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: 3.51). 11/2011; 54(3):247-53. DOI: 10.1111/j.1469-8749.2011.04150.x
Source: PubMed


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.

Download full-text


Available from: Johannes B van Goudoever, Nov 14, 2014
  • Source
    • "The EF skills that are developing in the preschool-aged child include inhibitory control, set shifting, planning and working memory [3] [4] [5] [6]. Deficits in EF are seen in young child clinical populations, such as children with histories of prematurity [4] [5] [7] [8], attention-deficit/ hyperactivity disorder (ADHD) [4] [9], aggression [2] or brain injury [10]. Poor EF skills are related to difficulties in important areas of function, including cognitive and academic domains [2] [11]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Symptoms of abnormal sensory processing have been related to preterm birth, but have not yet been studied specifically in preterm preschoolers. The degree of association between sensory processing and other domains is important for understanding the role of sensory processing symptoms in the development of preterm children. To test two related hypotheses: (1) preterm preschoolers have more sensory processing symptoms than full term preschoolers and (2) sensory processing is associated with both executive function and adaptive function in preterm preschoolers. Cross-sectional study. Preterm children (≤34weeks of gestation; n=54) and full term controls (≥37weeks of gestation; n=73) ages 3-5years. Sensory processing was assessed with the Short Sensory Profile. Executive function was assessed with (1) parent ratings on the Behavior Rating Inventory of Executive Function - Preschool version and (2) a performance-based battery of tasks. Adaptive function was assessed with the Vineland Adaptive Behavior Scales-II. Preterm preschoolers showed significantly more sensory symptoms than full term controls. A higher percentage of preterm than full term preschoolers had elevated numbers of sensory symptoms (37% vs. 12%). Sensory symptoms in preterm preschoolers were associated with scores on executive function measures, but were not significantly associated with adaptive function. Preterm preschoolers exhibited more sensory symptoms than full term controls. Preterm preschoolers with elevated numbers of sensory symptoms also showed executive function impairment. Future research should further examine whether sensory processing and executive function should be considered independent or overlapping constructs. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
    Early Human Development 02/2015; 91(3):227-233. DOI:10.1016/j.earlhumdev.2015.01.013 · 1.79 Impact Factor
  • Source
    • "Preterm compared to full-term children perform more poorly in working memory, planning, visual spatial organization, and mental flexibility,[12] and are over-represented among early intervention and special education service recipients.[3] Early brain-based differences[45] contribute to long-term disabilities. "
    [Show abstract] [Hide abstract]
    ABSTRACT: By school age, even low risk moderately preterm-born children show more neuro-cognitive deficits, underachievement, behavioral problems, and poor social adaptation than full-term peers. To evaluate the outcomes at school-age for moderately preterm-born children (29-33 weeks gestational age), appropriate in growth for gestational age (AGA) and medically at low-risk, randomized to Newborn Individualized Developmental Care and Assessment Program (NIDCAP) or standard care in the Newborn Intensive Care Unit. At school-age, the experimental (E) group will show better neuropsychological and neuro-electrophysiological function, as well as improved brain structure than the control (C) group. The original sample consisted of 30 moderately preterm-born infants (29 to 33 weeks), 23 (8C and 15E) of them were evaluated at 8 years of age, corrected-for-prematurity with neuropsychological, EEG spectral coherence, and diffusion tensor magnetic resonance imaging (DT MRI) measures. E-performed significantly better than C-group children on the Kaufman Assessment Battery for Children-Second Edition (KABC-II) and trended towards better scores on the Rey-Osterrieth Complex Figure Test. They also showed more mature frontal and parietal brain connectivities, and more mature fiber tracts involving the internal capsule and the cingulum. Neurobehavioral results in the newborn period successfully predicted neuropsychological functioning at 8 years corrected age. Moderately preterm infants cared for with the NIDCAP intervention showed improved neuropsychological and neuro-electrophysiological function as well as improved brain structure at school-age.
    03/2012; 1(4):184-194. DOI:10.4103/2249-4847.105982
  • Source
    • "Effects of preterm birth were also found on verbal working memory at school age with more pronounced differences between preterm and full-term children when demands were highest, impacting children's functional performance [Aarnoudse-Moens et al., 2009; Clark and Woodward, 2010]. Findings on shifting were influenced by tasks used, showing contrasting results and pointing out the need for more studies to establish how task interacted with preterm children's performance [Mulder et al., 2009; Rose et al., 2011; Aarnoudse-Moens et al., 2012]. Clark and Woodward [2010] revealed that very preterm children without cerebral abnormalities during the neonatal period performed similarly to full-term children at 6 years corrected age on verbal and visuospatial working memory. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Preterm birth is characterized by multiple interacting atypical constraints affecting different aspects of neuropsychological development. In the first years of life, perceptual, motor, and communicative-linguistic abilities, as well as attention, processing speed, and memory are affected by preterm birth resulting in cascading effects on later development. From school age to adolescence, a catch-up of simpler competencies (i.e., receptive lexicon) along with a more selective effect on more complex competencies (i.e., complex linguistic functions, math, motor, and executive functions) are observed, as well as a relevant incidence of behavioral outcomes. A wide heterogeneity in preterm children's neuropsychological profiles is described depending on the interaction among the degree of neonatal immaturity, medical complications, neurological damages/alterations, environmental and social factors. Severe neuromotor and sensory damages are not frequent, while low severity impairments are common among preterm children. It is argued that developmental pathways of preterm children are atypical, and not merely delayed, and are characterized by different developmental patterns and relationships among competencies. © 2013 Wiley Periodicals, Inc. Dev Disabil Res Rev 2011;17:102-113.
    Developmental Disabilities Research Reviews 11/2011; 17(2):102-13. DOI:10.1002/ddrr.1105 · 2.75 Impact Factor
Show more