Wednesday, December 9, 2009

Forecasting school readiness at birth

Talk about early screening and intervention. Doctors have created a new newborn exam they say predicts some things we would like to be able to predict. They followed 1200 babies in 4 cities and developed a set of neurobehavioral profiles.
At three to four and one half years of age, infants with poor performance were more likely to have behavior problems (age three), school readiness problems (age four) and low IQ (age four and one half). Forty percent of these infants had clinically significant problems externalizing (impulsivity and acting out), internalizing (anxiety, depression, withdrawn personalities), and with school readiness (delays in motor, concepts and language skills), and 35% had low IQ.
I have mixed feelings about this. I certainly want to find kids early who can be helped by treatment, but I will be surprised if the things this test uncovers can be helped much. If you can give kids a test at birth that predicts a big chunk of IQ, behavior problems, and school readiness, that means the causes are biological, not psychological.

While I wouldn't rule out amelioration of symptoms, or even "curing" them, the solutions will be found, if at all, by making the brain work differently. Maybe the solution will be drugs. Maybe cognitive therapy can rewire the brain. Or maybe we are just identifying people who are going to have problems in life.

As with identifying kids who have a disposition toward alcoholism, what would we do with the information? If you were running an infant center and knew the birth scores of all your kids on this test, what would you do differently based on the results? How would you treat an impulsive or depressed or developmentally delayed infant to prevent it from becoming an impulsive or depressed or developmentally delayed 4-year-old? How would you change your reaction when a kid hits you if you know she's been that way since birth?

I wish I were more optimistic about this.

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