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In the current study, a strong correlation was found between MDI measured at 2 years of age and
FSIQ measured at the age of 5 years, suggesting that early assessment of cognitive development is
significantly associated with cognitive development at least up to the age of 5 years. The stability of
the classification of cognitive outcome was high in normally developing and in significantly delayed
groups. This finding implies that early assessment of cognitive development is clinically important.
Children with significant developmental problems should be addressed to appropriate diagnostic,
etiologic, and rehabilitation services as early as possible in their development.
Di penelitian ini, ada hub yg kuat ditemukan antara pengukuran mdi pada uia 2 tahun dan pengukuran
fsiq pada umur tahun. Ass di awal awal pada prkembangan kognitif adalah scr signifikan dhubungkan
dg perkembangan kognitif setidaknya pada usia 5 tahun. Kestabilan pada klasifikasi dampak kognitif
adalah tinggi dalam perkembangan normal dan scr sig masuk kat terlambat.
Penemuan ini scr tdk langsung menunjukan bahwa ass pada awal thdp perkembangan kognitif scr
clinically penting. Anak2 yg memunyai masalah perkembangn scr sig shrusnya diberikan penanganan
yg tepat sejak awal sebisa mungkin pd perkembangnnya.
Conversely, parents of children with milder problems should also be provided with counseling to
support their child’s possible specific needs.
Sebaliknya ortu anak anak dg permsalah yg lebih menengah shrusnya juga di berikan konseling
untuk men support kebtuhan spesifik yg mungkin dibuthkan si anak
Cognitive development of the current study population has been shown to be relatively good, as the
meanvalue of MDI has been at the level of BSID-II norms at the age of 2 years. Our study confirmed
this developmental pattern because VLBW children performed at the level of WPPSI-R norms.

Despite this finding, the difference to control group was almost 1 SD also at the age of 5 years. Our
control group was, however, selected because it included only healthy-born infants excluding all
preterm and small for gestational age infants, those requiring NICU admission for any reason, and
those who were exposed antenatally to alcohol or illicit drugs. In addition, the average education level
in Finnish society is high, free health care is provided to all, and the variation in socioeconomic
background is smaller than in many other countries.
Prkembangan kog pada penelitian ini menunjukan relativ bagus dilihat dr rata2 mdi di usia 2 tahun.
Studi ini mengkonfirmasi pola prkembangan yg disebabkan vlbw pd anak. Disamping penemuan ini,
perbedaan antara kntrol group hampir 1 sd. Kontrol group

Therefore, these findings may not be directly generalized to other populations. Importantly, however,
the socioeconomic background factors (level of parental education, which correlates strongly with
socioeconomic status) did not differ between VLBW and term infants, which served to differentiate the
VLBW population in the current study from those of many other countries. This condition makes it
possible to study the impact of prematurity without the confounding effects of socioeconomic factors.
Children did not take part in any structured intervention programin this study. However, all of the
infants who had a significant motor delay received physiotherapy. If there were any concerns about
the development or the behavior of the child either at the age of 2 or 5 years, he or she was referred
to appropriate local rehabilitation services. In Finland, most children enter the communal day care
system. This system provides appropriate support for all children with developmental or behavioral

concerns, and no IQ discrepancy is required for inclusion. Trained nursery school teachers support
their development in daily play situations.
Oleh krn itu, penemuan ini tdk bs langsung di generalisasikan pada populasi. Faktor sosial ekonomi
pada populasidi sudiini dibuat sama, sehingga menurunkan biasdr faktor sosial eonomi.
Di finlandia sbgian besar anak anak menerima psikoterapi terutama anak anak yg eaami
keerlmabatan perkembangan.
The strengths of this study include high coverage of the VLBW children with a long follow-up period.
Standardized methods were used for follow-up, and a regional control group was used in addition to
the normative data of the BSID-II and WPPSI-R. Different psychologists conducted the assessment in
2 different time-points to avoid the bias of the previous assessment. Strong correlation was found
despite the fact that different methods had to be used to measure cognitive development at different
age point, as both methods cover only limited age-span. However, both methods provide information
about the individual development compared with age-appropriate normative data, and they use the
same scaling. An additional strength was that all children participated in the assessment within a very
strict time limit. Timing of theassessment was chosen to be both developmentally and clinically
relevant. From the developmental point of view, 2 years is an interesting time window as motor
development is less dominant and language development is in a very active phase. Clinically, it is
important to identify those children who have developmental problems as early and as accurately as
possible to provide them with appropriate services. Five years is a more reliable age of assessment
considering the later academic performance at school age, but there is still time for preventive

interventions if child is at risk for academic failure.
Kekuatan stud ini adalah mengcover anak anak vlbw dg fllow up yg lama. Metode standar yg
digunakan untuk mem follow up adalah data data normatif dr bsid edisi 2 dan wppsi-r. Perbedaan
psikologis dihubungkan dg ass dalam 2wkt yg berbeda untuk menghindari bias dr ass sebelumnya.
Hub yg kuat ditemukan meskipun faktanya metode yg berbeda hanya mng cover masa usia yg
terbatas. Bgmnpun kedua metode menyediakan info ttg individual perkembangan dg membandingkan
kesesuaian usia dan mereka menggunakan skala yg sama.
Usia 2 tahun adalah aktifnya fase bahsa. Scr clinical hal tsb penting untuk mengdentifikasi anak anak
yg mempunyai maslaah prkembangan scr awal, dan scr akurat dan sebisa mungkin untuk

meneydiakan mereka peleyanan yg sesuai. Tahun adalah usia yg mampu untuk meg ass demi
mempertimbangakn performa akademik di usia usia sekolah, namun masih ada waktu untuk
mencegahnya

Study limitations include that the BSID-II and WPPSI-R were used instead of the new versions (the
Bayley Scales of Infant and Toddler Development, Third Edition, and the third edition of the WPPSI),
as these tests were not available in Finland at the time of the study. It is also important to stress that
measures of cognitive development, such as used here, do not allow inferences about
neuropsychological deficits that can be found with more specificmeasures or that may become
evident only later in the child’s development. Low cognitive capacity is usually accompanied

with neuropsychological difficulties, but average cognition does not imply that one would be free from
more specific neuropsychological problems. Therefore, other methods are also needed to
complement follow-up of at-risk preterm children. Long-term follow-up is needed to identify specific
problems that may become evident only later in the development. However, it is important to offer
families with as accurate information as it is possible to gain at the child’s different developmental
stages.
Meskiun daam studi ini tdk menark kesiulan terkait kekurangan neuropsychological yg dpt ditemukan
dg pengukuran yg lebih spesifik atau y mungin menjadi bukti pada perkembangan anak. Kapasitas
kognitif yg rendah biasanya disertai dg kesulitan neuropsychological, namun rata rata kognitif tdk
menyaakan tdk scr implisit (gamblang)....
Bgmnpun metode lain juga dibutuhkan untuk melengkapi follow up pada masasblm anak anak yg
beresiko. Masa yg ama untuk mem follow up dibutuhkan untuk menidentifikasi masalah spesifik yg
mungkin enajdi bukti dr perkembnagan. Bgmnpun penting bg keluarga dalam berperan di
erkembangan anak

CONCLUSIONS
The current study revealed that the cognitive outcome of a regional VLBW cohort measured at the
age of 2 years was significantly associated with cognitive outcome at the age of 5 years. We suggest
that a well-conducted assessment is relevant and valuable also at the early age, making it possible to
support those children with developmental problems. However, at the same time, we stress the

importance to followup these at-risk children longitudinally and with methods covering both cognitive
and neuropsychological development.

Di studi ini dinyatakan dampak kog pada kel vlbw dg pengukuran kohort pada suai 2 ahun
berhubungan dg dampak kog pada usia 5 tahun. Kami mem suggest bahwa ass y baik akan
sesuai dan berarti bila dilakukan di usia usia awal, krn memungkinkan untk memsupport

anakaanka dg masalah perkebngan. Bgmnpun, kami memnenkankan pentingny mem follow
up anak anakyg beresiko dan dg metode2 yg meg cover kedua kog dan perkembangan neuro
AUTHORS: Petriina Munck, MA, Helena Lapinleimu, MD, PhD, Leena Haataja, MD, PhD,Pekka Niemi, PhD,
Liisa Lehtonen, MD, PhD, and the PIPARI Study Group