Skip to main content

The impact of preterm birth on participation in childhood occupation

European Journal of Pediatrics volume 174, pages 299–306 (2015)Cite this article

Abstract

Outcome studies of premature babies have focused their assessments predominately on neurodevelopmental impairments without relating these deficits to the impact they have on a child’s everyday life. This study aims to determine whether very ‘preterm birth alone’ impacts on a child’s ability to participate in and carry out childhood activities. Forty-four former premature infants between 6 months and 5 years 6 months, born in Galway University Hospital, Ireland, without physical or intellectual disability, were compared with 51 age-matched term-born infants. Study infants had an average gestation of 29 weeks and birth weight of 1,145 g. Functional skills were assessed using the Adaptive Behavior Assessment Scale-II and the Assessment of Preschool Children’s Participation. Premature infants had significantly lower mean scores in overall adaptive behaviour compared to term infants, regardless of whether chronological (difference = 13.6, 95 % (CI) = [8.2, 19.1]) or corrected (difference = 6.6, 95 % CI = [1.4, 11.8]) age was used. Premature infants had lower mean scores in conceptual, social and practical skills, but no difference was found between the groups in intensity or diversity of participation. Conclusion: Premature infants had significantly lower scores in adaptive behaviour than term infants. This measurable effect of preterm birth on ‘childhood occupations’ merits further investigation.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

43,34 €

Price includes VAT (Finland)
Tax calculation will be finalised during checkout.

Fig. 1
Fig. 2
Fig. 3

Abbreviations

ABAS-II:

Adaptive Behavior Assessment System, Second Edition

APCP:

Assessment of Preschool Children’s Participation

GUH:

Galway University Hospital

PREM:

Preterm infants, chronological age

PREM-COR:

Preterm infants, corrected age

Pl:

Play

SD:

Skill development

APR:

Active physical recreation

S:

Social

References

  1. Bruininks R, Woodcock R, Weatherman R, Hill B (1996) Scales of independent behavior-revised. Riverside Publishing, Chicago

    Google Scholar 

  2. Case-Smith J, Frolek Clark GJ, Schlabach TL (2013) Systematic review of interventions used in occupational therapy to promote motor performance for children ages birth-5 years. Am J Occup Ther 67:413–424

    Article  PubMed  Google Scholar 

  3. Cho J, Holditch-Davis D, Miles MS (2010) Effects of gender on the health and development of medically at-risk infants. JOGNN J Obstet Gynecol Neonatal Nurs 39:536–549

    Article  Google Scholar 

  4. Cooke RWI (2004) Health, lifestyle, and quality of life for young adults born very preterm. Arch Dis Child 89:201–206

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  5. Delobel-Ayoub M, Arnaud C, White-Koning M, Casper C, Pierrat V, Garel M, Burguet A, Roze JC, Matis J, Picaud JC, Kaminski M, Larroque B (2009) Behavioral problems and cognitive performance at 5 years of age after very preterm birth: the EPIPAGE Study. Pediatrics 123:1485–1492

    Article  PubMed  Google Scholar 

  6. Fernandes LV, Goulart AL, Nunes dos Santos AM, Barros MC, Guerra CC, Kopelman BI (2012) Neurodevelopmental assessment of very low birth weight preterm infants at corrected age of 18–24 months by Bayley III scales. J Pediatr 88:471–478

    Google Scholar 

  7. Fjørtoft T, Grunewaldt KH, Sognnæs M, Løhaugen GCC, Skranes J, Evensen KAI (2012) Adaptation problems in very low birth weight children at 10 years of age. Poster presentation 1241. Arch Dis Child 97:A354–A355

  8. Frolek Clark GJ, Schlabach TL (2013) Systematic review of occupational therapy interventions to improve cognitive development in children ages birth-5 years. Am J Occup Ther 67:425–430

    Article  PubMed  Google Scholar 

  9. Hack M (2009) Adult outcomes of preterm children. J Dev Behav Pediatr 30:460–470

    Article  PubMed  Google Scholar 

  10. Hack M, Flannery DJ, Schluchter M, Cartar L, Borawski E, Klein N (2002) Outcomes in young adulthood for very-low-birth-weight infants. N Engl J Med 346:149–157

    Article  PubMed  Google Scholar 

  11. Harman JL, Smith-Bonahue T (2010) The bayley III adaptive behavior scale. In Weiss L, Oakland T, & Aylward L (eds.) Bayley III: clinical use and interpretation. Academic Press

  12. Harrison PL, Oakland T (2003) Adaptive behavior assessment system, second edition. Harcourt Assessment, Inc, USA

    Google Scholar 

  13. Healy E, Reichenberg A, Nam KW, Allin MPG, Walshe M, Rifkin L, Murray SRM, Nosarti C (2013) Preterm birth and adolescent social functioning-alterations in emotion-processing brain areas. J Pediatr 163:1596–1604

    Article  PubMed  Google Scholar 

  14. Hille ETM, Weisglas-Kuperus N, Van Goudoever JB, Jacobusse GW, Ens-Dokkum MH, De Groot L, Wit JM, Geven WB, Kok JH, De Kleine MJK, Kollée LAA, Mulder ALM, Van Straaten HLM, De Vries LS, Van Weissenbruch MM, Verloove-Vanhorick SP (2007) Functional outcomes and participation in young adulthood for very preterm and very low birth weight infants: the Dutch project on preterm and small for gestational age infants at 19 years of age. Pediatrics 120:e587–e595

    Article  PubMed  Google Scholar 

  15. Horbar JD, Carpenter JH, Badger GJ, Kenny MJ, Soll RF, Morrow KA, Buzas JS (2012) Mortality and neonatal morbidity among infants 501 to 1500 grams from 2000 to 2009. Pediatrics 129:1019–1026

    Article  PubMed  Google Scholar 

  16. Huang J-H, Huang H-L, Chen H-L, Lin L-C, Tseng H-I, Kao T-J (2012) Inattention and development of toddlers born in preterm and with low birth weight. Kaohsiung J Med Sci 28:390–396

    Article  PubMed  Google Scholar 

  17. Johnson A, Bowler U, Yudkin P, Hockley C, Wariyar U, Gardner F, Mutch L (2003) Health and school performance of teenagers born before 29 weeks gestation. Arch Dis Child Fetal Neonatal Ed 88:F190–F198

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  18. King G, Law M, King S, Hurley P, Rosenbaum P, Hanna S, Kertoy M, Young N (2004) Children’s Assessment of Participation and Enjoyment (CAPE). Canchild Centre for Childhood Disability Research, McMaster University, Hamilton

    Google Scholar 

  19. King G, Law M, Petrenchik T, Kertoy M (2006) Assessment of preschool children’s participation (APCP). CanChild Centre for Childhood Disability Research, McMaster University, Hamilton

    Google Scholar 

  20. King M, Shields N, Imms C, Black M, Ardern C (2013) Participation of children with intellectual disability compared with typically developing children. Res Dev Disabil 34:1854–1862

    Article  PubMed  Google Scholar 

  21. Kingsley K, Mailloux Z (2013) Evidence for the effectiveness of different service delivery models in early intervention services. Am J Occup Ther 67:431–436

    Article  PubMed  Google Scholar 

  22. Lambert N, Nihira K, Leland H (1993) AAMR adaptive behavior scale—school, second edition. PRO-ED, Austin

    Google Scholar 

  23. Law M, Anaby D, Teplicky R, Khetani MA, Coster W, Bedell G (2013) Participation in the home environment among children and youth with and without disabilities. Br J Occup Ther 76:58–66

    Article  Google Scholar 

  24. Law M, King G, Petrenchik T, Kertoy M, Anaby D (2012) The assessment of preschool children’s participation: internal consistency and construct validity. Phys Occup Ther Pediatr 32:272–287

    Article  PubMed  Google Scholar 

  25. Oakland T, Iliescu D, Chen HY, Chen JH (2013) Cross-national assessment of adaptive behavior in three countries. J Psychoeduc Assess 31:435–447

    Article  Google Scholar 

  26. Oakland TH, Patti L (2008) ABAS-II clinical use and interpretation. Elsevier, London

    Google Scholar 

  27. Peterson J, Taylor HG, Minich N, Klein N, Hack M (2005) Subnormal head circumference in very low birth weight children: neonatal correlates and school-age consequences. Early Hum Dev 82:325–334

    Article  PubMed  Google Scholar 

  28. Schalock RL, Borthwick-Duffy SA, Bradley VJ, Buntinx WHE, Coulter DL, Craig EM et al (2010) Intellectual disability: definition, classification, and systems of support. Association on Intellectual and Developmental Disability, Washington DC

    Google Scholar 

  29. Slattery MM, Morrison JJ (2002) Preterm delivery. Lancet 360:1489–1497

    Article  PubMed  Google Scholar 

  30. Snider L, Majnemer A, Mazer B, Campbell S, Bos AF (2009) Prediction of motor and functional outcomes in infants born preterm assessed at term. Pediatr Phys Ther 21:2–11

    Article  PubMed  Google Scholar 

  31. Sparrow S, Cicchetti D, Balla D (2005) Vineland adaptive behavior scales, second edition. AGS Publishing, Circle Pines

    Google Scholar 

  32. Spittle A, Orton J, Anderson P, Boyd R, Doyle LW (2012) Early developmental intervention programmes post-hospital discharge to prevent motor and cognitive impairments in preterm infants. Cochrane Database of Systematic Reviews. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD005495.pub3/abstract

  33. Stevenson DK, Tyson JE, Korones SB, Bauer CR, Stoll BJ, Papile LA, Verter J, Fanaroff AA, Oh W, Ehrenkranz RA, Shankaran S, Donovan EF, Wright LL, Lemons JA (2000) Sex differences in outcomes of very low birthweight infants: the newborn male disadvantage. Arch Dis Child Fetal Neonatal Ed 83:F182–F185

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  34. Sullivan MC, Miller RJ, Msall ME (2012) 17-year outcome of preterm infants with diverse neonatal morbidities: part 2, impact on activities and participation. J Spec Pediatr Nurs 17:275–287

    Article  PubMed  Google Scholar 

  35. Sullivan MC, Msall ME, Miller RJ (2012) 17-year outcome of preterm infants with diverse neonatal morbidities: part 1-impact on physical, neurological, and psychological health status. J Spec Pediatr Nurs 17:226–241

    Article  PubMed Central  PubMed  Google Scholar 

  36. Tassé MJ, Schalock RL, Balboni G, Bersani H Jr, Borthwick-Duffy SA, Spreat S, Thissen D, Widaman KF, Zhang D (2012) The construct of adaptive behavior: its conceptualization, measurement, and use in the field of intellectual disability. Am J Intellect Dev Disabil 117:291–303

    Article  PubMed  Google Scholar 

  37. Taylor HG, Klein N, Drotar D, Schluchter M, Hack M (2006) Consequences and risks of <1000-g birth weight for neuropsychological skills, achievement, and adaptive functioning. J Dev Behav Pediatr 27:459–469

    Article  PubMed  Google Scholar 

  38. The American Occupational Therapy Association (2010) The role of occupational therapy with children and youth. https://www.aota.org/%7E/media/Corporate/Files/AboutOT/Professionals/WhatIsOT/CY/Fact-Sheets/Children%20and%20Youth%20fact%20sheet.ashx (accessed 9 January 2014)

  39. Verloove-Vanhorick SP, Veen S, Ens-Dokkum MH, Schreuder AM, Brand R, Ruys JH (1994) Sex difference in disability and handicap at five years of age in children born at very short gestation. Pediatrics 93:576–579

    CAS  PubMed  Google Scholar 

  40. Vos RC, Becher JG, Ketelaar M, Smits DW, Voorman JM, Tan SS, Reinders-Messelink HA, Dallmeijer AJ (2013) Developmental trajectories of daily activities in children and adolescents with cerebral palsy. Pediatrics 132:e915–e923

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

This study was supported by the National University of Ireland, Galway’s Millennium Research Fund.

Conflict of interest

No conflict of interest exists.

Author information

Affiliations

  1. Discipline of Occupational Therapy, School of Health Sciences, College of Medicine, Nursing and Health Sciences, National University of Ireland, Galway, Newcastle road, Galway, Ireland

    Hazel Killeen & Agnes Shiel

  2. School of Rehabilitation Science, McMaster University, Hamilton, Canada

    Mary Law

  3. Centre for Support and Training in Analysis and Research, School of Public Health, Physiotherapy & Population Science, University College Dublin, Dublin, Ireland

    Ricardo Segurado

  4. Department of Paediatrics, University College Hospital Galway, Galway, Ireland

    Donough O’Donovan

Authors
  1. Hazel Killeen
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Agnes Shiel
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Mary Law
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Ricardo Segurado
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Donough O’Donovan
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Hazel Killeen.

Additional information

Communicated by Patrick Van Reempts

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Killeen, H., Shiel, A., Law, M. et al. The impact of preterm birth on participation in childhood occupation. Eur J Pediatr 174, 299–306 (2015). https://doi.org/10.1007/s00431-014-2393-4

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00431-014-2393-4

Keywords

  • Neonatology
  • Preterm birth
  • Infant
  • Adaptive behaviour
  • Participation