Early identification of developmental problems in the preterm infant

It is well-established that the preterm infant is at increased risk for developmental disabilities in all spheres of development. Along with the improvements in neonatal intensive care, a better understanding of the risk factors for disability has emerged. An individual child's risk can now be better determined through both neonatal clinical history and through neonatal neurodevelopmental examination. The primary clinical perinatal risk factors are chronic lung disease, periventricular hemorrhage and leukomalacia, hydrocephalus, neonatal seizures, growth retardation, acidosis, and sepsis. Several neurodevelopmental examinations have also proved useful in predicting outcome, through assessment of an infant's neurologic development. The Neurodevelopmental Risk Examination, one such examination, uses a simplified scoring system in its assessment of sensory and behavioral response, axial tone, extremity tone, deep tendon reflexes, and primitive reflexes, allowing classification of children into low, moderate, and high risk groups, with good prediction of both normal and abnormal motor and cognitive outcomes.