- Email: [email protected]
Psychosocial development of adolescent preterm children
Early Human Development 89 (2013) 197–198
Contents lists available at SciVerse ScienceDirect
Early Human Development journal homepage: www.elsevier.com/locate/earlhumdev
Best practice guidelines
Psychosocial development of adolescent preterm children Maureen Hack ⁎ Department of Pediatrics, Case Western Reserve University, Cleveland, OH, United States
Contents Conflict of interest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
The majority of follow-up studies of preterm infants have focused on neurodevelopmental outcomes during early childhood. However the recognition that neuropsychological and behavioral deficits together with social and emotional problems account for a substantial proportion of the longer term impairment of preterm children has led to increased research on psychosocial problems and their sociodemographic and biologic correlates during the school age years and beyond. Adolescence is an especially important formative period of child development as it is characterized by profound biological, psychosocial, and social changes which are greater than at any stage of life other than during infancy. These changes would be expected to influence the functioning of preterm children with respect to their psychosocial adjustment and self perception of quality of life. Critical competencies in neuropsychological functioning and academic achievement are also strengthened during adolescence and become increasingly predictive of adult outcomes. Furthermore as neuroradiological techniques have advanced, continued maturation of brain processes during adolescence has been documented. In this edition of Best Practice Guidelines we present four reviews pertaining to the adolescent psychosocial development of preterm children and provide key guidelines with relevance to clinical practice and suggestions for future research directions. Samantha Johnson and Dieter Wolke provide an updated review of behavioral outcomes and psychopathology during adolescence. They note the preterm behavioral phenotype which is characterized by inattention, anxiety and socio-communicative problems and the higher prevalence of ADHD, emotional problems and Autism as compared to term born normal birth weight children as well as the comorbidity with neurodevelopmental problems which are prevalent among preterm children. They stress the importance of identification and treatment of mental health problems during adolescence as well as the need for studies of the biologic and socioenvironmental
⁎ Rainbow Babies and Children's Hospital, University Hospitals of Cleveland Case Medical Center, 11,100 Euclid Avenue, Cleveland, OH 44106-6010, United States. Tel.: + 1 216 8443387; fax: + 1 216 8443380. E-mail address: [email protected]. 0378-3782/$ – see front matter © 2013 Elsevier Ireland Ltd. All rights reserved. http://dx.doi.org/10.1016/j.earlhumdev.2013.01.011
198
correlates of preterm psychopathology and for more studies of behavioral problems among late preterm children. Alice Burnett, Shannon Scratch and Peter Anderson review executive functioning which encompasses higher-order problem-solving important for everyday adaptive behaviors. They present a conceptual framework of executive functioning which includes information processing, attentional control, cognitive flexibility and goal setting, all of which are deficient among preterm children and may be associated with functional consequences such as poorer academic achievement and social–emotional competence which may lead to difficulty in transitioning to adult independence. They stress the importance of monitoring of executive function into adolescence and the need for studies of the relationship of difficulties in executive function to social and emotional problems. Chiari Nosarti reviews normal brain development and the structural and functional brain correlates of the adolescent behavioral and psychiatric problems prevalent among preterm children as well as the selective vulnerability of specific brain regions underlying these problems. She reviews the associations of the various problems with abnormalities documented by magnetic resonance imaging (MRI), diffusion tensor MRI (DT-MRI), functional MRI (fMRI), electroencephalography (EEG) and neonatal cerebral ultrasonography. Nosarti stresses the importance of continued research into potentially different or abnormal trajectories of development of the preterm brain and their relationship to psychiatric disorder. Information in this regard may lead to the development of early interventions to prevent such abnormality which may possibly improve later functioning. Saroj Saigal reviews self- and proxy reports of the quality of life of preterm infants during adolescence and beyond. She stresses the importance of information not only on health outcomes but also on the personal burden of illness and life satisfaction in survivors of neonatal intensive care. Studies reveal that despite functional limitations, preterm adolescents and young adults rate their subjective quality of life as similar to that of term born controls and better than proxy reports from parents and health professionals. Such information is important when considering various aspect of the care of the adolescents and young adults. Saigal suggests that self reported quality of life measures should become an integral part of clinical therapeutic trials and taken into consideration in treatment decisions as to whether to offer neonatal intensive care to extremely preterm children.
198
M. Hack / Early Human Development 89 (2013) 197–198
Interventions and therapies for the special health care needs resulting from the sequelae of preterm birth currently pertain mainly to medical therapies of neurosensory disorders and to special education for cognitive and academic problems. The reviews emphasize the importance of equal attention to the identification of psychosocial and behavioral problems and to their neuropsychological correlates with appropriate interventions. Only in this way will we be able to
impact on the overall functioning and quality of life of preterm adolescents. Conflict of interest The author has no conflict of interest to declare.
Contents lists available at SciVerse ScienceDirect
Early Human Development journal homepage: www.elsevier.com/locate/earlhumdev
Best practice guidelines
Psychosocial development of adolescent preterm children Maureen Hack ⁎ Department of Pediatrics, Case Western Reserve University, Cleveland, OH, United States
Contents Conflict of interest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
The majority of follow-up studies of preterm infants have focused on neurodevelopmental outcomes during early childhood. However the recognition that neuropsychological and behavioral deficits together with social and emotional problems account for a substantial proportion of the longer term impairment of preterm children has led to increased research on psychosocial problems and their sociodemographic and biologic correlates during the school age years and beyond. Adolescence is an especially important formative period of child development as it is characterized by profound biological, psychosocial, and social changes which are greater than at any stage of life other than during infancy. These changes would be expected to influence the functioning of preterm children with respect to their psychosocial adjustment and self perception of quality of life. Critical competencies in neuropsychological functioning and academic achievement are also strengthened during adolescence and become increasingly predictive of adult outcomes. Furthermore as neuroradiological techniques have advanced, continued maturation of brain processes during adolescence has been documented. In this edition of Best Practice Guidelines we present four reviews pertaining to the adolescent psychosocial development of preterm children and provide key guidelines with relevance to clinical practice and suggestions for future research directions. Samantha Johnson and Dieter Wolke provide an updated review of behavioral outcomes and psychopathology during adolescence. They note the preterm behavioral phenotype which is characterized by inattention, anxiety and socio-communicative problems and the higher prevalence of ADHD, emotional problems and Autism as compared to term born normal birth weight children as well as the comorbidity with neurodevelopmental problems which are prevalent among preterm children. They stress the importance of identification and treatment of mental health problems during adolescence as well as the need for studies of the biologic and socioenvironmental
⁎ Rainbow Babies and Children's Hospital, University Hospitals of Cleveland Case Medical Center, 11,100 Euclid Avenue, Cleveland, OH 44106-6010, United States. Tel.: + 1 216 8443387; fax: + 1 216 8443380. E-mail address: [email protected]. 0378-3782/$ – see front matter © 2013 Elsevier Ireland Ltd. All rights reserved. http://dx.doi.org/10.1016/j.earlhumdev.2013.01.011
198
correlates of preterm psychopathology and for more studies of behavioral problems among late preterm children. Alice Burnett, Shannon Scratch and Peter Anderson review executive functioning which encompasses higher-order problem-solving important for everyday adaptive behaviors. They present a conceptual framework of executive functioning which includes information processing, attentional control, cognitive flexibility and goal setting, all of which are deficient among preterm children and may be associated with functional consequences such as poorer academic achievement and social–emotional competence which may lead to difficulty in transitioning to adult independence. They stress the importance of monitoring of executive function into adolescence and the need for studies of the relationship of difficulties in executive function to social and emotional problems. Chiari Nosarti reviews normal brain development and the structural and functional brain correlates of the adolescent behavioral and psychiatric problems prevalent among preterm children as well as the selective vulnerability of specific brain regions underlying these problems. She reviews the associations of the various problems with abnormalities documented by magnetic resonance imaging (MRI), diffusion tensor MRI (DT-MRI), functional MRI (fMRI), electroencephalography (EEG) and neonatal cerebral ultrasonography. Nosarti stresses the importance of continued research into potentially different or abnormal trajectories of development of the preterm brain and their relationship to psychiatric disorder. Information in this regard may lead to the development of early interventions to prevent such abnormality which may possibly improve later functioning. Saroj Saigal reviews self- and proxy reports of the quality of life of preterm infants during adolescence and beyond. She stresses the importance of information not only on health outcomes but also on the personal burden of illness and life satisfaction in survivors of neonatal intensive care. Studies reveal that despite functional limitations, preterm adolescents and young adults rate their subjective quality of life as similar to that of term born controls and better than proxy reports from parents and health professionals. Such information is important when considering various aspect of the care of the adolescents and young adults. Saigal suggests that self reported quality of life measures should become an integral part of clinical therapeutic trials and taken into consideration in treatment decisions as to whether to offer neonatal intensive care to extremely preterm children.
198
M. Hack / Early Human Development 89 (2013) 197–198
Interventions and therapies for the special health care needs resulting from the sequelae of preterm birth currently pertain mainly to medical therapies of neurosensory disorders and to special education for cognitive and academic problems. The reviews emphasize the importance of equal attention to the identification of psychosocial and behavioral problems and to their neuropsychological correlates with appropriate interventions. Only in this way will we be able to
impact on the overall functioning and quality of life of preterm adolescents. Conflict of interest The author has no conflict of interest to declare.