Developmental Trajectories of Executive Function From 2 to 13 Years in Children Born Very Preterm

Children born very preterm (VP; <32 weeks' gestation) are at risk of executive function (EF) difficulties, yet limited longitudinal research has examined how these evolve from early childhood to adolescence for this population. This study described developmental trajectories of parent-reported EF from ages 2 to 13 years in children born VP and full term (FT).

Participants were from the Victorian Infant Brain Study (VIBeS) longitudinal cohort comprising 224 children born VP (<30 weeks' gestation) and 77 born FT (≥37 weeks' gestation). EF difficulties were measured at 2, 5, 7, and 13 years using the parent-rated Behavior Rating Inventory of Executive Function (BRIEF) and its preschool version. Trajectories were estimated using multilevel mixed effects models.

EF difficulties were 0.3 to 0.7 SD higher in the VP than FT group across all BRIEF scales at each follow-up, and this difference tended to be greater in boys and those with higher socioeconomic risk. For both VP and FT groups, Global Executive Composite (GEC) and Shift T-scores increased from 2 to 13 years, Inhibit and Working Memory T-scores remained largely stable, and Emotional Control and Plan/Organize T-scores increased between 2 and 7 before stabilizing between 7 and 13 years.

Children born VP showed persistent EF difficulties from early childhood into adolescence, with little evidence of developmental catch-up to FT peers. These findings highlight the need for early and ongoing monitoring and intervention throughout development. Further research is needed to understand the role of sex and socioeconomic risk in the developmental course of behavioral EF difficulties.