Premature babies and learning disabilities in children

The Co-relation of the Uterine Environment and Premature Birth to Learning Disabilities in Children : 

The Co-relation of the Uterine Environment and Premature Birth to Learning Disabilities in Children Lisa Lahey, B.Ed.

Abstract : 

Abstract This report examines the co-relation between a child’s development from foetus to birth and it’s eventual academic performance in an educational setting. It examines two physical states and their impact on (1) the percentage of children developing learning and reading disabilities requiring support services and (2) the type and severity of these disabilities. Specifically this study focuses on the correlation between both unhealthy and healthy uterine environments before the infant’s birth, and the effect of premature birth on the infant and its future intellectual performance. 05/12/2010 2 Uterine Environment/Premature Birth/Learning Disabilities Lisa Lahey, B.Ed.

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Medical science research has proven conclusively that foetal development in an unhealthy uterine environment has a significant impact on the child after it is born including: Learning disabilities Physical disabilities Behavioural issues Poor social skills Typically these children perform poorly in school for a number of reasons including factors other than the uterine environment: Socioeconomic status Family environment 05/12/2010 3 Uterine Environment/Premature Birth/Learning Disabilities Lisa Lahey, B.Ed.

Pre-Natal Care : 

Pre-Natal Care A woman who is unable or unwilling to receive sufficient medical care before her infant’s birth puts the child at considerable risk for the factors previously noted as well as: Premature birth Low birth weight Stillbirth Sudden Infant Death Syndrome (SIDS) Insofar as the excess mortality among African-American and African-Canadian infants are concerned there is a high rate of very low birth-weight deaths. In fact very low birth rates account for almost two-thirds of the disparity in infant mortality between African-Americans/Canadians and whites. 05/12/2010 4 Uterine Environment/Premature Birth/Learning Disabilities Lisa Lahey, B.Ed.

Mother Malnutrition : 

Mother Malnutrition A mother who suffers from malnutrition while pregnant usually delivers an infant whose organs are smaller and have fewer cells than normal. Many different organs are adversely affected: the heart and lungs, the liver and kidneys, the thymus, and the brain. Smaller numbers of cells at birth set the stage for poor adult health and cognitive ability. 05/12/2010 5 Uterine Environment/Premature Birth/Learning Disabilities Lisa Lahey, B.Ed.

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Unhealthy conditions in the intrauterine environment has an impact on the development of the foetus, which becomes evident in later life, mainly in the form of cardiovascular diseases, diabetes, and certain learning disabilities. Besides being responsible for these delayed postnatal effects, abnormalities of the placenta, umbilical cord, and amniotic fluid also have associations with structural and chromosomal disorders. Infection, a family history of risky pregnancies, the use of alcohol, smoking, and hypertension should be taken into consideration when commenting on the placental size. A healthy foetal environment ensures a good birth outcome. 05/12/2010 6 Uterine Environment/Premature Birth/Learning Disabilities Lisa Lahey, B.Ed.

cocaine exposure pre-birth : 

cocaine exposure pre-birth 05/12/2010 Uterine Environment/Premature Birth/Learning Disabilities Lisa Lahey, B.Ed. 7 Full-term children with prenatal cocaine exposure drawn from a sample in a 2009 report conducted by Connie E. Morrow and others, included 409 children (212 cocaine-exposed, 197 non-cocaine-exposed) who were tested using the Wechsler Individual Achievement Test by age 7. Risk for developing a learning disability (LD) or impaired intellectual functioning was assessed using the Wechsler Intelligence Scale for Children–Third Edition. The cocaine-exposed children had 2.8 times greater risk of developing a LD by age 7 than non-cocaine-exposed children.

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05/12/2010 Uterine Environment/Premature Birth/Learning Disabilities Lisa Lahey, B.Ed. 8 Mothers were interviewed at birth regarding their drug use during pregnancy. Standardized drug use questions were asked by trimester and included number of weeks used, most days per week, fewest days per week, usual days per week, and usual dose per day. Dosage was measured in number of cigarettes smoked; number of marijuana joints smoked; number of drinks of beer, wine, or hard liquor; and number of cocaine lines/rocks; recorded in increments of usual daily dose; usual days per week; and number of weeks used. Standard definitions were used for determining 1-drink units for each type of alcohol (beer 12 oz., wine 5 oz., and liquor 1.5oz.). Pregnancy exposure composites were calculated for each drug by multiplying the number of weeks used by the usual days per week and the usual dose per day.

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05/12/2010 Uterine Environment/Premature Birth/Learning Disabilities Lisa Lahey, B.Ed. 9 For students with mental retardation and LD, their diminished academic functioning and the impact on opportunities for employment and economic productivity have lifelong consequences. Thus, examination of populations who may have increased risk for these types of disabilities is important for the affected individual as well as the educational system. Cocaine, a potential teratogen (an agent leading to a congenital disorder or physical malformation), crosses the placenta and impacts the developing monoaminergic neurotransmitter systems (derived from amino acids), disrupting structural and functional aspects of foetal brain development. Monoaminergic neurotransmitters appear early in foetal brain development and are important in the development of neuronal circuitry.

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05/12/2010 Uterine Environment/Premature Birth/Learning Disabilities Lisa Lahey, B.Ed. 10 The WIAT Screener included the following subtests: Basic Reading, Spelling, and Mathematics Reasoning. In addition, the Numerical Operations subtest was also administered. Evidence exists from infancy and preschool studies to suggest prenatal cocaine exposure results in subtle processing deficits that might increase risk for developing a learning disability, including deficits in visual attention, sustained attention, and inhibitory control. A total of 20 children were classified as having LD in at least one of the (15 CE children and 5 NCE children), and 19 were classified using the IQ ≥ 80 cutoff. In the IQ ≥ 70 cutoff condition, the CE children had an estimated 2.8 times greater risk of developing a learning disability by age 7.

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05/12/2010 Uterine Environment/Premature Birth/Learning Disabilities Lisa Lahey, B.Ed. 11 Additional analyses were conducted to determine whether increasing levels of prenatal cocaine exposure further increased risk for developing LD. A latent variable for maternal cocaine/crack usage during pregnancy was measured by separate categorical summaries of first, second, and third trimester self-report. The supposition of most longitudinal research studies was that prenatal cocaine exposure would be associated with severe developmental deficits similar to those associated with prenatal alcohol exposure. Subsequent research from large, prospectively enrolled cohorts has revealed a more balanced perspective, with cocaine-exposed children showing modest to moderate decrements in global developmental functioning during infancy, with an attenuation of these findings during the preschool years.

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05/12/2010 Uterine Environment/Premature Birth/Learning Disabilities Lisa Lahey, B.Ed. 12 Alcohol use can cause learning disabilities, hyperactivity and other disorders by damaging the delicate brain growth process in the unborn child during pregnancy. Attention, distraction and impulsive behaviour problems in particular were found to occur in a study of 475 young school age children whose mothers drank moderate amounts of alcohol during pregnancy. The study used neurological test measures, called Continuous Performance Tasks (CPT), to determine endurance, persistence, organization, distractibility and impulsivity in this large group of 7 year old children. One test given is called the AX-task. In this test the child sits at a computer screen that is flashing single letters at one second intervals. The child is asked to push a button when the letter "X" appears, but only when it was immediately preceded by the letter "A".

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05/12/2010 Uterine Environment/Premature Birth/Learning Disabilities Lisa Lahey, B.Ed. 13 The results showed that greater alcohol exposure resulted in far more errors on the AX task. The authors stated that, "The direction of the effect is as predicted, with poorer performance associated with higher (alcohol) exposure." Tests of distraction were also conducted while the child was taking CPT tests. There was an 8% distraction rate for the 0-3 drink exposure children, a 14% distraction rate for the 3-4 drink exposure children and a 46% distraction rate for the children whose mothers drank more than 4 drinks per day.

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05/12/2010 Uterine Environment/Premature Birth/Learning Disabilities Lisa Lahey, B.Ed. 14 Alcohol use during pregnancy causes many ill effects that directly effect a student’s academic ability. Some of these include: dyslexia loss of intellectual functioning developmental delay severe loss of intellectual potential behavioural problems ADHD, ADD inability to understand abstract concepts cognitive perseveration sensory integration problems developmental speech and language disorder mild to severe vision problems

Premature Births and Learning Disabilities : 

Premature Births and Learning Disabilities A baby born anywhere from one to several weeks premature has an increased risk of developing a learning disability than a baby that is born at full term. A longitudinal study of mildly preterm children and full-term comparison children found a higher-than-expected percentage among preterm children of learning disabilities, attention-deficit disorder (ADD), language impairment, mild neurologic impairment, and general school concerns by Grade 5. Seventy-five percent of the pre-terms fell into these diagnostic categories. Read Learning Disability, Attention-Deficit Disorder, and Language Impairment as Outcomes of Prematurity: A Longitudinal Descriptive Study 05/12/2010 Uterine Environment/Premature Birth/Learning Disabilities Lisa Lahey, B.Ed. 15

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The frequency of preterm births is higher than expected among children with ADD and among children with LD. Preterm infants are born more often to mothers who are poor, mothers who abuse substances, and pregnancy is a trigger for preterm birth. These biological risks also place an infant at risk for suboptimal environmental conditions. Although neurological and caretaking concerns of prematurity place the child at risk for developmental disturbances it has not been possible to identify with certainty which preterm infants will in fact manifest a disability and which will not. 05/12/2010 16 Uterine Environment/Premature Birth/Learning Disabilities Lisa Lahey, B.Ed.

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Infants with the same birth weight and the same number of medical complications can develop with varying degrees of impairment. Prediction is difficult with children born only mildly at risk, those who are born only a short time before term, and who weigh more than 1,500 grams. Definitive diagnosis of learning disability and related disorders, such as language impairment (LI), other mild neurologic impairments (NI), and attention-deficit disorders (ADD), remains elusive. It is unclear who is eligible for identification. Once found eligible, there is the further confusion about precise classification and which of several disorders might be primary. 05/12/2010 17 Uterine Environment/Premature Birth/Learning Disabilities Lisa Lahey, B.Ed.

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05/12/2010 Uterine Environment/Premature Birth/Learning Disabilities Lisa Lahey, B.Ed. 18 Premature infants are thought to be the prototype of children at risk for developmental difficulties. A child born premature means that at the time of birth the central nervous system was not able to sustain itself fully in the extra-uterine environment. These children have difficulty regulating enough interest to tolerate environmental stimulation. They allocate attention to an internal state rather than to the stimulus field. Prematurity places a child at risk for failure to achieve the self-regulation required for autonomic function. They are often identified in the early elementary grades as they begin to confront the acquisition of reading and math skills. By Grade 3 a large majority of those children who will be classified as LD have already been identified.

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05/12/2010 Uterine Environment/Premature Birth/Learning Disabilities Lisa Lahey, B.Ed. 19 Read Early Intervention for Low Birth Weight, Premature Infants: Participation and Intellectual Development. The Infant Health and Development Program studied a sample of 377 low birth weight, premature infants compared to a control group in the first 3 years of life. At 1 year no difference was noted between the 2 infant groups in terms of participation and IQ. At 24 months higher IQ was associated with increased levels of participation in years 1 and 2 of the study. At 36 months of age higher IQ was associated with increased participation in all 3 years of the study. Early educational intervention was judged crucial to achieving cognitive gains among low birth weight children. When interactions were accurately matched to intellectual structures in the child cognitive development was increased. The study hypothesized that higher levels of participation would be associated with positive gains.

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05/12/2010 Uterine Environment/Premature Birth/Learning Disabilities Lisa Lahey, B.Ed. 20 Between January 1985 and October 1985 families of low birth weight (<2500 grams), premature infants (<37 weeks of gestation) participated in a controlled trial of an early intervention program. Intervention was conducted until every child reached 36 months of age (corrected for prematurity). Half of the infants were male, 53% were African American, 10% were Hispanic and the remaining children were White, Asian or Other. At 1 year African-Americans scored below both Hispanic and White/Other/Asian, and the children of mothers with college degrees or some college scored higher than children of mothers with some high school. The children of mothers with a high school diploma scored higher than the children of mothers with some high school.

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05/12/2010 Uterine Environment/Premature Birth/Learning Disabilities Lisa Lahey, B.Ed. 21 The combination of biological and social risk cannot be overcome but children most-at-risk stand to make the greatest gains. The reduction or elimination of intergenerational low birth rate is one remote benefit that might be expected from early intervention programs. Childhood social and economic resources and intergenerational poverty suggest that effort to reduce poor birth outcomes should begin as early in life as possible.

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05/12/2010 Uterine Environment/Premature Birth/Learning Disabilities Lisa Lahey, B.Ed. 22 Read language development of preterm children 29 children between the ages of 4 and 5 who had been born prematurely were assessed for language development. They were assessed in terms of oral motor aspects, verbosity, phonological aspects, receptive semantics, expressive semantics, receptive syntax, and expressive syntax. Most of the neurologically normal preterm children had high passing scores but appeared to be at risk for mild language development delay. Most of the neurologically suspect preterm children had lower passing scores and they performed significantly lower on several measures than the neurologically normal children.

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05/12/2010 Uterine Environment/Premature Birth/Learning Disabilities Lisa Lahey, B.Ed. 23 Children in the toddler stage often exhibited language delays, however these delays diminished with age. Neurologically suspect and abnormal preterm children were at greater risk for delayed language development than neurologically normal children. Out of the 7 assessed categories, the neurologically normal and suspect/abnormal preterm children were scored on, 85% of the normal children scored 5 or higher. 70% of suspect children scored 4 or less. Most children failed oral motor development and syntax.

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05/12/2010 Uterine Environment/Premature Birth/Learning Disabilities Lisa Lahey, B.Ed. 24 Academic funding for students with learning disorders and lower intellectual functioning requiring educational assistance, has enormous impact on the individual child and family, as well as the systems that must support and care for children with disabilities. Recent data from the U.S. Department of Education revealed that over 5.7 million students ages 6 through 21 years received services under the Individuals with Disabilities Education Act during the 2000–2001 school year. This figure represents 11.5% of the estimated student enrolment in public schools for grades kindergarten through twelfth grade. Per-pupil special education expenditures for students with LDs average $10,558, compared with per-pupil expenditures of $6,556 for students who do not receive special education services