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Screening for Dysregulation Among Toddlers Born Very Low Birth Weight

Erickson, Sarah J. PhD; MacLean, Peggy PhD; Duvall, Susanne Woolsey PhD; Lowe, Jean R. PhD

doi: 10.1097/IYC.0b013e31829307b1
Original Study

Background: Children born very low birth weight (VLBW) are at increased risk for regulatory difficulties. However, identifying toddlers at risk has been impeded by a lack of screening measures appropriate for this population.

Methods: We studied the nature of dysregulation in toddlers born VLBW (N = 32) using the Infant-Toddler Social and Emotional Assessment (ITSEA) Dysregulation Domain, a multiscale (including negative emotionality, sleep, eating, and sensory sensitivity) screening assessment of regulatory abilities.

Results: As evidence of construct validity for this population, ITSEA scores for toddlers born VLBW showed greater overall dysregulation, as well as sensory sensitivity, compared with an ITSEA manual-based premature/LBW sample. This was seen both by higher overall Dysregulation Domain scores and higher percentages of toddlers exceeding the clinical cutoff levels. Furthermore, compared with age- and gender-matched full-term toddlers, the VLBW toddlers displayed gender-specific dysregulation profiles.

Conclusions: The greater overall dysregulation in VLBW toddlers compared with premature/LBW toddlers suggests that early screening for such difficulties among VLBW toddlers is warranted, and this study provides preliminary evidence that the ITSEA Dysregulation Domain may be an appropriate screening measure.

Departments of Psychology (Dr Erickson) and Pediatrics (Drs MacLean and Lowe), University of New Mexico, Albuquerque; and Oregon Health and Science University, Division of Psychology, Institute on Development and Disability, Portland (Dr Duvall).

Correspondence: Jean R. Lowe, PhD, Department of Pediatrics, MSC10 5590, 1, University of New Mexico, Albuquerque, NM 87131 (

The authors have no financial relationships to disclose. This research was supported by DHHS/NIH/NCRR/GCRC Grant No. 5M01RR00997 and the UNMH Pediatric Research Committee.

The authors declare no conflict of interest.

© 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins.