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The profile of executive function in very preterm children at 4 to 12 years
Cornelieke S H Aarnoudse-Moens1, Hugo J Duivenvoorden, Nynke Weisglas-Kuperus
1Division of Neonatology, Department of Pediatrics, Erasmus University Medical Centre, Sophia Children's Hospital, Rotterdam, Amsterdam, the Netherlands. c.moens@erasmusmc.nl
Insights
Very preterm children show executive function deficits in verbal fluency, response inhibition, planning, and working memory. These challenges persist, though response inhibition improves by age 12.
Area of Science:
- Neuroscience
- Developmental Psychology
- Pediatrics
Background:
- Very preterm birth (gestational age ≤30 weeks) can impact neurodevelopment.
- Executive functions are crucial for cognitive and behavioral regulation.
- Understanding long-term executive function outcomes in this population is important.
Purpose of the Study:
- To assess executive functioning in children born very preterm compared to term-born peers.
- To identify specific executive function domains affected by very preterm birth.
- To examine developmental trajectories of executive functions from 4 to 12 years.
Main Methods:
- Compared 200 very preterm children (mean GA 28.1 wks) with 230 term-born children (mean GA 39.9 wks).
- Assessed executive functions including working memory, planning, and verbal fluency using a standardized battery.
- Utilized multiple regression analyses, controlling for covariates like parental education and processing speed.
Main Results:
- Very preterm children exhibited significant deficits in verbal fluency, response inhibition, planning, and working memory (SMD 0.3-0.5).
- These deficits were independent of processing speed differences.
- Group differences in response inhibition diminished with age, showing a catch-up effect.
Conclusions:
- Very preterm birth is linked to specific executive function impairments, not global cognitive slowing.
- Deficits are generally small to moderate and enduring, with notable exceptions.
- Targeted interventions may support executive function development in very preterm children.
Aim:
To examine executive functioning in very preterm (gestational age ≤30 wks) children at 4 to 12 years of age.
Method:
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.
Results:
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.
Interpretation:
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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