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Executive Function Profiles at Home and at School in 11-Year-Old Very Low Birth Weight or Very Low Gestational Age

Anna Nyman1,2, Petriina Munck2,3, Mari Koivisto4

  • 1Department of Psychology, University of Turku, Turku, Finland.

Journal of Developmental and Behavioral Pediatrics : JDBP
|May 29, 2019
PubMed

Insights

Children born at very low birth weight or very low gestational age show executive function (EF) challenges, particularly in working memory at school. Early identification and support in the school environment are recommended for these vulnerable children.

Area of Science:

  • Neuroscience
  • Developmental Psychology
  • Pediatrics

Background:

  • Children born at very low birth weight (VLBW) or very low gestational age (VLGA) often experience executive function (EF) difficulties.
  • These EF challenges may manifest differently in academic settings compared to home environments.
  • Ecological assessment provides valuable insights into EF in real-world contexts.

Purpose of the Study:

  • To evaluate executive function (EF) profiles and associated risk factors in 11-year-old children born at VLBW or VLGA using ecological assessment.
  • To compare parent- and teacher-rated EF performance between VLBW/VLGA children and controls.
  • To identify specific EF domains and environmental factors influencing outcomes in this population.

Main Methods:

  • A cohort of 125 VLBW/VLGA children and 132 controls were assessed at age 11.
  • The Behavior Rating Inventory of EF (BRIEF) was used for parent- and teacher-rated EF, yielding Behavioral Regulation and Metacognition Indexes.
  • Full-scale intelligence quotient (IQ) was measured using the Wechsler Intelligence Scale for Children (WISC-IV); neonatal data were systematically collected.

Main Results:

  • VLBW/VLGA children with IQ ≥ 70 demonstrated significant working memory deficits in the school setting.
  • Clinically significant behavioral regulation issues were noted at home, but these diminished after adjusting for paternal education.
  • Risk factors for poorer EF included lower gestational age, lower birth weight z-score, necrotizing enterocolitis, lower parental education, and lower IQ.

Conclusions:

  • This cohort of VLBW/VLGA children exhibited fewer EF problems than reported in prior literature.
  • EF challenges varied between home and school settings, with working memory being a key area of concern at school.
  • Screening for EF difficulties within the school environment is advised to facilitate targeted interventions and support.
Abstract

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