The profile of executive function in very preterm children at 4 to 12 years

Division of Neonatology, Department of Pediatrics, Erasmus University Medical Centre, Sophia Children's Hospital, Rotterdam, Amsterdam, the Netherlands.
Developmental Medicine & Child Neurology (Impact Factor: 3.29). 11/2011; 54(3):247-53. DOI: 10.1111/j.1469-8749.2011.04150.x
Source: PubMed

ABSTRACT To examine executive functioning in very preterm (gestational age ≤30 wks) children at 4 to 12 years of age.
Two-hundred very preterm (106 males, 94 females; mean gestational age 28.1wks, SD 1.4; mean age 8y 2mo, SD 2y 6mo) and 230 term children (106 males, 124 females; mean gestational age 39.9wks, SD 1.2; mean age 8y 4mo, SD 2y 3mo) without severe disabilities, born between 1996 and 2004, were assessed on an executive function battery comprising response inhibition, interference control, switching, verbal fluency, verbal and spatial working memory, and planning. Multiple regression analyses examined group differences while adjusting for effects of parental education, age, sex, and speed indices.
Relative to children born at term, very preterm children had significant (p(s) <0.02; where p(s) represents p-values) deficits in verbal fluency (0.5 standardized mean differences [SMD]), response inhibition (0.4 SMD), planning (0.4 SMD), and verbal and spatial working memory (0.3 SMD), independent of slow and highly fluctuating processing speed. A significant group by age interaction indicated that group differences for response inhibition decreased between 4 and 12 years.
Very preterm birth is associated with a profile of affected and non-affected executive functions independent of impaired speed. Deficits are of small to moderate magnitude and persist over time, except for response inhibition for which very preterm children catch up with peers.

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    ABSTRACT: Preterm birth is associated with long-term deficits in executive functioning and cognitive performance. Using the model of brain plasticity as a theoretical framework, it is possible that preterm infants' neurodevelopmental sequelae can be altered. Evidence suggests that bilingualism confers cognitive advantages on executive functioning, so it is possible that bilingualism may improve preterm infants' neurodevelopment. However, bilingualism has only been studied in term children. This review examined literature that compared the performance of preterm-born children to term children and bilingual children to monolingual children on executive function tasks. To address cognitive disparities in preterm-born children, studies investigating the effect of bilingualism on preterm infants' executive functioning is warranted.
    Journal of Pediatric Health Care 09/2014; 29(2). DOI:10.1016/j.pedhc.2014.08.015 · 1.97 Impact Factor
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    Executive functioning: Role in early learning processes, impairments in neurological disorders and impact of cognitive behavior therapy (CBT)., Edited by K. P. Bennett, 01/2014: chapter Executive function in infants born preterm with varying birth weights and morbidities at emerging adulthood.: pages 81-114; Nova Science Publishers., ISBN: 978-1-63321-193-3
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    ABSTRACT: Preterm birth remains a public health priority given that one child out of ten is born before 37 weeks of gestation. Survival without major neonatal morbidity has increased in high-income countries, in particular in France and in cases of extreme preterm birth before 27 weeks of gestation. Rate of severe handicaps, such as cerebral palsy, is probably decreasing, but specific cognitive disabilities in a variety of domains remain frequent, interfering with normal learning abilities at school and explaining the high rate of special education needs. Prevalence of sequelae increases when gestational age at birth decreases. However, because there are more moderate to late preterm children compared to very preterm children, the absolute number of children with specific cognitive or neurological disabilities is equivalent in these two groups. Better characterization of the development in a recent cohort of very preterm children is necessary to improve the early detection of variations in normal neurodevelopment and to propose trials with remediation actions targeting working memory and language for example. These protocols could decrease the rates of learning disabilities at school. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

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