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Development in Children Born Prematurely: Are There Delays?

written by: Elizabeth Stannard Gromisch • edited by: Sarah Malburg • updated: 8/2/2012

When a child is born before 37 weeks of gestation, she is considered a premature infant, or “preemie." Since the child was born before full gestation, her nervous system and muscles are not fully developed. As a result, some premature children can have developmental delays.

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    How Early is Too Early?

    In the United States, about 12 percent of children are born prematurely, according to the Centers for Disease Control and Prevention. A premature birth is classified as a birth occurring less than 37 weeks gestation, with a full-term birth between 37 weeks to 42 weeks gestation. Several health conditions that occur during the pregnancy can increase a mother’s risk of going into preterm labor, such as placenta previa, preeclampsia and cervical incompetence. Because the child was born before she reached full gestation, her organs are not as developed as a full term infant. As a result, premature babies may have some health problems when she is born, such as problems with overall breathing, abnormal breathing habits, difficulty feeding and a lower muscle tone. Some premature children can have long-term complications.

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    What are Developmental Milestones?

    The University of Michigan defines developmental milestones as “a set of functional skills or age-specific tasks that most children can do at a certain age range." When assessing whether a child has reached her developmental milestones, her physician will look at different skills, such as cognitive, language, fine motor, gross motor and social skills. For example, with gross motor skills, the physician will see if the child can use large groups of her muscles, such as to sit or keep her balance. The American Academy of Pediatrics has developmental milestones based on the child’s age, but since a premature child was born before full gestation, parents and teachers need to figure out her corrected age before determining whether she is reaching these milestones or if she has a developmental delay.

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    Calculating a Premature Child’s Corrected Age

    Before parents and teachers can determine if a premature child has a developmental delay, they need to figure out her chronological age. Emory University School of Medicine explains that the process takes four steps: first, calculate how old the child is in months by subtracting her birthday from the current date. Next, determine how many weeks early the child was born; the number of weeks used is 40. After figuring out the number of weeks premature, convert that number into months. For example, if a child was 13 weeks early, she would be 3 months 7 days early. In the last step, subtract the number of weeks early from the chronological age. Parents and teachers can then look at the developmental milestones, using the child’s corrected age.

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    Possible Developmental Delays

    Do very premature babies have developmental delays? Being born before full gestation does put a child at risk for developmental delays, even if the child is moderately premature. In a study conducted by researchers from the National Institute of Child Health and Human Development and the Health Resources and Services Administration found that children who were moderately premature — two to four weeks before full gestation — were at risk for minor developmental delays. The types of developmental delays that a premature child can have may vary. For example, if a child has language delays, she may not make cooing sounds at 2 months corrected age, babble at 6 months corrected age, or use one word many times at 12 months corrected age. If the developmental delays are motor, the child may have trouble holding objects in her hands at 2 months corrected age, bringing her hands together at 4 months corrected age, or picking up small objects using her finger and thumb at 9 months corrected age. Social and emotional delays may also occur in premature children: they may not make eye contact at 2 months corrected age, react differently when they are around strangers at 6 months corrected age, or play with other children at 12 months corrected age. As the child gets older, these developmental delays can impact academic performance. For example, if the child has problems paying attention, she may have trouble finishing assignments. The American Academy of Pediatrics notes that ongoing physical and developmental problems are seen in premature children who were born very small.

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    Helping Premature Children with Delays

    The different interventions for premature children with developmental delays depend on the specific issues. If the child has a delay in language, then she may benefit from speech therapy. With gross motor delays, physical therapy may help, while occupational or physical therapy may be recommended for fine motor delays. If the child displays delays in cognitive development, then educational intervention may help. Therapists may ask parents to participate in different activities with their child. For example, if the developmental delay is in language, the speech-language pathologist may suggest that parents read to the child every day to encourage more language use in the child.

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    While developmental delays can occur in children born prematurely, WebMD points out that with many of these delays, they are not severe and children can catch up over time. If the developmental delays are severe, the different treatments available, such as speech or physical therapy, can help premature children make significant improvements.

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