Longstanding Auditory Sensory and Semantic Differences in Preterm Born Children.

More than 10% of births are preterm, and the long-term consequences on sensory and semantic processing of non-linguistic information remain poorly understood. 17 very preterm-born children (born at < 33 weeks gestational age) and 15 full-term controls were tested at 10 years old with an auditory object recognition task, while 64-channel auditory evoked potentials (AEPs) were recorded. Sounds consisted of living (animal and human vocalizations) and manmade objects (e.g. household objects, instruments, and tools). Despite similar recognition behavior, AEPs strikingly differed between full-term and preterm children. Starting at 50ms post-stimulus onset, AEPs from preterm children differed topographically from their full-term counterparts. Over the 108-224ms post-stimulus period, full-term children showed stronger AEPs in response to living objects, whereas preterm born children showed the reverse pattern; i.e. stronger AEPs in response to manmade objects. Differential brain activity between semantic categories could reliably classify children according to their preterm status. Moreover, this opposing pattern of differential responses to semantic categories of sounds was also observed in source estimations within a network of occipital, temporal and frontal regions. This study highlights how early life experience in terms of preterm birth shapes sensory and object processing later on in life.

Consequences of Prematurity on Cortisol Regulation and Adjustment Difficulties: A 9-Year Longitudinal Study.

A preterm birth represents a stressful event having potentially negative long-term consequences. Thirty-three children born preterm (<33 weeks gestational age) and eleven full-term children participated in a nine-year longitudinal study. Perinatal Risk Inventory (PERI) was used at birth to assess the perinatal stress. Salivary cortisol, collected four times a day over two consecutive days, was measured with radioimmunoassay technique at six months and nine years to assess the hypothalamic-pituitary-adrenal (HPA) axis. Mothers reported post-traumatic symptoms on a self-report questionnaire 12 months after their child's birth and children's adjustment problems at 9 years of child age on the Child Behavior Checklist. Results showed a significant difference in cortisol regulation at nine years between preterm and full-term children but no differences in adjustment problems. Whereas biological factors (i.e., PERI, cortisol regulation at six months) explained cortisol at nine years, maternal post-traumatic symptoms were predictive of adjustment problems in their child. In conclusion, very preterm birth has some long-term consequences on the HPA-axis regulation at nine years. Although cortisol regulation is mostly influenced by biological factors, the presence of maternal post-traumatic symptoms predicts the manifestation of adjustment problems in both groups. This shows the importance of maternal psychological well-being for child development. Further research is needed to understand the exact consequences of premature birth on cortisol regulation and the implication for the child's development and health.

The interplay between prematurity, maternal stress and children's intelligence quotient at age 11: A longitudinal study.

Very premature children (<33 weeks of gestational age (GA)) experience greater academic difficulties and have lower, though normal-range, intelligence quotients (IQs) versus their full-term peers. These differences are often attributed to GA or familial socio-economic status (SES). However, additional factors are increasingly recognized as likely contributors. Parental stress after a child's premature birth can present as post-traumatic stress disorder (PTSD) symptoms and can in turn reinforce difficulties in parent-child interaction pattern. Following a longitudinal design, we studied the interplay between a premature child's perinatal history and maternal PTSD symptoms on intelligence abilities assessed at 11 years of age. Thirty-three very preterm and 21 full-term mother-children dyads partook in the study. Children's perinatal risk was evaluated at hospital discharge, maternal PTSD symptoms were assessed when the children were 18 months old, and children's IQ was measured at 11 years old. IQ was significantly lower for preterm than full-term children, without reliable influences from perinatal risk scores. However, lower maternal PTSD symptoms predicted higher IQ in preterm children. This preliminary study highlights the importance detecting maternal PTSD symptoms after a preterm birth and suggests interventions should target reducing maternal PTSD symptoms during early childhood to enhance very preterm children's intelligence development.

Perinatal stress moderates the link between early and later emotional skills in very preterm-born children: An 11-year-long longitudinal study.

BACKGROUND: Very preterm (VPT) birth refers to an early stressful event putting children at heightened risk for emotional difficulties. However, there is an important individual variability, leaving unexplained why some VPT children do not develop emotional difficulties, while others develop such difficulties in the early years or later in life. AIM: In this study, we examined whether perinatal stress is a risk factor explaining heterogeneities in emotional problems in VPT children. METHODS: Thirty-six VPT children and 22 full-term born (FT) children participated in an 11 year-long study. Risk for perinatal stress was assessed at birth with the Perinatal Risk Inventory. Mothers reported children's emotional difficulties at 18 months of child age on the Symptom Checklist and at 11 years on the Child Behavior Checklist. RESULTS: Results indicated significant differences in emotional scores at 11 years not only between VPT and FT children but also between the low and high perinatal stress groups. More importantly, emotional scores at 18 months influenced variability in internalizing scores at 11 years only in VPT children with high perinatal stress. CONCLUSION: Although prematurity affects the emotional abilities of preadolescents, the link between emotional skills in early and later childhood is moderated by the severity of perinatal stress. In particular, VPT children who are born with more complications, and as such experience a more stressful perinatal environment, are more likely to show emotional difficulties at preadolescence.

ATTACHMENT IN INFANTS WITH CLEFT LIP AND/OR PALATE: MARGINAL SECURITY AND ITS CHANGES OVER TIME.

This study examines the attachment quality and how this changed over time among infants who had cleft lip and palate (CLP), by conducting a prospective longitudinal study addressing the effects of this type of perinatal event on the parent-infant relationship and the emotional development of the infants. At 12 months of age, the Strange Situation Paradigm (SSP; M. Ainsworth, M.C. Blehar, E. Waters, & T. Wall, 1978) was administered to a sample of 38 CLP infants (born between 2003 and 2010) and 17 healthy controls. At 4 years of age, the Attachment Story Completion Task (ASCT; I. Bretherton, D. Ridgeway, & J. Cassidy, 1990) was administered to 32 individuals from the CLP sample and 14 from the control group. As reported in the literature, CLP infants display secure attachment behaviors as frequently as do control infants (55%). However, a more detailed analysis of the attachment scales revealed that CLP infants show more avoidance and less proximity seeking. In addition, a closer examination of the subcategories of attachment styles revealed that most CLP infants (71%) displayed distal attachment strategies such as the B1/B2 or A1/A2 subcategories. At 4 years old, CLP infants clearly displayed more deactivation and less security than did the control sample. Moreover, when detailing the evolution of attachment individually, almost 60% of the CLP children showing distal strategies at 12 months became deactivated or disorganized when they reached 4 years. Indeed, subtle differences in attachment behaviors at 12 months old-which can be considered marginally secure at that age-may reveal attachment vulnerabilities, which seem to be more apparent over the course of development.

Maternal Representations and Parenting Style in Children Born With and Without an Orofacial Cleft.

OBJECTIVE: To investigate the evolution of maternal representations (ie, the way parents perceive their child in term of temperament, character, behaviors, etc) of children with a cleft at 3 major milestones: before/after reconstructive surgeries and at school age. Parenting style was also analyzed and compared with parents of children born without a cleft. DESIGN AND PARTICIPANTS: The sample was composed of 30 mothers of children with an orofacial cleft and 14 mothers of children without a cleft. Maternal representations were assessed when the child was 2 months (before surgery), 12 months (after surgery), and 5 years of age (when starting school) using semistructured interviews that were transcribed and coded according to the subscales of the Working Model of the Child Interview and the Parental Development Interview. At the 5-year appointment, mothers also completed a questionnaire about parenting style. RESULTS: Results showed no difference across groups (cleft/noncleft) in maternal representations at the 2-month, 12-month, and 5-year assessments. In the cleft group, significant differences were shown between 2 and 12 months in caregiving sensitivity, perceived infant difficulty, fear for the infant's safety, and parental pride, all factors being higher at 12 months. Those differences in parental representations over time were not found in the noncleft group. Additionally, mothers of the cleft group were significantly more authoritarian than mothers of children without a cleft. CONCLUSION: The absence of differences across cleft and noncleft groups suggests that having a child with a cleft does not affect maternal representations and emotions between 2 months and 5 years of the child's age. However, parenting style seems to be influenced by the presence of a cleft in the present sample.