Related Experiment Video
Updated: Feb 17, 2026
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Trends in Executive Functioning in Extremely Preterm Children Across 3 Birth Eras
Alice C Burnett1,2,3,4, Peter J Anderson5,2,6, Katherine J Lee2,7
1Premature Infant Follow-Up Program and alice.burnett@mcri.edu.au.
Insights
Extremely preterm or low birth weight children show worsening executive dysfunction over time. This trend, particularly in working memory and planning, may impact academic and social development.
Area of Science:
- Neuroscience
- Developmental Pediatrics
- Child Psychology
Background:
- Extremely preterm (EP) and extremely low birth weight (ELBW) children face risks for neurodevelopmental challenges.
- Executive functioning is crucial for academic and social success.
- Previous studies suggest executive dysfunction in EP/ELBW survivors, but trends over time require investigation.
Purpose of the Study:
- To compare executive functioning outcomes at school age between extremely preterm/extremely low birth weight children and term-born peers across different birth eras (1991-1992, 1997, 2005).
- To identify trends in executive dysfunction among EP/ELBW survivors over time.
Main Methods:
- Population-based cohorts of EP/ELBW survivors and matched term-born controls from Victoria, Australia, were studied.
- Parents rated executive functioning using the Behavior Rating Inventory of Executive Function (BRIEF) when children were 7-8 years old.
- Logistic regression analyzed differences in elevated BRIEF scores between groups and eras, with sensitivity analyses excluding intellectual impairment.
Main Results:
- EP/ELBW children consistently demonstrated higher rates of executive dysfunction across most BRIEF domains compared to controls.
- A significant increase in executive dysfunction was observed in the 2005 EP/ELBW cohort, particularly affecting working memory and planning/organization.
- This trend persisted after controlling for demographic factors and remained evident even when excluding children with intellectual impairment.
Conclusions:
- A concerning trend of increasing executive dysfunction is evident in more recently born extremely preterm/extremely low birth weight children.
- This escalating executive dysfunction may negatively impact academic achievement and social-emotional well-being.
- Longitudinal monitoring and targeted interventions are crucial for this vulnerable population.
Background And Objectives:
To determine if executive functioning outcomes at school age are different for extremely preterm (EP; <28 weeks' gestation) or extremely low birth weight (ELBW; <1000 g birth weight) children born in 1991 to 1992, 1997, and 2005 relative to their term-born peers.
Methods:
Population-based cohorts of all EP/ELBW survivors born in the state of Victoria, Australia, in 1991 to 1992, 1997, and 2005, and contemporaneous controls (matched for expected date of birth, sex, mother's country of birth [English speaking or not], and health insurance status) were recruited at birth. At 7 to 8 years of age, parents of 613 children who were EP/ELBW and 564 children who were controls rated their children's executive functioning on the Behavior Rating Inventory of Executive Function (BRIEF). The proportion of children with elevated BRIEF scores (in the clinically significant range) in each birth group and era was compared by using logistic regression. Sensitivity analyses explored these associations after excluding children with intellectual impairment.
Results:
Across the eras, EP/ELBW children had higher rates of elevated scores than controls in almost all BRIEF domains. The 2005 EP/ELBW cohort had increased executive dysfunction compared with earlier cohorts, particularly in working memory and planning and organization. This effect persisted after accounting for demographic factors and weakened slightly when those with intellectual impairment were excluded.
Conclusions:
These results indicate a concerning trend of increasing executive dysfunction for EP/ELBW children who were born more recently. This may have adverse implications for other functional domains, such as academic achievement and social-emotional well-being.
Related Concept Videos
01:30Information Processing Approach
01:30Biological Influences on Intelligence
01:30Attention-Deficit/Hyperactivity Disorder
Diagnostic Criteria and Symptoms
To diagnose ADHD, symptoms must manifest before age 12 and be evident across multiple settings....
01:29Three Developmental Domains
Physical Development
Physical processes, also known as maturation, encompass the biological changes that occur across an individual's life. These changes begin with genetic inheritance and continue through various stages, including growth in height and weight,...
01:30Socioemotional Development during Infancy
Primary Temperament Types
01:29Environmental Influences on Intelligence