Children born with very low birth weight show difficulties with sustained attention but not response inhibition

Children born with very low birth weight perform poorly on executive function and attention measures. Any difficulties with sustained attention may underpin impairments in performance on tasks measuring higher order cognitive control. Previous sustained attention research in very low birth weight cohorts has used tasks that involve arousing stimuli, potentially spoiling the measure of sustained attention. The aim of this study was to compare the performance of very low birth weight and normal birth weight children on a well-controlled task of sustained attention. The Fixed and Random versions of the Sustained Attention to Response Task were given to 17 very low birth weight and 18 normal birth weight children. The very low birth weight group performed the Fixed and Random Sustained Attention to Response Tasks in a similar manner as the normal birth weight group on all measures except for the omission error and Slow Frequency Area under the Spectra variables on the Fixed Sustained Attention to Response Task. These measures index lapses in sustained attention that may be underpinned by declining arousal. The very low birth weight group showed no response inhibition deficits. Omission errors and slow-timescale response-time variability on predictable tasks may thus present sensitive indices of difficulties with sustained attention and arousal associated with premature birth and low birth weight.     

Local and global aspects of biological motion perception in children born at very low birth weight

Biological motion perception can be assessed using a variety of tasks. In the present study, 8- to 11-year-old children born prematurely at very low birth weight (<1500 g) and matched, full-term controls completed tasks that required the extraction of local motion cues, the ability to perceptually group these cues to extract information about body structure, and the ability to carry out higher order processes required for action recognition and person identification. Preterm children exhibited difficulties in all 4 aspects of biological motion perception. However, intercorrelations between test scores were weak in both full-term and preterm children—a finding that supports the view that these processes are relatively independent. Preterm children also displayed more autistic-like traits than full-term peers. In preterm (but not full-term) children, these traits were negatively correlated with performance in the task requiring structure-from-motion processing, r(30) = ?.36, p < .05), but positively correlated with the ability to extract identity, r(30) = .45, p < .05). These findings extend previous reports of vulnerability in systems involved in processing dynamic cues in preterm children and suggest that a core deficit in social perception/cognition may contribute to the development of the social and behavioral difficulties even in members of this population who are functioning within the normal range intellectually. The results could inform the development of screening, diagnostic, and intervention tools.     

Impaired prospective memory but intact episodic memory in intellectually average 7- to 9-year-olds born very preterm and/or very low birth weight

Relatively little is known about episodic memory (EM: memory for personally-experienced events) and prospective memory (PM: memory for intended actions) in children born very preterm (VP) or with very low birth weight (VLBW). This study evaluates EM and PM in mainstream-schooled 7- to 9-year-olds born VP (≤ 32 weeks) and/or VLBW (< 1500 g) and matches full-term children for comparison (n = 35 and n = 37, respectively). Additionally, participants were assessed for verbal and non-verbal ability, executive function (EF), and theory of mind (ToM). The results show that the VP/VLBW children were outperformed by the full-term children on the memory tests overall, with a significant univariate group difference in PM. Moreover, within the VP/VLBW group, the measures of PM, verbal ability and working memory all displayed reliable negative correlations with severity of neonatal illness. PM was found to be independent of EM and cognitive functioning, suggesting that this form of memory might constitute a domain of specific vulnerability for VP/VLBW children.     

Visual configural processing in adults born at extremely low birth weight

Being born at extremely low birth weight (ELBW; ≤1,000 g) is associated with enduring visual impairments. We tested for long‐term, higher order visual processing problems in the oldest known prospectively followed cohort of ELBW survivors. Configural processing (spacing among features of an object) was examined in 62 adults born at ELBW (M_age = 31.9 years) and 82 adults born at normal birth weight (NBW; ≥2,500 g: M_age = 32.5 years). Pairs of human faces, monkey faces, or houses were presented in a delayed match‐to‐sample task, where non‐matching stimuli differed only in the spacing of their features. Discrimination accuracy for each stimulus type was compared between birth weight groups, adjusting for neurosensory impairment, visual acuity, binocular fusion ability, IQ, and sex. Both groups were better able to discriminate human faces than monkey faces (p < .001). However, the ELBW group discriminated between human faces (p < .001), between monkey faces (p < .001), and to some degree, between houses (p < .06), more poorly than NBW control participants, suggesting a general deficit in perceptual processing. Human face discrimination was related to performance IQ (PIQ) across groups, but especially among ELBW survivors. Coding (a PIQ subtest) also predicted human face discrimination in ELBW survivors, consistent with previously reported links between visuo‐perceptive difficulties and regional slowing of cortical activity in individuals born preterm. Correlations with Coding suggested ELBW survivors may have used a feature‐matching approach to processing human faces. Future studies could examine brain‐based anatomical and functional evidence for altered face processing, as well as the social and memory consequences of face‐processing deficits in ELBW survivors.     

The contribution of visual processing to academic achievement in adolescents born extremely preterm or extremely low birth weight

Children born extremely preterm (EP, <28 weeks) and/or extremely low birth weight (ELBW, <1000 g) have more academic deficiencies than their term-born peers, which may be due to problems with visual processing. The aim of this study is to determine (1) if visual processing is related to poor academic outcomes in EP/ELBW adolescents, and (2) how much of the variance in academic achievement in EP/ELBW adolescents is explained by visual processing ability after controlling for perinatal risk factors and other known contributors to academic performance, particularly attention and working memory. A geographically determined cohort of 228 surviving EP/ELBW adolescents (mean age 17 years) was studied. The relationships between measures of visual processing (visual acuity, binocular stereopsis, eye convergence, and visual perception) and academic achievement were explored within the EP/ELBW group. Analyses were repeated controlling for perinatal and social risk, and measures of attention and working memory. It was found that visual acuity, convergence and visual perception are related to scores for academic achievement on univariable regression analyses. After controlling for potential confounds (perinatal and social risk, working memory and attention), visual acuity, convergence and visual perception remained associated with reading and math computation, but only convergence and visual perception are related to spelling. The additional variance explained by visual processing is up to 6.6% for reading, 2.7% for spelling, and 2.2% for math computation. None of the visual processing variables or visual motor integration are associated with handwriting on multivariable analysis. Working memory is generally a stronger predictor of reading, spelling, and math computation than visual processing. It was concluded that visual processing difficulties are significantly related to academic outcomes in EP/ELBW adolescents; therefore, specific attention should be paid to academic remediation strategies incorporating the management of working memory and visual processing in EP/ELBW children.     

Still cautious: Personality characteristics of extremely low birth weight adults in their early 30s

Extremely low birth weight survivors (ELBW; <1000 g) display a personality style characterized by cautiousness, shyness, and risk aversion in their 20s. We examined whether non-impaired ELBW survivors were still more cautious than their normal birth weight (NBW) peers at ages 30–35 and assessed the stability of this personality characteristic across approximately a decade in the oldest known cohort of ELBW survivors. Of the 154 participants tested at ages 22–26, 111 (i.e., 72%) of them returned approximately 10 years later [i.e., 69% (49/71) ELBW and 75% (62/83) NBW], and once again they completed the Eysenck Personality Questionnaire-Revised (EPQ-R). We created the same theoretically and empirically derived composite measure of cautiousness at each visit by summing the EPQ-R psychoticism scale (reverse scored) and the EPQ-R lie scale. We found that ELBW adults reported higher cautiousness than their NBW counterparts at ages 30–35. We also found that levels of cautiousness remained stable over approximately 10 years in both groups. Our findings suggest that individuals born at ELBW were more cautious than NBW peers and that this personality characteristic remained stable into their early 30s. The present study appears to be the first empirical demonstration of personality stability among adult ELBW survivors.     

The association between maternal interaction and infant cortisol stress reactivity among preterm and full term infants at 4 months adjusted age

The purpose of this study was to assess the association between maternal interactive behavior and infant cortisol stress reactivity in response to the Still Face paradigm (SF) in a cohort of four-month old infants (adjusted age) born preterm (<32 weeks gestation, N = 22) compared with infants born full term (>37 weeks gestation, N = 28). Infant cortisol reactivity was calculated as area under the curve (AUC) from baseline to the third cortisol sample (30 min post-SF) using the trapezoidal rule, while the percent of time mothers spent using a contingent interaction style was measured (0–100%) during episodes 1 (Play; baseline), 3 (Reunion#1), and 5 (Reunion#2) while mother-infant dyads participated in the SF paradigm. We hypothesized that because infants born preterm are at increased risk for dysregulation, they would show, compared to full-term infants, a blunted stress response, involving under-responsiveness. We found blunted cortisol stress reactivity among the preterm infants. We also found that mothers of preterm infants demonstrated less contingent maternal interaction during Renion#1 of the SF; and that contingent maternal interaction at Reunion#2 of the SF was protective against cortisol stress reactivity in response to the SF. However, we did not find that the influence of maternal interaction on cortisol reactivity was moderated by gestational age group (full term vs preterm): the association between contingent maternal interaction and stress reactivity was similar for both gestational groups across episodes. In order to improve self-regulation and longer term social and cognitive developmental outcomes in medically at-risk infants, future research is warranted to determine how these findings relate to infants’ stress reactions in naturalistic settings, and the directionality and temporal relationship between cortisol stress responses and maternal interactive behavior.     

Assessment of parental sensitivity towards pre-school children born with very low birth weight

The article introduces the Parental Sensitivity Assessment Scale (PSAS) and examines the influence of the PSAS score and other factors on the general cognitive level in pre-school children born with very low birth weight (VLBW). McCarthy general cognitive index (GCI) was obtained for 102 VLBW and 92 normal birth weight (NBW) control children in Denmark in the mid-1980s. The mean ages of the two groups were 52.4 vs. 53.1 months. Parental sensitivity was assessed using PSAS. There was no significant difference in the mean PSAS score between the two birth weight groups (p > 0.3). Birth weight group (p < 0.001) and mother's schooling (p= 0.026) significantly correlated with GCI in the children. The PSAS score was highly significantly correlated to the variance of the GCI (p < 0.001), which was not explained by VLBW and mother's schooling. We found no interactional effect between parental sensitivity and birth weight group (p > 0.5) - the prematurely born children were not more affected by low parental sensitivity than were the control children.     

Early tactile experience of low birth weight children: links to later mental health and social adaptation

The purpose of this study was twofold: to determine (1) the degree to which specific qualities of maternal touch may contribute to the low birth weight infant's emotional and behavioural problems as well as social adaptation, and (2) the relationship between maternal touch and a mother's other caregiving behaviour. The sample included 114 socioculturally diverse infants and their mothers who were videotaped during an infant feeding when the baby was 3 months old. This videotape was analysed to assess dimensions of mother–infant interaction, including maternal touch. Data on perinatal risk and the mother's acceptance versus rejection of the infant were also acquired. Social adaptation and emotional/behavioural problems were measured when the child was 2 years of age. Hierarchical regression analyses indicated that maternal touch accounted for 15% of the variance in the likelihood of a child having emotional/behavioural problems at age 2. Children who received more nurturing touch had significantly fewer internalizing problems (such as depression) while children receiving both more frequent touch and harsh touch had more externalizing problems (such as aggressive behaviour). Infants who were less responsive to their caregivers were especially at risk of developing aggressive/destructive behaviour as a result of frequent touch. But less responsive infants also appeared to benefit most from greater use of diverse types of maternal touch, accounting for 6% of the variance in superior adaptive behaviour at age 2. Nurturing touch was the only quality that showed even a modest relationship to other caregiving behaviour, suggesting that touch may play a distinct role in the infant's psychosocial development. Copyright © 2001 John Wiley & Sons, Ltd.     

Representational momentum in children born preterm and at term

The term representational momentum (RM) refers to the idea that our memory representations for moving objects incorporate information about movement – a fact that can lead us to make errors when judging an object’s location (the RM effect). In this study, we explored the RM effect in a sample of children born very prematurely and a sample born at term. Because preterm children are known to be at risk for problems with motion perception, we anticipated that they would show a weaker or absent RM effect. This prediction was confirmed. In addition, we found that, in both samples of children, 5–6 year olds showed a reduced RM effect compared to 7–9 year olds. These results demonstrate that the ability to represent motion information in memory shows continued development over this age range, and may help to elucidate factors contributing to problems with fine and gross motor planning and execution that have been observed in the preterm population. We propose that problems affecting the formation, maintenance, or use of predictive models, or motion extrapolation skills, may have cascading effects on the development of other abilities.     

Mathematics ability and related skills in preschoolers born very preterm

Children born very preterm (VPT) are at risk for academic, behavioral, and/or emotional problems. Mathematics is a particular weakness and better understanding of the relationship between preterm birth and early mathematics ability is needed, particularly as early as possible to aid in early intervention. Preschoolers born VPT (n = 58) and those born full term (FT; n = 29) were administered a large battery of measures within 6 months of beginning kindergarten. A multiple-mediation model was utilized to characterize the difference in skills underlying mathematics ability between groups. Children born VPT performed significantly worse than FT-born children on a measure of mathematics ability as well as full-scale IQ, verbal skills, visual–motor integration, phonological awareness, phonological working memory, motor skills, and executive functioning. Mathematics was significantly correlated with verbal skills, visual–motor integration, phonological processing, and motor skills across both groups. When entered into the mediation model, verbal skills, visual–motor integration, and phonological awareness were significant mediators of the group differences. This analysis provides insights into the pre-academic skills that are weak in preschoolers born VPT and their relationship to mathematics. It is important to identify children who will have difficulties as early as possible, particularly for VPT children who are at higher risk for academic difficulties. Therefore, this model may be used in evaluating VPT children for emerging difficulties as well as an indicator that if other weaknesses are found, an assessment of mathematics should be conducted.     

Brain Activity and Cognitive Transition during Childhood: A Longitudinal Event-Related Brain Potential Study

This study examined the relation between brain activation and cognitive development using event-related brain potentials (ERPs) and a longitudinal design. Five-year-old girls performed a visual recognition (‘oddball’) task and an experimental analogue of the Piagetian conservation of liquid quantity task at three experimental sessions, with one year between consecutive sessions. The data revealed age-related changes in neurocognitive mechanisms common to both tasks. In comparing children before and after a Piagetian transition on a traditional clinical conservation test the data revealed a major shift in performance and ERPs to the experimental analogue of the liquid quantity task. These findings are consistent with a previously performed cross-sectional study and provide strong support for the hypothesis that cognitive transition is related to new neurocognitive mechanisms emerging during childhood. Possible implications of these findings for child neuropsychology are discussed.     

Cognitive control deficits in adolescents born with very low birth weight (≤ 1500 g): Evidence from dichotic listening

The objective of the paper is to explore bottom‐up auditory and top‐down cognitive processing abilities as part of long‐term outcome assessment of preterm birth. Fifty‐five adolescents (age 13–15) born with very low birth weight (VLBW) were compared to 80 matched controls born to term, using three consonant‐vowel dichotic listening (DL) instruction conditions (non‐forced, forced‐right and forced‐left). DL scores were correlated with cortical gray matter thickness derived from T1‐weighted structural MRI volumes using FreeSurfer to examine group differences also in the neural correlates of higher cognitive processes. While showing normal bottom‐up processing, VLBW adolescents displayed impaired top‐down controlled conflict processing related to significant cortical thickness differences in left superior temporal gryus and anterior cingulate cortex. Preterm birth with VLBW induces fundamental changes in brain function and structure posing a risk for long‐term neurocognitive impairments. Deficits emerge in situations of increasing cognitive conflict and can be related to measures of executive functions as well as morphology.     

The role of maternal responsiveness in predicting infant affect during the still face paradigm with infants born very low birth weight

There is limited empirical literature addressing infants' response to a standardized stressor with infants born very low birth weight (VLBW). The purpose of this study was to assess the relative strength of maternal responsiveness in predicting infant affect in response to the Still Face (SF) paradigm in a cross‐sectional cohort of ethnically diverse infants born VLBW and their mothers (N = 50; infants 6–8 months old). Infant affect and maternal responsiveness were coded in 1‐s intervals while dyads participated in the SF. In addition, perinatal medical status, developmental status, and infant temperament were assessed. Findings revealed that positive infant affect during and after the SF stressor were strongly associated with baseline infant positive affect and maternal responsiveness at the reunion episode, respectively. In contrast, when predicting negative infant affect during and after the SF stressor, prior infant negative affect was strongly and uniquely significant. Infant positive affect, negative affect, and maternal responsiveness were not significantly associated with gender, infant perinatal medical history, developmental status, or temperament. Future research is warranted to determine how these findings relate to infants' stress reactions in naturalistic settings and if relationship‐focused interventions may reverse infant negative emotionality, enhance positive emotionality, and thereby improve self‐regulation and longer term social and cognitive developmental outcomes in medically at‐risk infants.     

Very Low Birth Weight and Attention Deficit/Hyperactivity Disorder

It is well recognized that reaction time performance of term-born children with a normal birth weight (NBW > 2500 g) who fulfill the DSM-IV criteria for attention deficit/hyperactivity disorder (ADHD) in the primary school age is sensitive for the presentation rate of stimuli. They have been found to perform more poorly in conditions of relatively slow event rates as compared with fast event rates. The purpose of the current study was to explore whether reaction time performance of children with very low birth weight (VLBW < 1500 g) with or without ADHD showed the same sensitivity for the factor presentation rate of stimuli compared to children with a normal birth weight plus ADHD. To this end, reaction time performance of four groups of children was compared on a Go/No-Go test with a fast presentation rate of 1 second and a slow presentation rate of 6 seconds. Groups were: children with VLBW plus ADHD, children with VLBW only, children born full term with normal birth weight (NBW >2500 g) plus ADHD, and children born full term without ADHD (the control group). Findings indicated that, compared to the non-ADHD groups, the groups with ADHD (NBW and VLBW) showed a more dramatic decline in their reaction time performance in the slow condition: a state regulation deficit. In addition, both groups showed a response inhibition deficit. No difference was found in reaction time performance between the groups of children with VLBW only and the control group.     

Poverty,ethnicity, and risk of obesity among low birth weight infants

The independent and joint effects of family and neighborhood poverty and ethnicity upon weight trajectories from age two to six-and-a-half were examined using data from the Infant Health and Development Program (N = 985), an early intervention program for low birth weight children and families. At age two, family poverty was associated with higher body mass index (BMI), whereas neighborhood poverty and ethnicity were not. Over time, the BMI of toddlers from poor and near poor neighborhoods increased nonlinearly, while those from nonpoor neighborhoods remained stable. BMIs of Hispanic-American toddlers increased steadily over time, unlike African-American and Anglo-American toddlers. Although initially similar, over time African-American toddlers' BMIs increased more rapidly than Anglo-American toddlers. Family and neighborhood poverty and ethnicity were associated with BMI. More work is needed on how poverty and ethnicity contribute to differences in early weight gain in conjunction with sociocultural and environmental factors in the home and community.     

Emotional and neuroendocrine regulation in very preterm and full-term infants at six months of age

Emotional and neuroendocrine regulation have been shown to be associated. However, results are inconsistent. This paper explores the functioning and relationships between these two systems in 54 healthy preterm and 25 full-term born infants at six months of age. Results showed significant differences between very preterm and full-term children in emotional intensity and regulation, as well as in neuroendocrine regulation. No evidence of an association between neuroendocrine and emotional regulations was found. Results suggest a possible delay in the maturation of the neuroendocrine system as well as in emotional regulation in very preterm infants.     

Association between brain activation (fMRI), cognition and school performance in extremely preterm and term born children

The purpose of the study was to investigate a possible association between brain activation in functional magnetic resonance imaging scans, cognition and school performance in extremely preterm children and term born controls. Twenty eight preterm and 28 term born children were scanned while performing a working memory/selective attention task, and school results from national standardized tests were collected. Brain activation maps reflected difference in cognitive skills but not in school performance. Differences in brain activation were found between children born preterm and at term, and between high and low performers in cognitive tests. However, the differences were located in different brain areas. The implication may be that lack of cognitive skills does not alone explain low performance due to prematurity.