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Updated: Jun 16, 2025
A Method to Quantify Visual Information Processing in Children Using Eye Tracking
Published on: July 9, 2016
Visual attention and processing function in relation to executive functioning in very preterm-born children aged
Alja Bijlsma1, Maud M van Gils2, Victoria A A Beunders1
1Department of Neonatal and Pediatric Intensive Care, Division of Neonatology, Erasmus MC-Sophia Children's Hospital, Rotterdam, the Netherlands.
Insights
Visual orienting function (VOF) delays in very preterm children at 3 years corrected age were not linked to overall executive functions (EF). However, abnormal VOF was associated with specific attention and concentration issues, suggesting a nuanced relationship.
Area of Science:
- Developmental Neuroscience
- Pediatric Psychology
Background:
- Very preterm children face heightened risks for executive function (EF) deficits and delayed visual orienting function (VOF) compared to term-born peers.
- Early visual attention is crucial for developing executive functions in young children.
- Visual orienting function (VOF) offers an objective measure of early attentional development.
Purpose of the Study:
- To examine the association between objective visual orienting function (VOF) and subjective parent-reported executive functions (EF) in very preterm children at 3 years corrected age.
- To identify potential links between visual attention and executive function development in this vulnerable population.
Main Methods:
- A prospective cohort study (BOND) included 90 children born before 30 weeks gestation.
- Visual orienting function (VOF) was assessed using eye-tracking, and executive functions (EF) via the Behavior Rating Inventory of Executive Function–Preschool version (BRIEF-P).
- Multivariable regression analyses explored associations between VOF and EF scores.
Main Results:
- Abnormal VOF was identified in 31% of participants, and abnormal global EF scores in 41%.
- No significant association was found between abnormal VOF and global or domain-level EF scores.
- Children with abnormal VOF showed a higher likelihood of parent-reported attentional problems, specifically being "easily sidetracked" (OR 4.18) and having a "short attention span" (OR 4.52).
Conclusions:
- While abnormal visual orienting function (VOF) did not correlate with overall parent-reported executive functions (EF) at 3 years corrected age, specific attention and concentration difficulties were linked.
- These findings suggest a targeted relationship between VOF and certain EF components in very preterm children.
- Further research is warranted to explore the clinical utility of early VOF assessments for identifying executive function challenges in preterm infants.
Abstract:
The ability to orient attention to one's environment is a prerequisite for developing executive functions (EF) from preschool age. Very preterm children are vulnerable for delays in visual orienting function (VOF) and EF deficits. This study aimed to investigate associations between objective VOF and subjective parent-reported EF in very preterm-born children at 3 years corrected age (CA). In a prospective cohort study (BOND) involving 90 children born < 30 weeks, VOF and EF were assessed using an eye tracking-based method and BRIEF-P questionnaire. Associations between abnormal VOF (viewing reaction times) and EF scores (BRIEF-P scores) were studied using multivariable regression. Using a modified Delphi method, a subset of eight items related to VOF and EF was explored. Abnormal VOF was observed in 31% of the children and abnormal global EF composite scores in 41%. Abnormal VOF was not associated with global or domain-level EF scores. However, children with abnormal VOF more frequently had EF problems related to attentional behavior: "easily sidetracked" (OR 4.18 (CI: 1.21-14.41), p = 0.02) and "short attention span" (OR 4.52 (CI: 1.34-15.22), p = 0.02). Conclusion: Although abnormal VOF was not associated with global, parent-reported, EF at 3 years CA, secondary analyses did show a relation to specific attention and concentration span items. Further research is needed to study the role of VOF in objectifying preschool EF assessments in very preterm born children. What is known: • Very preterm children are vulnerable for executive function (EF) deficits and for delays in visual orienting function, as compared to term-born children • The ability to orient attention to one's visual environment is an important prerequisite for EF early in life and is easy to measure objectively with visual orienting function (VOF) assessment What is new: • VOF measurement at 3 years of age relates to parent-reported attention and concentration span items, important aspects of executive functions • Future work should explore the clinical additional value of early VOF measurement in children at risk for EF deficits.
