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Social and Behavioral Differences in Extremely Low Birthweight Children† 1257

Longitudinal studies of extreme low birthweight (ELBW) sequelae have most often focused on cognitive rather than on social or behavioral outcomes. Our objective was to examine these latter sequelae which also influence school and academic performance. Methods: We matched 24 children, 3-8 years of age, who were born from 1988-1992 weighing ≤ 1000gm (mean 860 gm, gestational age 27 wks) with 13 same-aged children born at term with birthweights ≥ 2500 gm (mean 3564 gm, gestational age 40 wks). Temperamental, behavioral, and social competency outcomes were assessed by parent report [Temperament Assessment Battery for Children (TABC), Child Behavior Checklist (CBCL)] and investigator evaluation [Vineland Adaptive Behavior Scales (VABS)]. Academic skills were assessed using the Test of Early Math Ability-2 (TEMA-2) and the Test of Early Reading Ability-2 (TERA-2). Results: ELBW subjects had more difficulty with attention and social interactions as compared to normal birthweight (NBW) controls. On theCBCL, the ELBW group scored significantly higher than the NBW group on subscales measuring attention problems (59± 8 vs 51± 2, p=0.014) and social problems (57 ± 8 vs 50 ± 1, p=0.02). On theVABS, ELBW children showed poorer development of adaptive behaviors including communication (p=0.003), daily living skills (p=0.002), and motor skills (p=0.002) as compared to NBW controls. In the VABS Socialization Domain, ELBW children had lower standard scores than controls (p=0.001) reflecting poorer social competency. ELBW children were also more likely to score in the “low” range (<2 SD) on the Adaptive Behavior Composite of the VABS (p=0.039). On the TABC, ELBW children were rated by parents to have higher activity levels than NBW children (51 ± 9 vs 43 ± 9, p=0.03). ELBW children scored less well on theTEMA-2 (89 ± 15 vs 106 ± 19, p=0.008) and theTERA-2 (96 ± 16 vs 111 ± 15, p=0.01). Conclusion: Compared to term NBW children, the ELBW group had higher activity levels and demonstrated more difficulty with attention, social competency, and adaptive behaviors. These problems may contribute to low self-esteem and impair socialization skills, adversely affecting success in school and academic performance.