de niños con alteraciones en el desarrollo y sin ellas

Introduction: The birth of a preterm child has a high family emotional cost. The aim of this study is to assess the quality of life of parents of children aged 5-7 years born prematurely (<1500 g). Participants and methods: This is a cross-sectional study of a sample of parents of preterm infants admitted to a third level hospital in Spain between 2009 and 2011. Their infants weighed less than 1500 g at birth, and were 5-7 years old at the moment of the study. Parents completed the Parental Stress Scale, Family Apgar, Zarit modified scale, and Graffar-Méndez Castellano method (1994). A total of 94 cases were analysed (40 girls and 54 boys). Results: All data passed normality assumptions. Results showed no gender, weight or gestational age differences in our sample on the Zarit modified scale, Parental Stress Scale, or by the Graffar method. Differences between boys and girls were found in the Family Apgar test. Also, the Graffar method and degree of familiar malfunction showed significant results. The parents of preterm children with developmental problems at the time of the study showed significant differences with respect to parents of children without these problems in the Family Apgar test and the Zarit modified scale. Conclusions: The possible impact of the birth of a preterm child with less than 1500g of weight is not appreciated between 5 to 7 years of age, except for the differences found in the perception of family functionality and caregiver overload among parents of children with and without developmental alterations

[Quality of life of parents of school age children with a birth weight less than 1500 grams]. / Calidad de vida de los padres de escolares nacidos prematuros con peso menor de 1.500 gramos.

INTRODUCTION: The birth of a preterm child has a high family emotional cost. The aim of this study is to assess the quality of life of parents of children aged 5-7 years born prematurely (<1500g). PARTICIPANTS AND METHODS: This is a cross-sectional study of a sample of parents of preterm infants admitted to a third level hospital in Spain between 2009 and 2011. Their infants weighed less than 1500g at birth, and were 5-7 years old at the moment of the study. Parents completed the Parental Stress Scale, Family Apgar, Zarit modified scale, and Graffar-Méndez Castellano method (1994). A total of 94 cases were analysed (40 girls and 54 boys). RESULTS: All data passed normality assumptions. Results showed no gender, weight or gestational age differences in our sample on the Zarit modified scale, Parental Stress Scale, or by the Graffar method. Differences between boys and girls were found in the Family Apgar test. Also, the Graffar method and degree of familiar malfunction showed significant results. The parents of preterm children with developmental problems at the time of the study showed significant differences with respect to parents of children without these problems in the Family Apgar test and the Zarit modified scale. CONCLUSIONS: The possible impact of the birth of a preterm child with less than 1500g of weight is not appreciated between 5 to 7 years of age, except for the differences found in the perception of family functionality and caregiver overload among parents of children with and without developmental alterations.