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D Wolke

Publications and source records attributed to D Wolke.

At least 37 records · Page 2Linked to original sources
PubMed1998

An epidemiologic longitudinal study of sleeping problems and feeding experience of preterm and term children in southern Finland: comparison with a southern German population sample.

OBJECTIVE: To determine the influence of breast-feeding on the prevalence and persistence of sleeping problems in southern Finland (SF) and southern Germany (SG). DESIGN: Prospective binational population study of infants admitted to special care units (SCUs) in geographically defined areas in SF and SG. SUBJECTS: In SF, the number of SCU infants was 1057 (very preterm, 47; preterm, 258; term, 752); 485 term infants were control subjects. In SG, the number of SCU infants was 4427 (very preterm, 284; preterm, 1419; term, 2724). MAIN OUTCOME MEASURE: Parent reports of child sleeping problems at 5, 20, and 56 months of age. RESULTS: Night waking at 5 months of age was less frequent for SCU very preterm (25.5%), preterm (40.6%), and term infants (48%) than for term control subjects (56.7% to 59.9%) in SF. No differences in sleeping behavior according to gestation were found at 20 and 56 months. Sleeping problems were greater in SF infants (25.5% to 48%) than in SG infants (15.1% to 19.1%) at 5 months of age and were explained by a higher rate of breast-feeding in SF. Breast-feeding had no long-term effects on night waking or on co-sleeping in SF. In contrast, breast-fed infants continued to wake more often in SG. CONCLUSIONS: Breast-feeding rather than gestational age is strongly related to night waking. More support for dealing with night waking might prevent early termination of breast-feeding.

Breast Feeding↗
PubMed1995

The objective rating of oral-motor functions during feeding.

The Schedule for Oral Motor Assessment (SOMA) was developed to record oral-motor skills objectively in infants between ages 8 and 24 months postnatal. Its aim is to identify areas of dysfunction that could contribute to feeding difficulties. The procedure takes approximately 20 min to administer, and is intended to be rated largely from a videorecording of a structured feeding session. A series of foodstuffs of varying textures, including liquids, is presented to the child in a standardized manner. Oral-motor skills are evaluated in terms of discrete oral-motor movements. The schedule distinguishes these from skills at more aggregated levels of functioning such as jaw, lip, and tongue control. A total of 127 children have been studied with the instrument, including normal healthy infants and samples with nonorganic failure to thrive, and cerebral palsy. Interrater and test-retest reliabilities were determined on a subset of 10 infants who each took part in three trials rated by 2 therapists. Excellent levels of interrater reliability (kappa > 0.75) were obtained for the presence/absence of 69% of discrete oral-motor behaviors. Test-retest reliability was similarly excellent for 85% of ratable behaviors. For the first time an assessment of oral-motor functioning has been shown to have adequate reliability for children aged 8-24 months. The validation of the SOMA on a large sample of normally developing infants and its application to clinical groups is presented in an accompanying paper [1].

Bottle Feeding↗
PubMed1995

The incidence of sleeping problems in preterm and fullterm infants discharged from neonatal special care units: an epidemiological longitudinal study.

Anecdotal reports have suggested that sleeping problems are a frequent complaint from parents of preterm infants. This prospective epidemiological study examined the incidence and stability of sleeping problems of very preterm (< 32 weeks gestation at birth), preterm (32-36 weeks gestation) and fullterm infants, all admitted to special care baby units (SCBU) after birth, in comparison to healthy term infants over the first 5 years of life. Preterm infants were found to have fewer and shorter night-wakings at 5 months. No differences in sleeping behaviour compared with healthy term children were found at 20 and 56 months of age. Similar significant, and moderate, stability of nightwaking from one age to the next were found for exSCBU-graduates and healthy fullterm infants. Parental interventions such as staying with the child until sleep and taking the infant into bed af night were related to nightwaking problems and increased parental distress. It is concluded that prematurity, and thus neurological immaturity and special care experience are less important than caretaking behaviour in the development of sleeping problems in both preterm and fullterm infants.

Birth Weight↗
PubMed1995

Failure to thrive and the risk of child abuse: a prospective population survey.

OBJECTIVE: To identify the relative importance of failure to thrive during infancy as a risk factor for later abuse or neglect. DESIGN: Whole population birth cohort (1 January to 31 December 1986) studied prospectively over a four year period. SETTING: An inner city health district in London, England. SUBJECTS: 2609 births, of whom 47 were identified as having non-organic failure to thrive by first birthday. MAIN OUTCOME MEASURES: Registration on Child Protection Register, or subject to investigation of suspected abuse or neglect without registration. RESULTS: 2.5% (64) of birth cohort had been placed on the Child Protection Register during the period 1986-1990, and a further 1.2% (32) had been a cause for concern. The relative risk attributable to non-organic failure to thrive was 4.3 (95% CI 1.65 to 11.94) and exceeded other measured risk factors, including birth weight < 2500 g, 1.96 (95% CI 1.01 to 3.82); gestation < 35 weeks, 3.26 (95% CI 1.32 to 3.75); ordinal position > or = 4, 1.53 (95% CI 0.72 to 3.23). A multiple logistic regression confirmed the independent contribution of non-organic failure to thrive to subsequent poor parenting warranting professional intervention. CONCLUSIONS: Early postnatal non-organic failure to thrive is a risk factor for later serious parenting deficiencies, but previous research has overstated its importance. Within the community studied the nature of subsequent risk was (non-nutritional) neglect, rather than non-accidental injury. More than eight out of 10 cases do not give further cause for concern.

Age Factors↗
PubMed1994

The cognitive outcome of very preterm infants may be poorer than often reported: an empirical investigation of how methodological issues make a big difference.

The effects of relying on outmoded IQ-test norms and the use of arbitrary classifications of developmental delay on estimates of cognitive impairment of very preterm infants (VPI) was evaluated in a prospective population study. Cognitive assessments included the Griffiths test at 5 and 20 months and the Columbia Mental Maturity Scales (CMM) and a vocabulary test (Aktiver Wortschatz Test, AWST) at 56 months of age. Rates of cognitive impairment of 321 very preterm infants (VPI; < 32 weeks gestation or < 1500 g birth weight) were determined according to the published test norms, to scores of a full-term control group (FC n = 321), and to scores from a representative sample of children (NC n = 431) of the same birth cohort. IQ-scores were higher in the FC and NC children than in the original standardisation sample (SS). Using the concurrent test norms (FC, NC) up to 2.4 times more VPI were identified as seriously impaired (<-2 SD) than if the published (outdated) norms were used. Serious developmental delay was underestimated when arbitrary (e.g. DQ < 70) rather than across age comparable definitions (DQ <-2 SD) were used. VPI study drop-outs had mothers with lower educational qualifications and poorer cognitive developmental scores at 5 or 20 months of age. In conclusion, a lack of appropriate control groups and use of arbitrary criteria for judging serious delay leads to large underestimations of cognitive impairment in VPI. Findings from previous uncontrolled studies of VPI need re-interpretation.

Child Development↗
PubMed1994

Postnatal growth and mental development: evidence for a "sensitive period".

For many years it has been suspected that severely impaired somatic growth during early postnatal life can be associated with the subsequent impairment of mental abilities. This study aimed to test that hypothesis on the basis of data gathered from a prospective whole population survey of infant development in south London. A year's birth cohort of 1558 full-term singletons was monitored; 47 otherwise healthy cases with serious growth faltering in the first year were recruited. Mental and psychomotor abilities were assessed at 15 months. Potentially confounding psychosocial variables, including cognitive stimulation received at home, were measured contemporaneously. A statistical model was constructed that enabled the timing, duration and severity of growth faltering to be used as predictors of mental functioning. Up to 37% of the variance in cognitive and psychomotor outcome at 15 months can be explained by the model. The first few postnatal months appear to constitute a "sensitive period" for the relationship between growth and mental development.

Anemia↗
PubMed1994

[Incidence and persistence of problems at sleep onset and sleep continuation in the preschool period: results of a prospective study of a representative sample in Bavaria].

The prevalence and persistence of sleeping problems was studied in a prospective investigation of a representative sample of 432 German children at the ages of 5, 20 and 56 months. 21.5% of children had night waking problems at 5 months, 21.8% at 20 months and 13.3% at 56 months. Falling asleep difficulties were diagnosed in 12.1% of 4-5 year olds. One in four of five year-olds slept regularly in the bed with the parents (co-sleeping). Children with night waking problems had a 2.2 to 2.5 fold increased risk to remain nightwakers from one assessment point to the next compared with non-wakers. 7 to 14% of parents were distressed by their children's sleeping behaviour. Parental behaviour often contributed to continued sleeping problems because the children were not supported in acquiring appropriate skills to settle to sleep unaided. A developmental model for the treatment of sleeping problems is discussed.

Child, Preschool↗
PubMed1994

Excessive infant crying: a controlled study of mothers helping mothers.

OBJECTIVE: To determine the efficacy of behavioral management counseling in the treatment of persistent, excessive infant crying (> 3 hours per day). DESIGN: Two treatments, one no treatment control group. Infants were group-matched according to baseline fuss/cry levels, sociodemographic, and infant variables. Treatments were carried out sequentially by the same counselors. SETTING: Telephone counseling by volunteers (mothers) of CRY-SIS, a national support group for the parents of crying infants. PATIENTS AND INTERVENTIONS: Sequential sample of 27 mother-infant pairs receiving treatment 1 (Tr1, empathy: talking through the problem), 21 receiving treatment 2 (Tr2, behavioral management: specific care taking suggestions) and 44 receiving no treatment (C, controls). Infants were between 1 to 5 months of age. MEASUREMENTS AND RESULTS: Mother-infant pairs had a pretreatment baseline assessment and a posttreatment follow-up (3 months after baseline) using 1-week diaries. Total fuss/cry duration reduced significantly more in the behavioral management group (by 51%) than the empathy group (37%) or the control group (35%). This was mainly due to significantly reduced evening fussing/crying in Tr2 (67%) compared with Tr1 (45%) and C (42%). No differences in total number of fuss/cry bouts/day were found. However, the number of fuss/cry bouts reduced significantly more in the evening in Tr2 (by 55%) compared with Tr1 (27%) and C (32%). Behavioral management mothers evaluated the same counselors as more sympathetic, knowledgeable, and understanding. Tr2 was also perceived by mothers to have helped them more in reducing the crying problem, coping with the infant, and improving the relationship with their infant than Tr1. No effects of treatment on infant difficult temperament were found. CONCLUSIONS: Behavioral management was more effective in reducing fussing/crying than spending time with the mother talking through the problem or just waiting for spontaneous remission. Treatment by suitably but briefly trained lay counselors is an inexpensive and successful treatment option.

Adaptation, Psychological↗
PubMed1990

Behavioral style in failure-to-thrive infants: a preliminary communication.

In a pilot inner-city survey, nine 1-year-old infants with nonorganic failure to thrive (NOFT) and pairwise matched controls from the same deprived inner-city area were studied at home. A multimethod approach to the study of infant behavioral style was adopted. A consistent pattern of NOFT infants' behaviors in mothers' descriptions, in observation of play behavior, and in interaction with the examiner during standard testing emerged. NOFT infants were found to be more fussy, demanding, and unsociable. They were also less task-oriented and persistent, and their mothers expressed more negative emotions during play interaction. Mental development was significantly delayed in NOFT infants. The findings emphasize the importance of behavioral contributions from both infant and mother to the relationship problems characteristic of NOFT.

Arousal↗
PubMed1989

Oral-motor dysfunction and failure to thrive among inner-city infants.

Non-organic failure to thrive among socio-economically deprived inner-city infants may be associated with abnormal oral-motor functioning and aspects of social adversity, such as disorganised meal-times. A Feeding Assessment Schedule was devised to rate oral-motor behaviour objectively and was used to test nine pairs of case and comparison children while they were being fed at home. Video-recordings were made for later analysis. The case infants had immature and abnormal oral-motor development that made them less able to be fed successfully. Temperamentally they were more 'difficult' than the comparison infants, and they were less adept at signalling their needs during meal-times. The case infants also were fed in inappropriate positions for their age, with more distractions and less suitable utensils.

Child↗
PubMed1988

Convergences and discrepancies, among mothers' and professionals' assessments of difficult neonatal behaviour.

The idea that difficult newborn behaviour reflects an inborn disposition was tested by comparing measures from different circumstances, occasions and observers. Correlations between researcher measures from separate settings and occasions were statistically significant but modest, indicating a "rudimentary" constitutional trait contribution to difficult newborn behaviour. Little evidence of a discrete subgroup of particularly difficult newborns was obtained. Maternal assessments were internally consistent but weakly explained by baby constitutional factors or nurses' reports. The importance of contextual and development variables is discussed. Alternative methodological strategies for studying constitutional and social-developmental contributions to difficult behaviour are needed.

Child Behavior↗
PubMed1988

Five-year follow-up study of extremely low-birthweight infants.

This study investigated whether extremely low-birthweight (ELBW) babies, who at two years had no major handicaps, were at higher risk for intellectual and socio-emotional problems at five years than a control group of children with normal birthweights. There were statistically significant differences between the two groups. The ELBW children were language-delayed, and more active and more intense in their behaviour. There was a tendency for the ELBW children to be lighter and shorter than the controls, but their mean head-circumference was significantly smaller. In general, however, if no serious neurological, neurosensory or cognitive impairment is found among ELBW children at two years, later cognitive and socio-emotional development is likely to be within the normal range.

Child↗