Parent-Reported Perceived Cognitive Functioning Identifies Cognitive Problems in Children Who Survived Neonatal Critical Illness
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Updated: Sep 6, 2025

Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Yerel Ilik1, Hanneke IJsselstijn1, Saskia J Gischler1
1Department of Pediatric Surgery and Intensive Care, Erasmus MC Sophia Children's Hospital, Dr. Molewaterplein 40, 3015 GD Rotterdam, The Netherlands.
Insights
Parent-reported cognitive functioning in children treated with neonatal extracorporeal membrane oxygenation (ECMO) or with foregut anomalies may identify issues missed by other assessments. The Pediatric Perceived Cognitive Functioning (PedsPCF) tool shows promise for guiding further evaluation.
Area of Science:
- Pediatric Neurocognition
- Clinical Psychology
- Neonatal Medicine
Background:
- Children with congenital anatomical foregut anomalies or neonatal extracorporeal membrane oxygenation (ECMO) treatment face risks for neurocognitive impairments.
- Accurate assessment of these cognitive risks is crucial for timely intervention and support.
Purpose of the Study:
- To evaluate the association between parent-reported Pediatric Perceived Cognitive Functioning (PedsPCF) scores and parent-reported Behavior Rating Inventory of Executive Function (BRIEF) and neuropsychological assessments (NPA).
- To determine the utility of PedsPCF in identifying cognitive problems in children with a history of neonatal critical illness.
Main Methods:
- Prospective follow-up study including 168 participants aged 8, 12, and 17 years.
- Collected self- and parental proxy-reported PedsPCF scores and proxy-reported BRIEF scores.
- Correlated PedsPCF and BRIEF scores, and examined associations between PedsPCF and NPA test scores.
Main Results:
- Both self- and proxy-reported PedsPCF scores were significantly below normal.
- Proxy-reported PedsPCF scores strongly correlated with BRIEF Metacognition Index subscores.
- Proxy-reported PedsPCF scores showed positive associations with multiple NPA scores, particularly intelligence.
Conclusions:
- Parent-reported PedsPCF identified cognitive problems more frequently than BRIEF in school-aged children post-neonatal critical illness.
- The PedsPCF may aid clinical decisions regarding the necessity of comprehensive neuropsychological assessments.
Abstract:
Children with congenital anatomical foregut anomalies and children treated with neonatal extracorporeal membrane oxygenation (ECMO) are at risk for neurocognitive morbidities. We evaluated the association between the parent-reported pediatric perceived cognitive functioning (PedsPCF) questionnaire and the parent-reported behavior rating inventory of executive function (BRIEF) as well as neuropsychological assessments (NPA). We included 8-, 12- and 17-year-old participants who had joined a prospective follow-up program between 2017 and 2019. Self- and parental proxy-reported PedsPCF and proxy-reported BRIEF scores and their mutual association were evaluated. In total, 168 participants were included. Self- and proxy-reported PedsPCF scores were significantly below normal (mean (SD) z-score: −0.35 (0.88), p < 0.001; −0.36 (1.06), p < 0.001, respectively). Total BRIEF scores were significantly above normal (mean (SD) z-score 0.33 (0.98), p < 0.001). Proxy-reported PedsPCF scores and the Metacognition Index subscores of the BRIEF correlated strongly (τ = 0.551, p < 0.001). Self-reported PedsPCF scores were not associated with NPA test scores. Proxy-reported PedsPCF scores were positively associated with multiple NPA test scores, especially intelligence (R2 = 0.141). The proxy-reported PedsPCF revealed cognitive problems more often than the BRIEF in school-aged children who had survived neonatal critical illness. The proxy-reported PedsPCF may support clinical decision-making regarding the need for extensive neuropsychological assessments.
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