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Trajectories of attention problems in preschoolers born very preterm
Marie Camerota1,2, Francisco Xavier Castellanos3,4, Brian S Carter5
1Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, USA.
Insights
Attention problems in preterm infants show varied developmental paths from ages 2 to 5. Understanding these trajectories is crucial for predicting attention-deficit/hyperactivity disorder (ADHD) risk and informing care.
Area of Science:
- Neuroscience
- Developmental Psychology
- Pediatrics
Background:
- Children born preterm (<30 weeks gestational age) face increased risks for neurodevelopmental issues, particularly attention deficits.
- Limited research exists on the developmental trajectories of attention problems in this population before school entry.
Purpose of the Study:
- To describe attention problem trajectories from ages 2 to 5 in very preterm infants.
- To identify factors associated with these trajectories.
- To determine if trajectories predict attention-deficit/hyperactivity disorder (ADHD) diagnosis.
Main Methods:
- Latent growth curve (LGC) modeling was used on data from 608 infants (<30 weeks GA) in the NOVI Study.
- Parental reports of attention problems (ages 2-5) and ADHD diagnosis were collected.
- Sociodemographic, medical, and neurobehavioral data were assessed.
Main Results:
- A linear LGC model fit the data, showing low average initial attention problems with little change over time.
- Significant heterogeneity existed in both initial levels and changes in attention problems.
- Individual differences in trajectories were linked to sociodemographic, medical, environmental, and neurobehavioral factors.
Conclusions:
- Heterogeneity in attention problem trajectories from ages 2 to 5 is clinically significant for very preterm infants.
- These findings can guide follow-up care and intervention strategies for preterm children.
Background:
Children born preterm are at heightened risk for neurodevelopmental impairment, including specific deficits in attention. Few studies have investigated change over time in attention problems prior to school entry. The current study aims to describe trajectories of attention problems from age 2 through 5 years in a cohort of children born <30 weeks of gestational age (GA), identify sociodemographic, medical, and neurobehavioral characteristics associated with attention trajectories, and test whether attention problem trajectories predict the risk of a reported attention-deficit/hyperactivity disorder (ADHD) diagnosis.
Methods:
We studied 608 infants from the Neonatal Neurobehavior and Outcomes in Very Preterm Infants (NOVI) Study, a prospective, multisite study of infants born <30 weeks of GA. Parents reported on child attention problems at ages 2, 3, 4, and 5 years using the Child Behavior Checklist and the Behavior Assessment System for Children. Sociodemographic and medical characteristics were assessed via maternal interview and medical record review. Neurobehavioral characteristics were determined using neonatal and 2-year assessments. Parent report of child ADHD diagnosis was obtained. We used latent growth curve (LGC) modeling to test our study aims.
Results:
A linear LGC model provided the best fit to the data. The average trajectory of attention problems evidenced low initial levels of symptoms and little change over time, yet there was significant heterogeneity in both initial levels and change over time. Individual differences in trajectory parameters were associated with sociodemographic, medical, environmental, and neurobehavioral characteristics. Children with higher initial levels of attention problems as well as steeper increases in attention problems over time were more likely to have a reported ADHD diagnosis.
Conclusions:
There is significant heterogeneity in trajectories of attention problems from age 2 to 5 in children born <30 weeks of GA and these differences have clinical relevance. These data could inform follow-up guidelines for preterm infants.
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