The New Survivors: The Longer Term Cognitive, Scholastic and Motor Outcomes of a Total Scottish Population of Surviving Very Low Birthweight Infants

Hall, Alastair Eaton (2000) The New Survivors: The Longer Term Cognitive, Scholastic and Motor Outcomes of a Total Scottish Population of Surviving Very Low Birthweight Infants. PhD thesis, University of Glasgow.

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Abstract

The prevalence of learning problems and impairments in cognitive ability and neuromotor functioning in a total geographically based very low birthweight population (N=324) was compared at eight years of age with that in a population comprising two classroom peers, matched for gender and age (N=590). The sociodemographic characteristics of the index and comparison groups were similar. The analyses reported in this thesis do not include those children being educated in the special school sector - as appropriate controls could not be identified. The mean IQ score for the index group was significantly lower than the mean IQ score for the comparison group. A significantly greater proportion of the index group had serious cognitive impairment, that is, they were performing more than 2 SD below the mean. The index children were found to be significantly underperforming in relation to the comparison children on tests of reading and number - although after controlling for IQ (ANCOVA) the difference between the two groups was no longer significant for reading. In terms of neuromotor competence, a significantly greater proportion of the index group than the comparison group were functioning below the 10th percentile. The 10th percentile (for the comparison group) was taken as the cut off to define motor impairment and 36% of the index group were categorised as motor impaired. Furthermore, a significantly greater proportion of the index group were classified as "suspicious" or "abnormal" in terms of their neurological status. The performance of the index children was also analysed by birthweight groupings (below 1000g and 1000 to 1499g) because of increasing clinical interest in the outcomes of children born on the limits of viability. The mean IQ scores for both index groups were significantly lower than those of their respective comparison groups. In all cognitive subscales apart from that testing short term auditory sequential memory, both index groups performed less well. Both index groups performed less well in tests of reading and number - although the differences were no longer significant after controlling for IQ. Fifteen per cent of the below 1000g index children and six per cent of those with birthweights 1000 to l499g attended special schools. Index children in both groupings who attended mainstream schools performed significantly less well in tests of neuromotor function than their peers. The differential effects of being small for gestational age (SGA) and of appropriate size for gestational age (AGA) on outcome measures of cognitive ability, scholastic attainment and neuromotor functioning were investigated. No differences were found between SGA and AGA index children, probably because the mean gestational age of the AGA children was lower than that of the SGA children. The SGA comparison children performed significantly less well on some measures of cognitive ability than the AGA comparison children. Gender differences on measures of cognitive ability, scholastic attainment and neuromotor functioning were investigated for both index and comparison groups. No gender differences were found in the index group with the exception of the ball skills element of the motor skills assessment where the performance of the females was poorer. The picture was the same for the comparison group except that, additionally, females were outperforming boys on tests of scholastic attainment. The extent to which under reporting of serious cognitive impairment can result from the use of published test norms was investigated. A larger proportion of index children were classified as seriously impaired in terms of cognitive ability when their performance was measured against norms derived from the comparison group. The same was true also for performance on measures of scholastic attainment. The possibility that motor impairment might affect performance on the visual items of the cognitive assessment battery used in this study was explored. While there was some evidence of such an effect particularly for the index children of satisfactory overall cognitive ability, the results of this investigation were inconclusive. The relationship between motor competence, neurological functioning and performance on measures of scholastic attainment was investigated. This strand of the investigation demonstrated that the test of neurological functioning used in this study is a useful screening tool for identifying children at high risk of learning difficulties.

Item Type: Thesis (PhD)
Qualification Level: Doctoral
Additional Information: Adviser: I W R Bushnell
Keywords: Cognitive psychology, Developmental psychology
Date of Award: 2000
Depositing User: Enlighten Team
Unique ID: glathesis:2000-75964
Copyright: Copyright of this thesis is held by the author.
Date Deposited: 19 Dec 2019 09:15
Last Modified: 19 Dec 2019 09:15
URI: https://theses.gla.ac.uk/id/eprint/75964

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