Rates of Skill Acquisition in Non-Stressed 30- to 33-Week Gestational Age Prematurely Born Infants with Birthweights of ( and Lt; Or =) 2000 Grams.
McDonald, Gay Susan Thompson
1980
Abstract
The literature is replete with investigations describing the biological and behavioral development of the premature infant. These studies have generally stressed the similarities between infants of comparable conceptual ages regardless of age since birth. While they tend to support and emphasize the observed similarities between full-term and prematurely born infants of like conceptual age, several investigators have included discussions of observed differences in these two infant populations. There are observable behavioral discrepancies in the early developmental patterns of the prematurely born infant which cannot be accounted for by a strict adherence to a biological model as explanation for their skill acquisition; st and ard scores for the premature are elevated over those of the full-term infant for the first three months. While it is only a transient advantage to prematurity it has led recent investigators to focus on these striking and potentially important differences in the biological and behavioral maturation of the prematurely born infant. This study was designed to look specifically at rates of skill acquisition in non-stressed prematurely born infants or 30- to 33-week gestational age with brithweights < 2000 grams as compared with skill acquisition rates observed in a nonstressed control group in order to address these questions. In order to assure non-stressed infants this study excluded any infant who ran a higher than normal risk of subsequent abnormal development due to, among other causes, intrauterine growth retardation (SGA infant), congenital anomalies, serious neonatal infections or other stressful conditions currently known from the treatment and neonatal course of recovery for the premature. Twenty-one Black premature infants were assessd weekly for the first eight weeks of life and bimonthly until approximately seven to eight months of age. Data were collected using the Bayley Scales of Infant Development - Mental Scale and the Brazelton Neonatal Assessment Scale. Data analysis revealed a statistically significant difference (p = < .001) in the mean rates of skill acquisition in the premature and full-term control group. However, graphic representation of the mean rates obtained on a regression analysis showed that the two distributions were much more similar than shown by a simple analysis of the mean rates. Further analysis by student t-ratio on each mean assessment score revealed a clearer picture of the relationship between the two rates of skill acquisition. No statistically significant difference in mean assessment rate was found following twelve weeks chronological age for the full-term infant and like conceptual age for the premature. This replicated earlier findings of elevated st and ard scores for the first three months for the premature by Hunt and Rhodes (1977). Observations from this study and collected data suggest that prematures at term were generally at a higher level of arousal and more visually alert than the fullterm infant. However, while the premature was noted to have a high level of arousal the premature also had more weak responses indicating an inability to inhibit his arousal responses in order to respond more selectively to his environment. These observations suggest that the nervous system of the premature infant at term may be less well organized than that of the infant born at term. There are indications that the premature infant may, in fact, be overstimulated in the early neonatal period. Responses on the Brazelton for the premature and full-term infant were significantly different. Typically, the term infant sought out the stimulation, the premature turned away from it. Excessive physiologic changes were also noted in the premature upon stimulation.Types
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