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Early cognitive assessment in premature infants: the discriminatory value of eye-tracking vs. Bayley Scales
Maria Kaltsa1, Evgenia Babacheva2, Georgia Fotiadou3
1Language Development Lab, School of English, Department of Theoretical and Applied Linguistics, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Insights
Eye-tracking effectively measures visual working memory and attention in infants, identifying early cognitive deficits in preterm infants. This tool aids in early detection of prematurity and fetal growth restriction effects on neurodevelopment.
Area of Science:
- Developmental neuroscience
- Infant cognition
- Perinatal health
Background:
- Visuocognitive development in preterm infants is influenced by perinatal factors.
- Early assessment of cognitive function in the first year of life is crucial.
- Eye-tracking for anticipatory gaze can predict neurodevelopmental outcomes.
Purpose of the Study:
- To introduce a novel eye-tracking tool, the Delayed Match Retrieval (DMR) paradigm.
- To measure visual working memory (VWM) and attention in preterm and full-term infants.
- To assess the efficacy of eye-tracking compared to traditional methods like the Bayley Scales.
Main Methods:
- Employed a Delayed Match Retrieval (DMR) eye-tracking paradigm.
- Recruited 63 infants (39 preterm, 24 full-term) at 8-9 months corrected age.
- Administered Bayley Scales of Infant and Toddler Development alongside eye-tracking tasks.
Main Results:
- Eye-tracking revealed significant differences in VWM and attention between preterm and full-term infants.
- Preterm infants showed significantly lower VWM performance.
- Birth weight and fetal growth restriction (FGR) impacted eye-tracking metrics but not always Bayley scores.
Conclusions:
- Eye-tracking is a sensitive, non-intrusive tool for early detection of cognitive deficits in preterm infants.
- Traditional assessments like Bayley Scales may not detect early effects of prematurity or FGR.
- Early identification via eye-tracking enables timely intervention for vulnerable preterm infants.
Introduction:
The testing of visuocognitive development in preterm infants shows strong interactions between perinatal characteristics and cognition, learning and overall neurodevelopment evolution. The assessment of anticipatory gaze data of object-location bindings via eye-tracking can predict the neurodevelopment of preterm infants at the age of 3 years; little is known, however, about the early cognitive function and its assessment methods during the first year of life.
Methods:
The current study presents data from a novel assessment tool, a Delayed Match Retrieval (DMR) paradigm via eye-tracking was used to measure visual working memory (VWM) and attention skills. The eye-tracking task that was designed to measure infants' ability to actively localize objects and to make online predictions of object-location bindings. 63 infants participated in the study, 39 preterm infants and 24 healthy full term infants - at a corrected age of 8-9 months for premature infants and similar chronological age for full term infants. Infants were also administered the Bayley Scales of Infant and Toddler Development.
Results:
The analysis of the Bayley scores showed no significant difference between the two groups while the eye-tracking data showed a significant group effect on all measurements. Moreover, preterm infants' VWM performance was significantly lower than full term's. Birth weight affected the gaze time on all Areas Of Interest (AOIs), overall VWM performance and the scores at the Cognitive Bayley subscale. Furthermore, preterm infants with fetal growth restriction (FGR) showed significant performance effects in the eye-tracking measurements but not on their Bayley scores verifying the high discriminatory value of the eye gaze data.
Conclusion:
Visual working memory and attention as measured via eye-tracking is a non-intrusive, painless, short duration procedure (approx. 4-min) was found to be a significant tool for identifying prematurity and FGR effects on the development of cognition during the first year of life. Bayley Scales alone may not pick up these deficits. Identifying tools for early neurodevelopmental assessments and cognitive function is important in order to enable earlier support and intervention in the vulnerable group of premature infants, given the associations between foundational executive functional skills and later cognitive and academic ability.
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