Evaluation of a tool to screen at preschool age for minor cognitive disorders liable to affect schooling among children born premature

Childs Nerv Syst. 2009 Nov;25(11):1437-45. doi: 10.1007/s00381-009-0922-7. Epub 2009 Jul 24.

Abstract

Purpose: To evaluate a detection tool designed to help paediatricians identify, at preschool age, minor neurocognitive disorders that interfere with normal schooling.

Methods: One hundred-and-fourteen preterm singletons born between 1997 and 2001 at less than 32 weeks of amenorrhoea, in a tertiary perinatal care center, were invited to visit us for a medical examination and a rapid neurocognitive assessment (BREV) when they were aged between 4 and 8 years and were re-contacted at 6-10 years of age to evaluate their current schooling situation. Results of BREV and schooling parameters were compared.

Results: Mean gestational age was 29 weeks and mean birth weight was 1,164 g. Fifteen children (13.2%) showed abnormal results on BREV testing and had unusual schooling histories. Among the 68 children with normal BREV, 65 (95.6%) had achieved normal schooling. The sensitivity of the BREV test in this population for detection of minor disorders interfering with schooling was thus 83.3% (95% CI = 57.7-95.6) and the predictive value of a negative test was 95.6% (95% CI = 86.8-98.9). For the 57 children (50%) assessed before the age of 5 years, the sensitivity and the predictive value of a negative test were both 100%.

Conclusion: Our survey shows that the BREV test can, in a population of preschool children who were born premature, screen for minor neurocognitive disorders that impact schooling parameters. BREV assessment, used in the setting of follow-up of premature infants, would identify children in need of early remedial education before schooling under-attainment or failure developed.

Publication types

  • Evaluation Study

MeSH terms

  • Child
  • Child, Preschool
  • Cognition Disorders / diagnosis*
  • Education
  • Female
  • Follow-Up Studies
  • Gestational Age
  • Humans
  • Infant, Newborn
  • Infant, Premature*
  • Infant, Very Low Birth Weight
  • Longitudinal Studies
  • Male
  • Neuropsychological Tests*
  • Prognosis
  • Prospective Studies
  • Sensitivity and Specificity