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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Executive function assessment in New Zealand 2-year olds born at risk of neonatal hypoglycemia
Judith M Ansell1, Trecia A Wouldes2, Jane E Harding1
1Liggins Institute, University of Auckland, Auckland, New Zealand.
Insights
A new executive function test battery for 2-year-olds shows feasibility and sensitivity to socioeconomic status. This tool can help identify at-risk children needing early support services for better development.
Area of Science:
- Child Development
- Neuroscience
- Developmental Psychology
Background:
- Perinatal risk factors can impact early child development, necessitating early assessment.
- Executive function (EF) is crucial for academic and behavioral outcomes, but assessments for 2-year-olds are limited, especially in at-risk populations.
- Early identification of EF deficits aids in providing timely support services.
Purpose of the Study:
- To develop and evaluate a battery of age-appropriate tasks to assess executive function in 2-year-olds.
- To examine the feasibility of administering these tasks to a cohort of 368 children at 24 months' corrected age.
- To investigate the influence of sex, socioeconomic status, maternal education, and neighborhood deprivation on executive function in early childhood.
Main Methods:
- A battery of four tasks was administered to 368 children at 24 months' corrected age to assess attention, inhibition, working memory, and cognitive flexibility.
- Performance was analyzed for correlations between tasks, sex differences, and the impact of socioeconomic factors.
- Statistical analyses examined the relationships between task performance and family income, maternal education, and neighborhood deprivation.
Main Results:
- The four tasks showed weak correlations, indicating they measure distinct aspects of executive function.
- Boys exhibited more difficulty with inhibition than girls on the Snack Delay Task.
- Girls scored higher than boys on a working memory task (Ducks and Buckets Reverse Categorization Task).
- Lower socioeconomic status (household income <$40,000) was associated with lower performance across all tasks and the global score.
- Maternal education and neighborhood deprivation showed specific associations with certain EF components and the global score.
Conclusions:
- The developed test battery is feasible for assessing executive function in 2-year-olds.
- Executive function assessment in early childhood can discriminate the effects of socioeconomic status.
- Further development and standardization are needed to provide a valuable tool for identifying at-risk children and informing early intervention strategies.
Abstract:
A growing number of babies are born with perinatal risk factors that may impair later development. These children are often assessed at 2 years to help predict outcome and direct support services. Executive function is an important predictor of academic achievement and behavior, but there are limited assessments of executive function in 2-year-olds and few have been tested in at-risk populations. Therefore, we developed a battery of four age-appropriate tasks to assess executive function in 2-year-olds. At 24 months' corrected age 368 children completed tasks assessing attention, inhibition, working memory and cognitive flexibility. Scores on different tasks were weakly correlated, suggesting that they measured separate aspects of executive function, with combined scores for this cohort approximating a normal distribution. Significantly more boys (67%) than girls (57%) were unable to inhibit their behavior on the Snack Delay Task and girls (M = 3.24, SD = 2.4) had higher mean scores than boys (M = 2.7, SD = 2.7) on the Ducks and Buckets Reverse Categorization Task of working memory. Performance was significantly affected by family socioeconomic status. Mean scores were lower on all four individual tasks and on the global score of overall performance in children from a low household income (<$40,000) compared to those from medium ($40,001-$70,000) and high income households (>$70,001). Maternal education was only associated with scores on the working memory task and the global score; and a measure of neighborhood deprivation was only associated with scores on the two inhibitory tasks and the global score. Our findings confirm the feasibility of assessing executive function in 2-year-olds, and its ability to discriminate effects of socioeconomic status, a common confounder in child development research. Further development and standardization of this test battery comparing at-risk children with a normative population would provide a much-needed measure of executive function in early childhood.
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