Article

This historical cohort study describes the use of educational and
rehabilitation services in adolescents born preterm or with a congenital heart
defect (CHD). METHOD:
Parents of 76 young people (mean age 15y 8mo [SD 1y 8mo])
with CHD and 125 born </=29 weeks gestational age
(mean age 16y [SD 2y 5mo])
completed a demographics questionnaire including educational and rehabilitation
resource utilization within the previous 6 months.
Rehabilitation services
included occupational therapy, physical therapy, speech language pathology,
psychology. Developmental (Leiter Brief IQ, Movement-ABC, Strengths and
Difficulties Questionnaire) and functional (Vineland) status of the young people
was assessed. Pearson chi2 tests were used to perform simple pairwise comparisons
of categorical outcomes across the two groups (CHD, preterm). Univariate logistic
regression was used to examine predictors of service utilization. RESULTS:
Developmental profiles of the two groups (CHD/preterm) were similar (29.9%/30%
IQ<80; 43.5%/50.0% motor difficulties; 23.7%/22.9% behavior problems). One-third
received educational supports or attended segregated schools. Only 16% (preterm)
and 26.7% (CHD) were receiving rehabilitation services. Services were provided
predominantly in the school setting, typically weekly. Few received occupational
therapy or physical therapy (1.3-7.6%) despite functional limitations. Leiter
Brief IQ<70 was associated with receiving educational supports (CHD: OR 5.53, 95%
CI 1.29-23.68; preterm: OR 14.63, 3.10-69.08) and rehabilitation services (CHD:
OR 4.46, 1.06-18.88; preterm: OR 5.11, 1.41-18.49). Young people with motor
deficits were more likely to require educational (CHD: OR 5.72, 1.99-16.42;
preterm: OR 3.11, 1.43-6.77) and rehabilitation services (preterm: OR 3.97,
1.21-13.03). INTERPRETATION: Although young people with impairments were more
likely to receive educational and rehabilitation services, many may not be
adequately supported, particularly by rehabilitation specialists. Rehabilitation
services at this important transition phase could be beneficial in optimizing
adaptive functioning in the home, school, and community.
CI - (c) 2017 Mac Keith Press.

Langue : ANGLAIS