Processing speed mediates executive function difficulties in very preterm children in middle childhood
Hanna Mulder1, Nicola J Pitchford2, Neil Marlow1
11School of Clinical Sciences, University of Nottingham, Nottingham, United Kingdom.
Insights
Very preterm children show lasting executive function and attention deficits in middle childhood. Slow processing speed underlies many of these neuropsychological issues, except response inhibition.
Area of Science:
- Neuroscience
- Developmental Psychology
- Pediatrics
Background:
- Very preterm (VPT) children often exhibit executive function and attention difficulties.
- It remains unclear if these deficits persist into later childhood and are linked to basic cognitive functions.
Purpose of the Study:
- To investigate the persistence of executive function and attention difficulties in VPT children at 9-10 years of age.
- To determine if processing speed mediates these difficulties.
Main Methods:
- Compared 56 VPT children (gestational age <31 weeks) with 22 term-born children aged 9-10 years.
- Administered comprehensive executive function and attention tasks (Test of Everyday Attention for Children, NEPSY).
- Assessed selective and sustained attention, inhibition, working memory, shifting, verbal fluency, planning, and processing speed.
Main Results:
- VPT children performed significantly worse on most executive function tasks compared to term-born peers.
- Slow processing speed in VPT children mediated deficits in working memory, verbal fluency, and shifting.
- Response inhibition was not mediated by processing speed.
Conclusions:
- Processing speed is a key factor underlying many neuropsychological deficits in VPT children during middle childhood.
- Targeting processing speed may help mitigate executive function and attention problems in this population.
Abstract:
Executive function and attention difficulties are reported in very preterm (VPT) children at school entry, but it is unclear if these remain at later ages and/or if these difficulties are mediated by more basic functions, such as processing speed. Processing speed has been shown to underlie academic and behavioral problems in VPT children in middle childhood (Mulder, Pitchford, & Marlow, 2010, 2011), so may also underpin executive function and attention difficulties. We investigated this by comparing VPT (gestational age <31 weeks; N = 56) to term children (N = 22) aged 9-10 years on a comprehensive battery of executive function and attention tasks from the Test of Everyday Attention for Children (Manly, Robertson, Anderson, & Nimmo-Smith, 1999) and NEPSY (Korkman, Kirk, & Kemp, 1998). Selective and sustained attention, inhibition, working memory, shifting, verbal fluency, planning, and processing speed were examined. Group differences favoring term children were shown on most executive function tasks (i.e., inhibition, working memory, verbal fluency, and shifting), all of which were mediated by slow processing speed in the VPT group, except response inhibition. Seemingly, processing speed is an important determinant underpinning many neuropsychological deficits seen in VPT children in middle childhood.
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