Neurodevelopmental outcomes in neonatal extracorporeal membrane oxygenation survivors: An institutional perspective.

AIM: To describe the neurodevelopmental outcomes following extracorporeal membrane oxygenation (ECMO) in early infancy. METHODS: Thirty-seven patients who had survived following ECMO support from 2008 to 2018 had their neurodevelopmental outcomes assessed and analysed using the Bayley Scales of Infant and Toddler Development. Developmental outcome was defined as impairment in any of the developmental domains of motor function, cognition and language with mild impairment being 1-2 standard deviations below the test mean, moderate being 2-3 standard deviations below and severe being greater than 3 standard deviations below. RESULTS: Of these 37 patients, the median age at admission to Paediatric Intensive Care Unit was 0.4 months (interquartile range 2.8 months) with all of the study patients having an underlying diagnosis of congenital cardiac disease and 37/40 (92.5%) ECMO runs occurring in the immediate post-operative period. Of the 29 patients who had had follow-up at 12 months of age or older, 3 (10.3%) had severe impairment, 4 (13.8%) had moderate impairment, 12 (41.3%) had mild impairment and 10 (34.5%) had no impairment. Gross motor function was most significantly impacted in 18/29 (62.1%) patients, of which 7/18 (38.9%) had severe impairment. This was followed by impairment of receptive language in 8/29 (27.6%) patients and expressive language in 6/29 (20.1%) patients. CONCLUSIONS: One in four infants undergoing ECMO treatment in early infancy has moderate to severe neurodevelopmental impairment. Gross motor and language are the most affected developmental domains.

Development and change in attachment: A multiwave assessment of attachment and its correlates across childhood and adolescence.

This research examines the contextual factors that facilitate development and change in attachment during later childhood, adolescence, and early adulthood using a longitudinal cohort design involving 690 children (7-19 years old) and their parents. At each wave, a variety of interpersonal variables (e.g., parent-child stress) were measured. We examined alternative developmental processes (i.e., long-term, catalytic, and short-term processes) that have not been previously distinguished in attachment research. Preregistered analyses revealed that nondevelopmental processes can explain the associations between almost all of the interpersonal variables of interest and attachment security, suggesting that previous research using traditional longitudinal methods may have misattributed nondevelopmental processes for developmental ones. For example, we found that friendship quality, although prospectively associated with attachment both in prior work and in the current study, was not developmentally associated with attachment. However, after controlling for nondevelopmental sources of covariation, we identified a number of developmental processes that may help explain change in attachment. For example, we found that initial levels of parental depression, as well as growth in parent-child stress, were related to growth in adolescent insecurity over 3 years. We also examined 12 genetic variants studied in previous research and found that they were not related to average levels or changes in attachment. These results highlight how distinguishing unique kinds of developmental processes allows for a more comprehensive understanding of attachment. (PsycInfo Database Record (c) 2020 APA, all rights reserved).