Four-year follow-up of a sample of regulatory disordered infants
In this prospective descriptive study, the developmental outcomes of 9 untreated infants with moderate to severe regulatory disorders were examined at 8 to 11 months and again at 4 years of age and compared with 13 normal infants. Regulatory disordered infants were defined as being behaviorally difficult, exhibiting disturbances in sleep, feeding, state control, self-calming, and mood regulation and evidencing poor sensory processing. Eight of the nine regulatory disordered children had developmental, sensorimotor, and/or emotional and behavioral deficits at 4 years. Group differences were found in atten tion and activity level, emotional maturity, motor coordination, and tactile sensitivity at 4 years. For normal infants, ratings of difficultness on the Bates Infant Characteristics Questionnaire and higher baseline cardiac vagal tone were related to better developmental outcomes and behavioral organization respectively at 4 years. In contrast, ratings of difficultness and higher baseline cardiac vagal tone in regulatory disordered infants were associated with poorer developmental outcomes and behavioral difficulties at 4 years. At the time the study was conducted, the clinical significance of regulatory problems was not known, therefore treatment was not considered. The results of this study suggest that untreated regulatory disordered infants may not outgrow behavioral difficulties over time.