Комплексная оценка траектории развития нейрокогнитивных навыков у недоношенных детей в лонгитюде
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Ключевые слова

когнитивное развитие
внимание
моторное развитие
коммуникативное развитие
визуальное восприятие
недоношенность
младенчество
раннее детство
Шкалы Бейли
айтрекинг

Аннотация

Введение. Целью исследования было выявление различий в уровне развития когнитивных и сенсомоторных функций у недоношенных и доношенных детей раннего возраста. Недоношенность является значимым фактором риска возникновения неврологических и психомоторных отклонений, а также нарушений когнитивного развития. Новизна работы заключается в проведении комплексного исследования с применением современных аппаратурных и поведенческих методов в рамках лонгитюдного подхода.

Методы. Экспериментальную группу составили 42 недоношенных младенца (срок гестации 32,4 ± 2,1 недели), в контрольную группу вошли 60 детей, родившихся в срок, с типичным развитием и отсутствием заболеваний ЦНС в анамнезе. Проводилось лонгитюдное исследование в следующих возрастах: 5, 10, 14 и 24 месяца. Для оценки навыков зрительного поиска и совместного внимания был использован айтрекер модели SMI RED500. Для оценки когнитивного развития, рецептивной и экспрессивной коммуникации, крупной и мелкой моторики применялись «Шкалы развития Н. Бейли, 3-е издание».

Результаты. Недоношенные испытуемые показали достоверно более низкие результаты по когнитивной и коммуникативным субшкалам Бейли в 5 и 10 месяцев, а также отставание в развитии моторики в 14 и 24 месяца в сравнении с контрольной группой. Кроме того, экспериментальной группой было продемонстрировано снижение устойчивости и скорости переключения зрительного внимания и более низкий результат по зрительному поиску простого несоциального стимула в возрасте 14-и месяцев. Не было выявлено значимых межгрупповых различий по восприятию социальных стимулов и развитию совместного внимания.

Обсуждение результатов. Делается вывод об избирательном влиянии недоношенности на становление нейрокогнитивных функций и частичном нивелировании этого влияния у детей к третьему году жизни.

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