Late Preterm Birth: A Review of Medical and Neuropsychological Childhood Outcomes

Late preterm (LP) birth (34 0/7 - 36 6/7 weeks?? gestation) accounts for nearly three-fourths of all preterm births, making this population a sizeable public health concern. The immature fetal development associated with LP delivery increases the risk of mortality and short-term medical complications. Which combination of maternal, fetal, or neonatal risk factors may be most critical has only recently begun to be addressed, and whether LP birth??s disruptive impact on brain development will exert adverse effects on neuropsychological functioning in childhood and adolescence has been understudied. Early data have shown a graded response, with LP children often functioning better than very preterm children but worse than term children, and with subtle intellectual and neuropsychological deficits in LP children compared with healthy children born at term gestational age. Further characterization of the neuropsychological profile is required and would be best accomplished through prospective longitudinal studies. Moreover, since moderate and LP births result in disparate medical and psychological outcomes, the common methodology of combining these participants into a single research cohort to assess risk and outcome should be reconsidered. The rapidly growing LP outcomes literature reinforces a critical principle: fetal development occurs along a dynamic maturational continuum from conception to birth, with each successive gestational day likely to improve overall outcome.     

Assessment of Intelligence in the Preschool Period

Intelligence testing has a long and revered history in psychological measurement in childhood. Yet, the years between infancy and early childhood have been understudied with respect to emergent intellectual and cognitive functioning. Factor analytic models of intelligence that have demonstrated applicability when testing older children and adults often appear inadequate in the preschool period. As more is learned about brain development in typically developing children during these crucial years the distinctive relationships between neural system development and intellectual functioning are being revealed more completely. The aim of this paper was to provide a brief historical background as a foundation for discussion of intelligence testing, review what is known about the dynamic course of brain development during the preschool years, acknowledge limitations specific to intelligence testing in young children, and provide support for maintaining a comprehensive neuropsychological perspective that considers the wider range of variables that influence intellectual functioning in the preschool period.     

The harmony of grounding

Philosophical Studies - Mereological harmony is the idea that the mereological structure of objects mirrors the mereological structure of locations. Grounding harmony is the idea that there is a...     

Eliciting Empathy for Adults in Chronic Pain through Autobiographical Memory Sharing

Two studies (N = 80; N = 91) investigated whether sharing an autobiographical memory increases empathy for a person experiencing chronic pain. Across studies, empathy was assessed after reading a pain‐related narrative of either a 25‐ or 85‐year‐old target and again after assignment to one of two recall conditions. Conditions involved recalling a pain‐related autobiographical memory (Studies 1 and 2), or as comparisons, recalling the target's pain narrative (Study 1) or recalling a character in pain from a movie (Study 2). Looking across both studies, empathy levels appear to increase after sharing an autobiographical memory but not in the comparison conditions. Increases in empathy were related to trait‐level agreeableness. When target‐age differences emerged (Study 2), participants felt greater empathy for the older person. Findings are discussed in terms of the function of autobiographical memory in eliciting pro‐social emotions such as empathy and implications for training empathic responding. Copyright © 2012 John Wiley & Sons, Ltd.     

Selective deficit in spatial location memory in extremely low birth weight children at age six: The PETIT Study

Spatial location memory has rarely been assessed in young children due to a scarcity of developmentally appropriate tests. This study sought to compare nonverbal learning and recall in children born extremely low birth weight (ELBW; <1000 g) and less than 33 gestational weeks (GW) with term-born children at early school age using a recently developed and adapted test. We administered a modification of the Hopkins Board to 210 children at age six; 84 born ELBW (35 born < 26 GW; 49 born 26–33 GW) and 126 term-born. Six measures were obtained: naming, trials-to-criterion, errors-to-criterion, delayed item recall, delayed location recall, and percent retention. After age correction, ELBW children had worse general cognition, item naming, delayed item recall, delayed location recall, and percent retention than term-born children. Delayed item recall and percent retention performances of ELBW children remained worse after correction for general cognition. ELBW groups (< 26 GW and 26–33 GW) groups performed worse than term-born children in naming and delayed item recall with chronological age as covariate. Those born before 26 GW, but not 26–33 GW, performed worse than term-born children in delayed location recall and percent retention. Differences remained significant after controlling for gender, maternal education, and delivery type. All three groups' performance declined from final learning trial to delayed location recall, with a decline greater for less than 26 GW than term-born children. Extreme prematurity (< 26 GW) and ELBW are significant risk factors for spatial location memory deficit. The modified Hopkins Board discriminated high-risk preterm and term-born children at early school age and appears to be a useful test to measure this rarely studied cognitive capacity.     

Executive functions in extremely low birth weight and late-preterm preschoolers: Effects on working memory and response inhibition

Executive function (EF) refers to fundamental capacities that underlie more complex cognition and have ecological relevance across the individual's lifespan. However, emerging executive functions have rarely been studied in young preterm children (age 3) whose critical final stages of fetal development are interrupted by their early birth. We administered four novel touch-screen computerized measures of working memory and inhibition to 369 participants born between 2004 and 2006 (52 Extremely Low Birth Weight [ELBW]; 196 late preterm; 121 term-born). ELBW performed worse than term-born on simple and complex working memory and inhibition tasks and had the highest percentage of incomplete performance on a continuous performance test. The latter finding indicates developmental immaturity and the ELBW group's most at-risk preterm status. Additionally, late-preterm participants performed worse compared with term-born on measures of complex working memory but did not differ from those term-born on response inhibition measures. These results are consistent with a recent literature that identifies often subtle but detectable neurocognitive deficits in late-preterm children. Our results support the development and standardization of computerized touch-screen measures to assess EF subcomponent abilities during the formative preschool period. Such measures may be useful to monitor the developmental trajectory of critical executive function abilities in preterm children, and their use is necessary for timely recognition of deficit and application of appropriate interventional strategies.     

Extremely Preterm Birth Outcome: A Review of Four Decades of Cognitive Research

Premature birth incidence and survival rates are increasing steadily due to advances in obstetric and neonatal intensive care. Those born at the limits of viability are highly at-risk of adverse neurocognitive function over their lifespan, leading to current controversy regarding aggressive resuscitation efforts for these extremely preterm children. However, data from earlier generation cohorts who were born in substantially different eras of neonatal intensive care cannot be relied on to predict outcome of today’s newborn. Our review by the crucial variable of birth cohort year shows a changing developmental trajectory in which today’s extremely preterm survivor is likely to have fewer severe medical complications, better neurological outcomes, and fewer adverse cognitive late effects. Such data further underscore the importance of concurrently considering medical, familial, socioenvironmental, and neurobiological factors in combination with individual neonatal intensive care center protocols when studying outcomes of the preterm child. This complex, interrelated range of factors directly affects the immature, rapidly developing premature brain. However, ongoing surveillance to detect subsequent delay or impairment and to apply interventional strategies early in the developmental course holds promise for further enhancement of functional outcome.