In this thesis, four studies on children and adolescents with Down syndrome are described. The first study showed that the number of live births of children with Down syndrome in the Netherlands... Show moreIn this thesis, four studies on children and adolescents with Down syndrome are described. The first study showed that the number of live births of children with Down syndrome in the Netherlands remained stable over the period 1997-2007 on 14.6 per 10,000 births. Of these, 85% were live born. In the second study is observed that growth retardation in children with Down syndrome meanly occurs in three critical periods of growth, resulting in shorter final stature and smaller head circumference than the general Dutch population shows. Furthermore, Dutch children with Down syndrome have alarmingly high prevalence rates of overweight and obesity during childhood and adolescence. The third study showed that eight-year-old children with Down syndrome have an average developmental delay of four years, more often have emotional and behavioral problems, and have a less favorable health-related quality of life (HRQoL) compared with children from the general population. Children with Down syndrome and recurrent respiratory tract infections showed relatively more delayed development. In the fourth study, results showed that adolescents with Down syndrome remain dependent to a large degree and have serious difficulties in functioning socially. Additionally, results showed that serious problem behavior is highly prevalent in adolescents with Down syndrome. Show less
This thesis examines the effect of developmental care in a tertiary NICU in 2 locations in the Netherlands on preterm infants born < 32 weeks gestational age. Following a pilot study with 22... Show moreThis thesis examines the effect of developmental care in a tertiary NICU in 2 locations in the Netherlands on preterm infants born < 32 weeks gestational age. Following a pilot study with 22 preterm infants and their parents, two consecutive randomized controlled trials (n=179, n=164) in which first basic developmental care (use of incubator covers and positioning aids), and then the comprehensive Newborn Individualized Developmental Care and Assessment Program (NIDCAP), an individual approach in which caregiving is based on the behavior of the infant, was studied in preterm infants born < 32 weeks GA. Basic developmental care had no effect on short-term physical and neurological outcomes; a positive effect on psychomotor development at 1 CA, but no effect on neurological and mental development or growth at 1 and 2 years. NIDCAP showed no effect on short-term physical and neurological outcomes as well as no effect on growth, neurological, mental and psychomotor development at 1 and 2 years CA in infants born < 32 weeks, as compared to basic developmental care. Future research should include not only the effect of developmental care in the neonatal centers but also the effect of continuing the intervention once infants are transferred to regional hospitals. Show less
