according to the korea institute for health and social affairs , the number of people 
 registered with disabilities in korea increases by approximately 5% each year , and brain 
 lesion - related disabilities account for approximately 10% of all cases . of the total number 
 of disabled children in the 09  year - age range , 55% are children with cerebral palsy , which 
 is higher than any other age group1 . this result is attributable to the fact that although the survival rate of high risk 
 newborn infants , such as premature babies and low birth - weight infants due to premature 
 birth , has increased thanks to the development of neonatal intensive care technologies , 
 brain damage , which is the root cause of cerebral palsy , has not been prevented . infant temperaments are affective ties that humans experience for the first time 
 immediately after birth , and they are one of the factors that affect mother - child 
 relationships . to form strong mother - child relationships , it is necessary to understand 
 infant temperaments and elicit appropriate interactions2 . infants that are underdeveloped due to premature birth are in insufficient arousal states ; 
 thus , they have picky temperaments such as low mobility , decreased ability to concentrate , 
 and a lack of patience . they are also hard to soothe and they avoid eye contact with 
 others3 , 4 . in the case of infants with cerebral palsy due to complications of premature birth , picky 
 temperaments and physical and mental disabilities make it difficult for parents to nurture 
 their children and this adds to their parenting stress5,6,7 . therefore , this study aimed to examine the infant temperaments of newborns with cerebral 
 palsy as perceived by the mothers who were taking care of them in order to better understand 
 cerebral palsied infants , and to promote positive interactions between parents and children , 
 thereby helping to improve effective adaptation . the study subjects were 118 mothers of infants diagnosed with cerebral palsy due to 
 premature birth among infants younger than 36 months who were receiving rehabilitation at 
 three university hospitals , two children s rehabilitation hospitals , and three private 
 treatment centers located in daegu . after first explaining the purpose of the study to the 
 study subjects , and with the cooperation of the relevant institutions , the study subjects 
 were asked to complete structured questionnaires , which took approximately 510 minutes . the 
 protocol of this study was approved by daegu university . the questionnaires contained questions regarding the general characteristics of infants 
 with cerebral palsy , questions about diverse premature birth - related variables such as 
 gestational age , periods of hospitalization in the neonatal intensive care unit ( nicu ) , type 
 of cerebral palsy , and the degree of disabilities , and questions regarding the infants 
 temperaments . the infant characteristics questionnaire ( icq ) developed by bates8 was used to measure infant temperament . this questionnaire 
 consists of a total of 24 questions which aim to assess the infants temperamental 
 difficulties using a seven - point scale , and higher scores indicate parents perceptions of 
 higher levels of difficulties in dealing with the infants characteristics . that is , higher 
 scores indicate that the parents feel that their child is harder to deal with in comparison 
 to normal children , and that they feel that it is more difficult to nurture their child . sub - items under the factor analysis of the infant temperament scale include questions 
 addressing : the  degrees of pickiness , the degree of infants whining and the degree of 
 difficulties in soothing ; maladjustment , infants reactions and adaptation to new events , 
 objects , or humans ; insensitivity , infants activity and sociability ; and 
  non - predictability , infants physiological needs , such as hunger and wet diapers . the test and anova 
 were conducted to examine infant temperament in relation to the respondents general 
 characteristics , and correlation analyses were conducted to examine the correlations between 
 different temperaments in cerebral palsied infants . although no statistically significant differences were found , in the analysis of infant 
 temperament in relation to infants general characteristics and premature birth - related 
 variables , icq scores were higher when the degree of disability was greater , such as when a 
 child with cerebral palsy also had quadriplegia , thereby indicating a picky temperament . infants with a birth - weight below 1,000  g showed higher sub - scale scores indicating 
 maladjustment and insensitivity . the infant temperament scores were higher in infants that 
 had longer periods of hospitalization in the nicu . with regard to gestational age , infant 
 temperament scores were higher in cases of premature birth before 28 weeks , although the 
 differences were not statistically significant . the purpose of this study was to examine children with cerebral palsy due to premature 
 birth to evaluate the infants temperaments as perceived by their mothers , in order to help 
 mothers caring for them better understand the characteristics of premature birth and 
 cerebral palsy . this study also aimed to present the basic data necessary for the formation 
 of healthy mother - child relationships and to identify therapeutic interventions for children 
 born prematurely . although no statistically significant differences were found the scores of 
 some of the infant temperament sub - scales were higher in relation to the degrees of 
 disability , type of disability , birth weight , period of hospitalization in the nicu , and 
 gestational age ( table 1table 1.scores of sub - scales of infant temperaments in relation to the characteristics of 
 infantsnirritabilitynon - adaptabilitydullnessunpredictabilityseverity of disabilitymild533.3  0.83.2  0.93.0 0.73.5  0.7average severity513.5  0.73.3  0.72.9  0.73.5  0.7very severe143.8  1.23.7  0.92.9 0.83.9  0.8spastic diplegia553.4  0.63.2  0.93.0  0.63.4  0.8spastic hemiplegia313.3  0.93.3 0.93.0  0.73.4  0.7other153.3  0.83.4  0.72.6  0.63.5  0.7birth weight ( g ) < 1,000213.2  0.83.5  0.82.8  0.83.3  0.81,0001,500293.3  0.83.2  0.93.0  0.73.5  0.81,5002,500493.8  0.83.3  0.92.9  0.63.7  0.7 2,500193.1  0.73.3 0.72.9  0.63.3  0.6term of nicu ( days)none153.1  0.83.3  0.72.8  0.63.5  0.7 30463.5  0.73.1  0.92.9  0.73.5  0.7 60273.7  0.83.4  0.72.9  0.53.7  0.8 90303.4  0.83.5  0.83.0  0.83.5  0.8gestational age ( weeks ) < 28323.4  0.93.3  1.03.0  0.83.6  0.82834563.4  0.73.3  0.82.9  0.63.5  0.73437173.5  0.93.0  0.83.0  0.73.4  0.8 37133.6  0.83.6  0.73.0  0.63.5 thus , our results indicate that infant temperaments perceived by mothers of 
 premature children with cerebral palsy were not as good as infant temperaments perceived by 
 mothers of normal children9 . the results 
 of studies that compared the infant temperaments of normal children with those of premature 
 children , the results of studies that compared the infant temperaments of normal newborn 
 babies with those of high risk newborn babies10 , and the results of studies that compared normal weight birth 
 infants with low birth weight infants show that higher risk infants and lower birth weight 
 infants have pickier infant temperaments2 . other studies have shown significant correlations between infant temperaments and a mother s 
 parenting stress , confidence in infant care , depression , and self - worth11 , 12 . nicu : neonatal intensive care unit this is considered to be attributable to the fact that a correct understanding of infant 
 temperaments can lead to the formation of positive mother - child relationships and enhance a 
 mother s confidence and satisfaction in her role , thereby relieving her level of parenting 
 stress . a previous study reported that among the mother of high risk newborn infants , an 
 experimental group that received education in integrated newborn infant intensive care units 
 showed higher maternal self - esteem than a control group . therefore , studies and programs 
 should be developed to provide information regarding the infant temperaments of children 
 with cerebral palsy due to premature birth13 . since this study only investigated mothers who had children with cerebral palsy due to 
 premature birth , additional studies are necessary in order to verify the statistical 
 significance of this study s findings by comparing children with cerebral palsy due to 
 premature birth with normal children .
[ purpose ] the purpose of this study was to examine the infant temperaments of children 
 with cerebral palsy due to premature birth . 
 [ subjects and methods ] data were collected 
 through questionnaires sent to 118 mothers of infants diagnosed with cerebral palsy due to 
 premature birth . 
 [ results ] different infant temperament scores were obtained according to 
 the degrees of disability , type of palsy , birth weights , gestational age , and periods of 
 hospitalization in an nicu ; however , the differences were not statistically significant . 
 [ conclusion ] additional comprehensive studies are necessary in order to understand the 
 infant temperaments of newborns with cerebral palsy due to premature birth , as a 
 prerequisite to providing efficient intervention programs supporting the children s 
 development and growth , and to verify statistical significance .