Latent mean differences in executive function in at-risk preterm children: the delay-deficit dilemma

Area of Science:

• Neuroscience
• Developmental Psychology
• Pediatrics

Background:

• Executive function (EF) is crucial for cognitive development and academic success.
• Preterm birth, including extremely low birth weight (ELBW) and late preterm (LPT) births, is associated with potential neurodevelopmental challenges.
• Understanding the trajectory of EF in these populations is vital for timely interventions.

Purpose of the Study:

• To assess the fit of a one-factor executive function (EF) model in children with different birth criteria (ELBW, LPT, Term) at ages 3 and 6 years.
• To determine if the latent mean of EF differs across these birth groups at these ages.
• To investigate the developmental course of EF deficits in ELBW and LPT children.

Main Methods:

• A retrospective observational cohort study included 1,079 children, assessed at ages 3 and 6 years.
• Participants were categorized by birth criteria: extremely low birth weight (ELBW), late preterm (LPT), and term-born.
• Executive function was measured using five indicators: noun fluency, action-verb fluency, similarities reasoning, matrices reasoning, and working memory, analyzed with latent means analysis.

Main Results:

• A one-factor EF model demonstrated acceptable fit across all birth groups and ages.
• Significant differences in EF were observed between ELBW, LPT, and Term groups at age 3.
• At age 6, ELBW children continued to show deficits compared to LPT and Term peers, while LPT-Term differences diminished.

Conclusions:

• Early executive function deficits in ELBW children may represent transient delays or persistent subtle adverse effects.
• The findings highlight the need for longitudinal studies to differentiate between transient delays and lasting impacts of preterm birth on EF.
• These insights have significant implications for early neuropsychological screening and intervention strategies for at-risk children.