Neonatal Predictors of School-Based Services Used by NICU Graduates at School Age

BACKGROUNDIll or premature newborns are at increased risk for ongoing morbidity throughout childhood. Federal legislation now mandates that states provide early intervention, special education, and disability accommodations for children with special needs. Because all children born prematurely do no...

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Bibliographic Details
Published in:	MCN, the American journal of maternal child nursing Vol. 27; no. 1; pp. 41 - 46
Main Authors:	Lindeke, Linda L., Stanley, Jennifer R., Else, Beth S., Mills, Marla M.
Format:	Journal Article
Language:	English
Published:	United States Lippincott Williams & Wilkins, Inc 01-01-2002
Subjects:	Child Child Health Services Developmental Disabilities - diagnosis Developmental Disabilities - nursing Disabled Children Education, Special Female Humans Infant, Newborn Infant, Premature Intensive Care Units, Neonatal Length of Stay Male Needs Assessment Nursing Pediatric Nursing
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Summary:	BACKGROUNDIll or premature newborns are at increased risk for ongoing morbidity throughout childhood. Federal legislation now mandates that states provide early intervention, special education, and disability accommodations for children with special needs. Because all children born prematurely do not require all services, targeting services to the children with greatest risk is essential. This study examined whether neonatal characteristics could predict special school-based service use (speech, occupational, physical therapy, special education) in later childhood. METHODSSubjects were 53 children, ages 7 to 11 years, graduates of one Midwest Level 3 neonatal intensive care unit (NICU). Neonatal data were used to calculate Neurobiologic Risk Scores (NBRS), a sum of illness factors related to brain damage. Birth weight, length of NICU stay, and NBRS were compared to the children’s school performance on standardized tools and to report cards. RESULTSMost children studied were not receiving special school services. The NBRS and parent report of child competency were related (p = 0.01). Length of NICU stay correlated with teachers’ reports of children’s academic performance (p = 0.04), and to use of special school services use (p = 0.03). As the NBRS score increased, report card performance decreased. CONCLUSIONSNeonatal characteristics predicted school-age service use. This is important for nurses because predicting which children are most likely to need special services can aid in tracking children at high risk for prompt assessments and referrals. Parents, healthcare providers, educators, advocacy groups, and funding agencies need accurate outcome data to influence health, educational, and social policy decisions.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 ObjectType-Article-2 ObjectType-Feature-1
ISSN:	0361-929X 1539-0683
DOI:	10.1097/00005721-200201000-00012