human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Objectives : 1 ) To investigate the comorbidity of verbal and nonverbal learning disability subtypes with several domains of behavior problems among 8-year-old children . 2 ) To determine whether receipt of an early intervention modified the association between childhood behavior problems and learning disabilities ( LD ) . Methods : This is a secondary data analysis of the Infant Health and Development Program ( IHDP ) , a r and omized clinical trial of an early intervention provided between ages 0 and 3 involving 985 children born low birthweight and premature . The findings are based on a prospect i ve follow-up of these children at 8 years of age . Results : Compared to children without verbal LD ( VLD ) , those with VLD were twice as likely to exhibit clinical levels of total behavior problems and 89 % more likely to exhibit externalizing behavior problems . Analysis of specific subscales of behavior revealed significant associations with anxious/depressed and withdrawn behaviors , as well as an increased likelihood of attention problems among children with VLD . No significant association was found between nonverbal LD ( NVLD ) and any type of behavior problem . Furthermore , there was a significant interaction between VLD and the intervention , in which the odds of internalizing behavior problems were greater among children with VLD . No interaction effect of the intervention occurred for any type of behavior problem among children with NVLD . Conclusions : These findings provide evidence that distinct differences exist for different learning disability subtypes with regards to behavioral outcomes and the effects of early intervention services among 8-year-old children OBJECTIVE : To determine whether mild and severe growth restriction at birth among preterm infants is associated with neonatal mortality and cerebral palsy and cognitive performance at 5 years of age and school performance at 8 years of age . METHODS : All 2846 live births between 24 and 32 weeks ' gestation from 9 regions in France in 1997 were included in a prospect i ve observational study ( the EPIPAGE [ Étude Epidémiologique sur les Petits Ages Gestationnels ] study ) and followed until 8 years of age . Infants were classified as “ small-for-gestational-age ” ( SGA ) if their birth weight for gestational age was at the < 10th centile , “ mildly-small-for-gestational-age ” ( M-SGA ) if birth weight was at the ≥10th centile and < 20th centile , and “ appropriate-for-gestational-age ” ( AGA ) if birth weight was at the ≥20th centile . RESULTS : Among the children born between 24 and 28 weeks ' gestation  , the mortality rate increased from 30 % in the AGA group to 42 % in the M-SGA group and to 62 % in the SGA group ( P < .01 ) . Birth weight was not significantly associated with any cognitive , behavioral , or motor outcomes at the age of 5 or any school performance outcomes at 8 years . For the children born between 29 and 32 weeks ' gestation , SGA children had a higher risk for mortality ( adjusted odds ratio [ aOR ] : 2.79 [ 95 % confidence interval ( CI ) : 1.50–5.20 ] ) , minor cognitive difficulties ( aOR : 1.73 [ 95 % CI : 1.12–2.69 ] ) , inattention-hyperactivity symptoms ( aOR : 1.78 [ 95 % CI : 1.10–2.89 ] ) , and school difficulties ( aOR : 1.74 [ 1.07–2.82 ] ) compared with AGA children . Being born M-SGA was associated with an increased risk for minor cognitive difficulties ( aOR : 1.87 [ 95 % CI : 1.24–2.82 ] ) and behavioral difficulties ( aOR : 1.66 [ 95 % CI : 1.04–2.62 ] ) . CONCLUSIONS : In preterm children , growth restriction was associated with mortality , cognitive and behavioral outcomes , as well as school difficulties OBJECTIVE To compare healthy late-preterm infants with their full-term counterparts from age 4 through 15 years for numerous st and ard cognitive , achievement , socioemotional , and behavioral outcomes . DESIGN Prospect i ve cohort study . SETTING National Institute of Child Health and Development Study of Early Child Care and Youth Development , 1991 - 2007 . PARTICIPANTS A total of 1298 children ( 53 born at 34 - 36 weeks ' gestational age ) , and their families , observed from birth through age 15 years . None of the infants had major health problems before or immediately following birth , and all the infants were discharged from the hospital within 7 days . MAIN EXPOSURE Preterm status : children born late preterm ( 34 - 36 weeks ) vs those born full term ( 37 - 41 weeks ) . MAIN OUTCOME MEASURES Eleven st and ard outcomes measuring cognition , achievement , social skills , and behavioral/emotional problems using the Woodcock-Johnson Psycho-Educational Battery-Revised and the Child Behavior Checklist , administered repeatedly through age 15 years . RESULTS No consistent significant differences were found between late-preterm and full-term children for these st and ard measures from ages 4 to 15 years . Through age 15 years , the mean difference of most of these outcomes hovered around 0 , indicating , along with small confidence intervals around these differences , that it is unlikely that healthy late-preterm infants are at any meaningful disadvantage regarding these measures . CONCLUSION Late-preterm infants born otherwise healthy seem to have no real burdens regarding cognition , achievement , behavior , and socioemotional development throughout childhood OBJECTIVES . Our objective was to determine motor , cognitive , and behavioral outcome at school age in preterm children with periventricular hemorrhagic infa rct ion and to identify cerebral risk factors for adverse outcome . METHODS . This was a prospect i ve cohort study of all preterm infants who were < 37 weeks ' gestation , had periventricular hemorrhagic infa rct ion , and were admitted between 1995 and 2003 .  Ultrasound scans were review ed for characteristics of periventricular hemorrhagic infa rct ion and other cerebral abnormalities . At 4 to 12 years of age , motor outcome was assessed by the Gross Motor Function Classification System and the Manual Ability Classification System , by a neurologic examination ( Touwen ) , an intelligence test ( Wechsler Intelligence Scale III/Wechsler Preschool and Primary Scale of Intelligence-Revised ) , and tests for visual-motor integration , visual perception , and verbal memory . Behavior was assessed by using the Child Behavior Checklist and the Behavior Rating Inventory of Executive Function . RESULTS . Of 38 infants , 15 ( 39 % ) died . Twenty-one of the 23 survivors were included in the follow-up . Four infants were neurologically normal , 1 had minor neurologic dysfunction , 13 had unilateral spastic cerebral palsy , and 3 had bilateral cerebral palsy . Coordination , associated movements , and fine manipulative abilities were affected most according to the neurologic examination . Gross Motor Function Classification System scores were level 1 ( 7 children ) , level 2 ( 7 children ) , level 3 ( 1 child ) , and level 4 ( 2 children ) . Manual Ability Classification System scores were normal ( 4 children ) , level 1 ( 8 children ) , level 2 ( 7 children ) , and level 3 ( 2 children ) . The mean and median total IQ was 83 . Visual perception was normal in 88 % of children , visuomotor integration was normal in 74 % , and verbal memory was normal in 50 % . Behavior was normal in 53 % of children , and executive functions were normal in 65 % and 29 % of children ( by parent and teacher report , respectively ) . Characteristics of the periventricular hemorrhagic infa rct ion were not related to functional motor outcome and intelligence . Posthemorrhagic ventricular dilatation was a risk factor for poorer total and performance intelligence and abnormal fine manipulative abilities . CONCLUSIONS . The majority of surviving preterm children with periventricular hemorrhagic infa rct ion had cerebral palsy with limited functional impairment at school age . Intelligence was within 1 SD of the norm of preterm children without lesions in 60 % to 80 % of the children . Verbal memory , in particular , was affected . Behavioral and executive function problems occurred slightly more than in preterm infants without lesions . The functional outcome at school age of preterm children with periventricular hemorrhagic infa rct ion is better than previously thought OBJECTIVE To investigate neurodevelopment at school age in preterm infants treated with hydrocortisone for bronchopulmonary dysplasia ( BPD ) in the neonatal period . STUDY DESIGN Preterm infants ( n = 226 ; gestational age < or = 32 weeks and /or body weight < or = 1500 grams ) performed subtests of the Wechsler Intelligence Scale for Children-Revised , the Visual Motor Integration test , a 15-Word Memory Test and the Movement Assessment Battery for Children at school age . Conventional MRI of the brain was obtained . Sixty-two children who received hydrocortisone for BPD ( starting dose , 5 mg/kg/day ; median duration , 27.5 days ) were compared with 164 nontreated neonates . RESULTS Hydrocortisone-treated infants were younger , lighter , and sicker than their non-steroid-treated counterparts . Adjustments for gestational age , body weight , sex , mechanical ventilation , and small for gestational age were made . Adjusted mean Intelligence Quotient , Visual Motor Integration test , and memory test results were the same in the hydrocortisone-treated group and the non-steroid-treated group ( 99 versus 101 , P = .62 ; 97 versus 99 , P = .49 , 7.9 versus 7.5 , P = .42 , respectively ) . Motor function and incidence of cerebral palsy in both groups was not different ( 11 % versus 7 % , P = .97 ) . Occurrence of brain lesions on MRI was similar for the two groups . CONCLUSIONS Neonatal hydrocortisone treatment for BPD had no long-term effects on neurodevelopment Objectives . To examine the prevalence , stability , and predictors of clinical ly significant behavior problems in 869 preterm low birth weight ( LBW ) infants at 3 , 5 , and 8 years of age . Methods . A prospect i ve cohort study was conducted . Clinical ly significant behavior problems were assessed using dichotomized total problem Child Behavior Checklist scores in LBW children at ages 3 , 5 , and 8 years . Baseline sociodemographic and obstetric data were collected . Maternal General Health Question naire performed at 40 weeks ' gestation was dichotomized at a score of 12 to give a measure of maternal psychological distress . Prevalence and stability of behavior problems at ages 3 , 5 , and 8 were determined and potential predictors of behavior problems at age 3 , 5 , and 8 were examined using multiple logistic regression . Results . Prevalence of behavior problems remained at ∼20 % at 3 , 5 , and 8 years . Stability of behavior problems between different ages was ∼50 % . Significant behavior problems at ages 3 , 5 , and 8 were predicted by maternal psychological distress at 40 weeks ( odds ratio [ OR ] : 1.59 ; 95 % confidence interval [ CI ] : 1.21–2.09 ) , maternal cigarette smoking during pregnancy ( OR : 1.57 ; 95 % CI : 1.20–2.04 ) , Hispanic ethnicity ( OR : 2.00 ; 95 % CI : 1.24–3.24 ) , and maternal age ( OR : 0.97 ; 95 % CI : 0.94–0.99 ) . Conclusions . This sample had double the prevalence of behavior problems expected in the general child population . These problems showed stability over time . Cigarette smoking in pregnancy , maternal psychological distress at 40 weeks ' gestation , maternal age , and Hispanic ethnicity all were significant predictors of the development of behavior problems from ages 3 to 8 . These findings have implication s for health policies on smoking and postnatal depression CONTEXT The outcome into school age of regional cohorts of children born in the 1990s with birth weights less than 1000 g ( extremely low birth weight , ELBW ) or earlier than 28 weeks ' gestation ( very preterm ) is not known . OBJECTIVE To determine the cognitive , educational , and behavioral outcome of ELBW or very preterm infants born in the 1990s compared with normal birth weight ( NBW ) controls . DESIGN Regional cohort study . SETTING Victoria , Australia . PARTICIPANTS The ELBW or very preterm cohort was composed of 298 consecutive survivors born during 1991 - 1992 . The NBW cohort was composed of 262 r and omly selected children with birth weights of more than 2499 g. MAIN OUTCOME MEASURES Cognitive ability , educational progress , and behavioral problems . RESULTS The follow-up rates from birth to 8 years of age for survivors were 92.3 % ( 275/298 ) for the ELBW or very preterm cohort and 85.1 % ( 223/262 ) for the NBW cohort . The ELBW or very preterm children scored significantly below NBW controls on full-scale IQ ( mean difference , -9.4 ; 95 % confidence interval [ CI ] , -12.1 to -6.7 ; P<. 
    Output:
    
agent
premature infants are more susceptible to motor development , behavior and academic performance impairment when compared to term infants .
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Objectives : 1 ) To investigate the comorbidity of verbal and nonverbal learning disability subtypes with several domains of behavior problems among 8-year-old children . 2 ) To determine whether receipt of an early intervention modified the association between childhood behavior problems and learning disabilities ( LD ) . Methods : This is a secondary data analysis of the Infant Health and Development Program ( IHDP ) , a r and omized clinical trial of an early intervention provided between ages 0 and 3 involving 985 children born low birthweight and premature . The findings are based on a prospect i ve follow-up of these children at 8 years of age . Results : Compared to children without verbal LD ( VLD ) , those with VLD were twice as likely to exhibit clinical levels of total behavior problems and 89 % more likely to exhibit externalizing behavior problems . Analysis of specific subscales of behavior revealed significant associations with anxious/depressed and withdrawn behaviors , as well as an increased likelihood of attention problems among children with VLD . No significant association was found between nonverbal LD ( NVLD ) and any type of behavior problem . Furthermore , there was a significant interaction between VLD and the intervention , in which the odds of internalizing behavior problems were greater among children with VLD . No interaction effect of the intervention occurred for any type of behavior problem among children with NVLD . Conclusions : These findings provide evidence that distinct differences exist for different learning disability subtypes with regards to behavioral outcomes and the effects of early intervention services among 8-year-old children OBJECTIVE : To determine whether mild and severe growth restriction at birth among preterm infants is associated with neonatal mortality and cerebral palsy and cognitive performance at 5 years of age and school performance at 8 years of age . METHODS : All 2846 live births between 24 and 32 weeks ' gestation from 9 regions in France in 1997 were included in a prospect i ve observational study ( the EPIPAGE [ Étude Epidémiologique sur les Petits Ages Gestationnels ] study ) and followed until 8 years of age . Infants were classified as “ small-for-gestational-age ” ( SGA ) if their birth weight for gestational age was at the < 10th centile , “ mildly-small-for-gestational-age ” ( M-SGA ) if birth weight was at the ≥10th centile and < 20th centile , and “ appropriate-for-gestational-age ” ( AGA ) if birth weight was at the ≥20th centile . RESULTS : Among the children born between 24 and 28 weeks ' gestation  , the mortality rate increased from 30 % in the AGA group to 42 % in the M-SGA group and to 62 % in the SGA group ( P < .01 ) . Birth weight was not significantly associated with any cognitive , behavioral , or motor outcomes at the age of 5 or any school performance outcomes at 8 years . For the children born between 29 and 32 weeks ' gestation , SGA children had a higher risk for mortality ( adjusted odds ratio [ aOR ] : 2.79 [ 95 % confidence interval ( CI ) : 1.50–5.20 ] ) , minor cognitive difficulties ( aOR : 1.73 [ 95 % CI : 1.12–2.69 ] ) , inattention-hyperactivity symptoms ( aOR : 1.78 [ 95 % CI : 1.10–2.89 ] ) , and school difficulties ( aOR : 1.74 [ 1.07–2.82 ] ) compared with AGA children . Being born M-SGA was associated with an increased risk for minor cognitive difficulties ( aOR : 1.87 [ 95 % CI : 1.24–2.82 ] ) and behavioral difficulties ( aOR : 1.66 [ 95 % CI : 1.04–2.62 ] ) . CONCLUSIONS : In preterm children , growth restriction was associated with mortality , cognitive and behavioral outcomes , as well as school difficulties OBJECTIVE To compare healthy late-preterm infants with their full-term counterparts from age 4 through 15 years for numerous st and ard cognitive , achievement , socioemotional , and behavioral outcomes . DESIGN Prospect i ve cohort study . SETTING National Institute of Child Health and Development Study of Early Child Care and Youth Development , 1991 - 2007 . PARTICIPANTS A total of 1298 children ( 53 born at 34 - 36 weeks ' gestational age ) , and their families , observed from birth through age 15 years . None of the infants had major health problems before or immediately following birth , and all the infants were discharged from the hospital within 7 days . MAIN EXPOSURE Preterm status : children born late preterm ( 34 - 36 weeks ) vs those born full term ( 37 - 41 weeks ) . MAIN OUTCOME MEASURES Eleven st and ard outcomes measuring cognition , achievement , social skills , and behavioral/emotional problems using the Woodcock-Johnson Psycho-Educational Battery-Revised and the Child Behavior Checklist , administered repeatedly through age 15 years . RESULTS No consistent significant differences were found between late-preterm and full-term children for these st and ard measures from ages 4 to 15 years . Through age 15 years , the mean difference of most of these outcomes hovered around 0 , indicating , along with small confidence intervals around these differences , that it is unlikely that healthy late-preterm infants are at any meaningful disadvantage regarding these measures . CONCLUSION Late-preterm infants born otherwise healthy seem to have no real burdens regarding cognition , achievement , behavior , and socioemotional development throughout childhood OBJECTIVES . Our objective was to determine motor , cognitive , and behavioral outcome at school age in preterm children with periventricular hemorrhagic infa rct ion and to identify cerebral risk factors for adverse outcome . METHODS . This was a prospect i ve cohort study of all preterm infants who were < 37 weeks ' gestation , had periventricular hemorrhagic infa rct ion , and were admitted between 1995 and 2003 .  Ultrasound scans were review ed for characteristics of periventricular hemorrhagic infa rct ion and other cerebral abnormalities . At 4 to 12 years of age , motor outcome was assessed by the Gross Motor Function Classification System and the Manual Ability Classification System , by a neurologic examination ( Touwen ) , an intelligence test ( Wechsler Intelligence Scale III/Wechsler Preschool and Primary Scale of Intelligence-Revised ) , and tests for visual-motor integration , visual perception , and verbal memory . Behavior was assessed by using the Child Behavior Checklist and the Behavior Rating Inventory of Executive Function . RESULTS . Of 38 infants , 15 ( 39 % ) died . Twenty-one of the 23 survivors were included in the follow-up . Four infants were neurologically normal , 1 had minor neurologic dysfunction , 13 had unilateral spastic cerebral palsy , and 3 had bilateral cerebral palsy . Coordination , associated movements , and fine manipulative abilities were affected most according to the neurologic examination . Gross Motor Function Classification System scores were level 1 ( 7 children ) , level 2 ( 7 children ) , level 3 ( 1 child ) , and level 4 ( 2 children ) . Manual Ability Classification System scores were normal ( 4 children ) , level 1 ( 8 children ) , level 2 ( 7 children ) , and level 3 ( 2 children ) . The mean and median total IQ was 83 . Visual perception was normal in 88 % of children , visuomotor integration was normal in 74 % , and verbal memory was normal in 50 % . Behavior was normal in 53 % of children , and executive functions were normal in 65 % and 29 % of children ( by parent and teacher report , respectively ) . Characteristics of the periventricular hemorrhagic infa rct ion were not related to functional motor outcome and intelligence . Posthemorrhagic ventricular dilatation was a risk factor for poorer total and performance intelligence and abnormal fine manipulative abilities . CONCLUSIONS . The majority of surviving preterm children with periventricular hemorrhagic infa rct ion had cerebral palsy with limited functional impairment at school age . Intelligence was within 1 SD of the norm of preterm children without lesions in 60 % to 80 % of the children . Verbal memory , in particular , was affected . Behavioral and executive function problems occurred slightly more than in preterm infants without lesions . The functional outcome at school age of preterm children with periventricular hemorrhagic infa rct ion is better than previously thought OBJECTIVE To investigate neurodevelopment at school age in preterm infants treated with hydrocortisone for bronchopulmonary dysplasia ( BPD ) in the neonatal period . STUDY DESIGN Preterm infants ( n = 226 ; gestational age < or = 32 weeks and /or body weight < or = 1500 grams ) performed subtests of the Wechsler Intelligence Scale for Children-Revised , the Visual Motor Integration test , a 15-Word Memory Test and the Movement Assessment Battery for Children at school age . Conventional MRI of the brain was obtained . Sixty-two children who received hydrocortisone for BPD ( starting dose , 5 mg/kg/day ; median duration , 27.5 days ) were compared with 164 nontreated neonates . RESULTS Hydrocortisone-treated infants were younger , lighter , and sicker than their non-steroid-treated counterparts . Adjustments for gestational age , body weight , sex , mechanical ventilation , and small for gestational age were made . Adjusted mean Intelligence Quotient , Visual Motor Integration test , and memory test results were the same in the hydrocortisone-treated group and the non-steroid-treated group ( 99 versus 101 , P = .62 ; 97 versus 99 , P = .49 , 7.9 versus 7.5 , P = .42 , respectively ) . Motor function and incidence of cerebral palsy in both groups was not different ( 11 % versus 7 % , P = .97 ) . Occurrence of brain lesions on MRI was similar for the two groups . CONCLUSIONS Neonatal hydrocortisone treatment for BPD had no long-term effects on neurodevelopment Objectives . To examine the prevalence , stability , and predictors of clinical ly significant behavior problems in 869 preterm low birth weight ( LBW ) infants at 3 , 5 , and 8 years of age . Methods . A prospect i ve cohort study was conducted . Clinical ly significant behavior problems were assessed using dichotomized total problem Child Behavior Checklist scores in LBW children at ages 3 , 5 , and 8 years . Baseline sociodemographic and obstetric data were collected . Maternal General Health Question naire performed at 40 weeks ' gestation was dichotomized at a score of 12 to give a measure of maternal psychological distress . Prevalence and stability of behavior problems at ages 3 , 5 , and 8 were determined and potential predictors of behavior problems at age 3 , 5 , and 8 were examined using multiple logistic regression . Results . Prevalence of behavior problems remained at ∼20 % at 3 , 5 , and 8 years . Stability of behavior problems between different ages was ∼50 % . Significant behavior problems at ages 3 , 5 , and 8 were predicted by maternal psychological distress at 40 weeks ( odds ratio [ OR ] : 1.59 ; 95 % confidence interval [ CI ] : 1.21–2.09 ) , maternal cigarette smoking during pregnancy ( OR : 1.57 ; 95 % CI : 1.20–2.04 ) , Hispanic ethnicity ( OR : 2.00 ; 95 % CI : 1.24–3.24 ) , and maternal age ( OR : 0.97 ; 95 % CI : 0.94–0.99 ) . Conclusions . This sample had double the prevalence of behavior problems expected in the general child population . These problems showed stability over time . Cigarette smoking in pregnancy , maternal psychological distress at 40 weeks ' gestation , maternal age , and Hispanic ethnicity all were significant predictors of the development of behavior problems from ages 3 to 8 . These findings have implication s for health policies on smoking and postnatal depression CONTEXT The outcome into school age of regional cohorts of children born in the 1990s with birth weights less than 1000 g ( extremely low birth weight , ELBW ) or earlier than 28 weeks ' gestation ( very preterm ) is not known . OBJECTIVE To determine the cognitive , educational , and behavioral outcome of ELBW or very preterm infants born in the 1990s compared with normal birth weight ( NBW ) controls . DESIGN Regional cohort study . SETTING Victoria , Australia . PARTICIPANTS The ELBW or very preterm cohort was composed of 298 consecutive survivors born during 1991 - 1992 . The NBW cohort was composed of 262 r and omly selected children with birth weights of more than 2499 g. MAIN OUTCOME MEASURES Cognitive ability , educational progress , and behavioral problems . RESULTS The follow-up rates from birth to 8 years of age for survivors were 92.3 % ( 275/298 ) for the ELBW or very preterm cohort and 85.1 % ( 223/262 ) for the NBW cohort . The ELBW or very preterm children scored significantly below NBW controls on full-scale IQ ( mean difference , -9.4 ; 95 % confidence interval [ CI ] , -12.1 to -6.7 ; P<. 
    Output:
    