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      Early and long-term outcome of infants born extremely preterm

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      Archives of Disease in Childhood
      BMJ

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          Abstract

          There is no question that birth at extremely low gestational ages presents a significant threat to an infant's survival, health and development. Growing evidence suggests that gestational age may be conceptualised as a continuum in which births before 28 weeks of gestation (extremely preterm: EP) represent the severe end of a spectrum of health and developmental adversity. Although comprising just 1%–2% of all births, EP deliveries pose the greatest challenge to neonatal medicine and to health, education and social services for the provision of ongoing support for survivors with additional needs. Studying the outcomes of these infants remains critical for evaluating and enhancing clinical care, planning long-term support and for advancing our understanding of the life-course consequences of immaturity at birth. Here we review literature relating to early and long-term neurodevelopmental, cognitive, behavioural and educational outcomes following EP birth focusing on key themes and considering implications for intervention.

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          Most cited references74

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          Is working memory training effective? A meta-analytic review.

          It has been suggested that working memory training programs are effective both as treatments for attention-deficit/hyperactivity disorder (ADHD) and other cognitive disorders in children and as a tool to improve cognitive ability and scholastic attainment in typically developing children and adults. However, effects across studies appear to be variable, and a systematic meta-analytic review was undertaken. To be included in the review, studies had to be randomized controlled trials or quasi-experiments without randomization, have a treatment, and have either a treated group or an untreated control group. Twenty-three studies with 30 group comparisons met the criteria for inclusion. The studies included involved clinical samples and samples of typically developing children and adults. Meta-analyses indicated that the programs produced reliable short-term improvements in working memory skills. For verbal working memory, these near-transfer effects were not sustained at follow-up, whereas for visuospatial working memory, limited evidence suggested that such effects might be maintained. More importantly, there was no convincing evidence of the generalization of working memory training to other skills (nonverbal and verbal ability, inhibitory processes in attention, word decoding, and arithmetic). The authors conclude that memory training programs appear to produce short-term, specific training effects that do not generalize. Possible limitations of the review (including age differences in the samples and the variety of different clinical conditions included) are noted. However, current findings cast doubt on both the clinical relevance of working memory training programs and their utility as methods of enhancing cognitive functioning in typically developing children and healthy adults. (c) 2013 APA, all rights reserved.
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            Early developmental intervention programmes provided post hospital discharge to prevent motor and cognitive impairment in preterm infants.

            Infants born preterm are at increased risk of developing cognitive and motor impairment compared with infants born at term. Early developmental interventions have been provided in the clinical setting with the aim of improving overall functional outcomes for these infants. Long-term benefits of these programmes remain unclear.
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              Meta-analysis of neurobehavioral outcomes in very preterm and/or very low birth weight children.

              Sequelae of academic underachievement, behavioral problems, and poor executive function (EF) have been extensively reported for very preterm ( 0.51). Very preterm and/or VLBW children have moderate-to-severe deficits in academic achievement, attention problems, and internalizing behavioral problems and poor EF, which are adverse outcomes that were strongly correlated to their immaturity at birth. During transition to young adulthood these children continue to lag behind term-born peers.
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                Author and article information

                Journal
                Archives of Disease in Childhood
                Arch Dis Child
                BMJ
                0003-9888
                1468-2044
                December 14 2016
                January 2017
                January 2017
                August 10 2016
                : 102
                : 1
                : 97-102
                Article
                10.1136/archdischild-2015-309581
                27512082
                3efe0cbd-5835-48a6-8ce5-2d547157283f
                © 2016
                History

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