Neurodevelopmental Outcome of ECMO Survivors at Five Years of Age: The Potential for Academic and Motor Difficulties

This study examined areas of cognitive and motor functioning in survivors of neonatal extracorporeal membrane oxygenation (ECMO) at age 5. Fifty-two English-speaking ECMO survivors were seen for follow-up evaluations of cognitive, physical, and motor status, using the WPPSI-R, PPVT-R, PDMS, VABS, Achenbach CBCL, and physical examination. Children were assigned to groups of "normal," "at risk," and "delayed" on the basis of their functional outcome. Profile analyses were done on the verbal and performance intelligence quotients of the WPPSI-R and the developmental motor quotient subtests of the PDMS. A higher number of children than expected (10%) were diagnosed with mental retardation, while an additional 12% presented other disabilities. In addition, a pattern of specific vulnerabilities in cognitive and gross motor abilities was present for many children, including difficulties with fine motor and motor planning using paper and pencil. ECMO survivors are at greater risk than would be expected for academic difficulties and gross motor deficits, suggesting that many children may require special education services. Evaluation in second or third grade, when learning disabilities can be more easily identified, is indicated for ECMO survivors.