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[Cognitive, emotional and behavioral development of VLBW and ELBW preterm infants: diagnostic and therapeutic follow-up at preschool age].

AIM
Aims of the present study ware: to identify in preterm children of 4-6 years of age outcomes concerning cognitive, linguistic, emotional and behavioral development; to develop a therapeutic-rehabilitative project for those children in collaboration with the family and school.


METHODS
The study enrolled 20 children born prematurely at ≤32 weeks of gestational age and/or with a weight ≤1500 g, 12 VLBW (7 male e 5 female), 8 ELBW (4 male e 4 female), hospitalized at Novara Hospital "Maggiore della Carità" during the years 2003 and 2004, without severe outcomes. Psychodiagnostic evaluation was performed with standardized tests. On the final report results were discussed with parents, with specific indications for families and schools. Follow-up was at 6 months. Statistical elaboration of data was performed using Spss (Statistical Package for Social Sciences) version 16.


RESULTS
Normal cognitive level resulted from the Griffiths Scale, without significant differences between VLBW and ELBW. The overall lowest score, in the "performance" subscale, especially for ELBW, was correlated with Vineland Scales (low scores in the subscales "everyday skills" and "motor ability"). The highest scores were detected in the "linguistic" subscale of the Griffiths Scales and in the "Communication" subscale of the Vineland Scales. The results at Bus Story Test (narrative language) were lower than average for that age. CBCL and TRF do not demonstrate clinical results in the emotional-behavioural area, but the teachers give a more critical assessment. Difficulties in emotional self-regulation interfere in the test, in the separation from the parents and in socializing.


CONCLUSION
Monitoring development before starting primary school helps to discover potential problems and to activate supportive interventions. Early interventions allow to control and contain academic failure at school, which could have a negative impact on the child's image of himself and on the perception that the parents and school could have.