It is generally acknowledged that infants born very preterm are at a high risk of developmental delay. It has been suggested that the first few months of life ex-utero might constitute a "sensitive period" during which growth rate could influence later outcome measures including cognitive development. This study investigated the early growth of a sample of 90 infants born very preterm and the developmental status (at 18 months of age) of 81 of those infants (mean gestational age 29.4 weeks; mean birth weight 1283g). Two main issues were addressed. One concerned the relative contribution of various early infant, maternal and medical factors to rate of growth up to 3-months corrected age. The other issue was the extent to which these early factors, as well as early growth rate, were predictive of developmental status at 18 months of age (again corrected for gestation), using the Mental Development Index of the Bayley Scales. Analyses revealed that there were few significant predictors of early growth among the variables that were examined. Infants who had required more intensive medical care during the neonatal period showed a slower growth rate than the more robust infants. Breast-fed infants grew slower from birth to term, but thereafter grew significantly better, resulting in no discernable difference over the whole 5-7 month period. None of the infant behavioural, maternal or social variables examined appeared to be related to early growth. Infants who were born lighter-for-gestation grew faster than the infants who were heavier for gestational age. At the 18-month follow-up assessment this very preterm sample performed poorly overall in comparison to published norms for full term infants. When regression analyses were performed, weight at 3-months of age was found to be predictive of developmental status at 18-months (even when concurrent weight was taken into account), whereas actually being born growth retarded was not found to be a risk factor for poorer developmental outcome. This supports the concept of a "sensitive period" during the first few months of life, when growth rate may influence developmental outcome. Other significant predictors of developmental outcome were gender, early brain scan and mean parental height.

Thesis (Ph. D.)--University of Sydney, 2003. / Includes tables and questionnaires. Title from title screen (viewed Apr. 28, 2008). Submitted in fulfilment of the requirements for the degree of Doctor of Philosophy to the Centre for Perinatal Health Services Research, School of Public Health. Includes bibliography. Also available in print form.

Infants born extremely prematurely (ie. &lt29 weeks gestation) or with extremely low birth weight (ie. &lt1000 grams) are at high-risk of major and minor motor sequelae that persist into the school years. Most of the research on the outcome of these high-risk infants has concentrated on the prevalence of major disability. The majority of high-risk children at school age have normal intelligence and no sensorineural disability. Despite this, these ???apparently normal??? high-risk children have a higher incidence of minor morbidities. Motor coordination problems are frequently reported, yet further investigation into the emergence of minor motor dysfunction, or its impact on academic achievement and everyday activities is seldom explored. The aim of this thesis was to provide a comprehensive investigation into motor dysfunction, which is commonly found in ???apparently normal??? high-risk children. This was addressed in a series of five studies that intended to provide insight into the emergence, prevalence, nature, and prediction of motor dysfunction in otherwise ???normal??? high-risk children. Study 1 examined the development of gross and fine motor skills from infancy to school age using a longitudinal cohort study design. ???Apparently normal??? high-risk children (n=58) were assessed with the Peabody Developmental Motor Scales at 18 months corrected age, 3 and 5 years. A significant proportion continued to have fine motor deficits to school age (64%), reflecting a persistent problem with fine motor skills throughout this period. The proportion of infants with gross motor deficits significantly increased from 18 months to 5 years (81.1%), particularly for the ???micropreemies???. Whilst there was no gender difference found, the development of gross and fine motor skills appeared to be influenced differently by the home environment. Study 2 examined the impact of motor dysfunction on performance at school age. The prevalence of Developmental Coordination Disorder (DCD) in ???apparently normal??? high-risk children was determined using a controlled cohort study design. In addition, the nature of DCD in this population was explored by testing sensorimotor abilities that possibly underlie the motor dysfunction. Fifty (50) high-risk children with IQ&lt85 and no identified sensorineural disability were assessed at 8 years of age along with a matched control from their respective class at school. The Movement Assessment Battery for Children and a battery of sensorimotor tests were administered. Results indicated a significantly higher prevalence of DCD (42%) in the high-risk group in comparison to the control group (8%). In relation to sensorimotor abilities that may influence motor performance, the high-risk group scored significantly lower on most of tests, however it was neurological ???soft signs???, postural praxis, and sequencing praxis that contributed to DCD in the high-risk group. Study 3 was designed to investigate the impact of motor dysfunction on a motor-based task performed within the school setting. Specifically, this study described handwriting skills in ???apparently normal??? high-risk children, determined the prevalence of handwriting dysfunction, and investigated sensorimotor abilities that may be associated with problematic handwriting. The high-risk cohort and matched controls described in study 2 were also administered a number of handwriting tests. High-risk children were found to have poorer handwriting legibility and speed in comparison to their classmates. The prevalence of handwriting dysfunction in the high-risk group was 46%, significantly higher than controls (18%). Hand preference, pencil grasp used, and pain whilst writing were comparable to the control group. The contribution of underlying sensorimotor abilities to handwriting dysfunction in the high-risk population however was not evident. By using the same subjects in studies 2 and 3, the co-morbidity of handwriting dysfunction with DCD could be determined. Of those high-risk children identified with DCD, 43% had co-morbid handwriting dysfunction. Study 4 explored the relationship between perinatal and environmental variables to Developmental Coordination Disorder and handwriting dysfunction in high-risk children. Perinatal and environmental variables of the 50 ???apparently normal??? high-risk children that participated in the previous study were analysed. Results indicated prolonged rupture of membranes (PROM) and retinopathy of prematurity (ROP) were significantly and independently associated with DCD, perhaps reflecting the impact of the antenatal infection process and visual development related to ROP on motor outcome in high-risk children. Perinatal variables were not associated with handwriting dysfunction, but high-risk males were more likely to have handwriting dysfunction. Maternal education and paternal occupation were associated with aspects of handwriting. Whilst handwriting is a motor-based activity, it appears to be influenced by environmental variables, similar to other academic areas for the high-risk population. Study 5 sought to determine whether a motor assessment at an earlier age could predict DCD in the ???apparently normal??? high-risk population at school age. Motor assessment at 12 months, 3 and 5 years for the high-risk subjects who participated in study 2 were analysed using Receiver Operator Curves (ROC curves). The 3 year assessment with the Peabody Developmental Motor Scales was the best predictor of DCD at 8 years, with the Griffiths Locomotor Scale at 3 years yielding a similar result. Findings suggest that high-risk children who scored below the specified cut-off points on 3 year motor assessments and who had a history of PROM or ROP were at greater risk of having motor-based problems that had the potential to interfere with functioning at school.

Thesis (MAResearch)--University of South Australia, 2002.

Thesis (MHlthSc(OccTh))--University of South Australia, 1999

Infants born extremely prematurely (ie. &lt29 weeks gestation) or with extremely low birth weight (ie. &lt1000 grams) are at high-risk of major and minor motor sequelae that persist into the school years. Most of the research on the outcome of these high-risk infants has concentrated on the prevalence of major disability. The majority of high-risk children at school age have normal intelligence and no sensorineural disability. Despite this, these ???apparently normal??? high-risk children have a higher incidence of minor morbidities. Motor coordination problems are frequently reported, yet further investigation into the emergence of minor motor dysfunction, or its impact on academic achievement and everyday activities is seldom explored. The aim of this thesis was to provide a comprehensive investigation into motor dysfunction, which is commonly found in ???apparently normal??? high-risk children. This was addressed in a series of five studies that intended to provide insight into the emergence, prevalence, nature, and prediction of motor dysfunction in otherwise ???normal??? high-risk children. Study 1 examined the development of gross and fine motor skills from infancy to school age using a longitudinal cohort study design. ???Apparently normal??? high-risk children (n=58) were assessed with the Peabody Developmental Motor Scales at 18 months corrected age, 3 and 5 years. A significant proportion continued to have fine motor deficits to school age (64%), reflecting a persistent problem with fine motor skills throughout this period. The proportion of infants with gross motor deficits significantly increased from 18 months to 5 years (81.1%), particularly for the ???micropreemies???. Whilst there was no gender difference found, the development of gross and fine motor skills appeared to be influenced differently by the home environment. Study 2 examined the impact of motor dysfunction on performance at school age. The prevalence of Developmental Coordination Disorder (DCD) in ???apparently normal??? high-risk children was determined using a controlled cohort study design. In addition, the nature of DCD in this population was explored by testing sensorimotor abilities that possibly underlie the motor dysfunction. Fifty (50) high-risk children with IQ&lt85 and no identified sensorineural disability were assessed at 8 years of age along with a matched control from their respective class at school. The Movement Assessment Battery for Children and a battery of sensorimotor tests were administered. Results indicated a significantly higher prevalence of DCD (42%) in the high-risk group in comparison to the control group (8%). In relation to sensorimotor abilities that may influence motor performance, the high-risk group scored significantly lower on most of tests, however it was neurological ???soft signs???, postural praxis, and sequencing praxis that contributed to DCD in the high-risk group. Study 3 was designed to investigate the impact of motor dysfunction on a motor-based task performed within the school setting. Specifically, this study described handwriting skills in ???apparently normal??? high-risk children, determined the prevalence of handwriting dysfunction, and investigated sensorimotor abilities that may be associated with problematic handwriting. The high-risk cohort and matched controls described in study 2 were also administered a number of handwriting tests. High-risk children were found to have poorer handwriting legibility and speed in comparison to their classmates. The prevalence of handwriting dysfunction in the high-risk group was 46%, significantly higher than controls (18%). Hand preference, pencil grasp used, and pain whilst writing were comparable to the control group. The contribution of underlying sensorimotor abilities to handwriting dysfunction in the high-risk population however was not evident. By using the same subjects in studies 2 and 3, the co-morbidity of handwriting dysfunction with DCD could be determined. Of those high-risk children identified with DCD, 43% had co-morbid handwriting dysfunction. Study 4 explored the relationship between perinatal and environmental variables to Developmental Coordination Disorder and handwriting dysfunction in high-risk children. Perinatal and environmental variables of the 50 ???apparently normal??? high-risk children that participated in the previous study were analysed. Results indicated prolonged rupture of membranes (PROM) and retinopathy of prematurity (ROP) were significantly and independently associated with DCD, perhaps reflecting the impact of the antenatal infection process and visual development related to ROP on motor outcome in high-risk children. Perinatal variables were not associated with handwriting dysfunction, but high-risk males were more likely to have handwriting dysfunction. Maternal education and paternal occupation were associated with aspects of handwriting. Whilst handwriting is a motor-based activity, it appears to be influenced by environmental variables, similar to other academic areas for the high-risk population. Study 5 sought to determine whether a motor assessment at an earlier age could predict DCD in the ???apparently normal??? high-risk population at school age. Motor assessment at 12 months, 3 and 5 years for the high-risk subjects who participated in study 2 were analysed using Receiver Operator Curves (ROC curves). The 3 year assessment with the Peabody Developmental Motor Scales was the best predictor of DCD at 8 years, with the Griffiths Locomotor Scale at 3 years yielding a similar result. Findings suggest that high-risk children who scored below the specified cut-off points on 3 year motor assessments and who had a history of PROM or ROP were at greater risk of having motor-based problems that had the potential to interfere with functioning at school.

Premature birth occurs before parents have had time to prepare for the birth of the infant. This survey was conducted to describe the responses of fathers of preterm low birth weight babies (PTLBW) and their involvement in the care of those babies in a neonatal intensive care unit. A quantitative descriptive non-experimental study design using purposive sampling (a non -probability method of sampling) was adopted. Fifty fathers of PTLBW babies of less than 2500grams, who visited and were involved in the care of their babies in NICU, voluntarily participated in the study by completing a self-administered questionnaire. The questionnaire was designed to collect the demographic information of the participants and to address their responses and their involvement in the care of the baby. Analysis of the findings revealed that fathers reacted positively on the birth of their babies as the majority of the fathers indicated that they were happy despite the fact that their babies were born before time. Fathers in this study experienced varying reactions to the equipment that they saw being used on their babies, 76% mentioned that they were frightened. Moreover, the research findings revealed that a high percentage of fathers, 88%, in the study mentioned that talking to their wives, partners or spouses as well as talking to nurses and doctors in NICU was the main strategies that they had used to cope with their feelings. Teaching is part of the support available to fathers as a tool to enhance their psychological well being and increase their interdependence relationship. Fathers in this study indicated they received information about their babies during visits. Thirty four (68%) of the fathers in the study acknowledged that nurses gave the most teaching about the baby, baby's care, baby's progress and about their overall role while the baby is in NICU. The fathers also in the same manner demonstrated that the information that they received on the NICU environment has helped them to participate in the care of the baby. / Thesis (M.A.)-University of KwaZulu-Natal, 2007.

Thesis equivalent (M.P.H.)--University of Michigan, 1947.

Thesis equivalent (M.P.H.)--University of Michigan, 1947.

Thesis (Ph. D.)--University of Texas at Austin, 1997. / Vita. Includes bibliographical references (leaves 267-276).