This is a 4-year application to continue following at 10 and 12 years of age a cohort of very low birthweight (VLBW) and full term (FT) comparison children studied since birth. Maintenance of 77 percent of the original cohort at 8 years allows this study to address important theoretical and clinical issues for a group that presents a major public health problem because of long term developmental deficits. A major objective is to identify the influence of parenting, medical risk factors, and early learning skills on VLBW children's development of self regulation and executive processing (SR/EP) skills that place demands on flexibility in problem solving and behavioral organization. SR/EP skills are a major focus as they are expected to be early origins for the high incidence of behavior problems (e.g., poor attention and impulse control, social immaturity) frequently reported for VLBW children at school age. Deficits in SR/EP skills measured across 3-8 years have been identified for our large cohort of tri-ethnic, socially disadvantaged, medically high risk (HR, n 70) and low risk (LR, n = 106) VLBW vs. FT (n = 104) children. Of importance, relations are found between SR!EP skill growth (3-8 years) and 8 year outcomes requiring more complex aspects of these skills. The major goals for this continuation study are: 1) documenting separate early (i.e., 3, 4, 6, 8 years) and later (8, 10, 12 years) developmental trajectories of SR/EP skills for VLBW and FT children, 2) determining the relations of trajectories to early adolescent outcomes expected to require a strong foundation of development of SR/EP skills, and 3) determining the influence of early and concurrent parenting and child behaviors to later adolescent executive functioning. We are evaluating our cohort of children on a range of more complex SR/EP skills at 8 years (i.e., perspective taking, problem solving with peers, Tower of London, impulse control) and are finding lower scores for the VLBW vs. FT children. We propose to continue to study these same areas of ability at 10 and 12 years of age. By modeling rates of growth from 8-12 years, we can determine if VLBW children show slower growth rates throughout this age range, thus documenting persistent deficits. SR/EP growth trajectories across 3-8 and 8-12 years then will be related to 12 year adolescent outcomes (e.g., deductive reasoning, conflict resolution, friendship network, risk taking, academics, behavior problems). HR and LR VLBW children are expected to display slower growth than FT children and slower growth, in turn, is expected to predict poorer performance on 12-year outcomes. At present, little empirical information is available on the role of SR/EP skill development in understanding VLBW children's later, school age problems.
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