Examining the relationship between performance-based and questionnaire assessments of executive function in young preterm children: Implications for clinical practice

The aim of this study was to determine whether specific performance-based executive function assessment tools were associated with executive functioning in everyday life as reported by parents and teachers of four- to five-year-old preterm and term children. At the age of 4 years, 141 preterm children born <33 weeks’ gestation and 77 term children were assessed using performance-based intelligence (WPPSI-III) and executive function (EF) assessment tools (NEPSY-II, Day-Night and Shape School tasks). The assessment results were compared with the parent and teacher completed questionnaires of EF (BRIEF-P) when the children started kindergarten at the age of 4 to 5 years. The performance-based intelligence and EF assessment results were not consistently associated with the parent and teacher reports of EF in everyday life for either preterm or term groups. Clinical implications of using and interpreting performance-based EF assessment tools and EF questionnaires are discussed with a particular focus on young preterm children at the commencement of formal schooling.     

Individual differences in ERP measures of executive function in early childhood: Relation to low-risk preterm birth and parent-reported behavior

Although behavioral studies have demonstrated that executive function (EF) develops rapidly during early childhood, few studies have investigated neural systems supporting EF during the preschool years. These systems are sensitive to variations in children’s early life experiences, including preterm birth. The current study collected behavioral and event related potential (ERP) data during an EF task (directional Stroop) in a sample of 150 full-term and low-risk preterm children aged 4-years. Children’s IQ and processing speed (WPPSI-III), and parent report of EF (BRIEF-P), were also measured. Forty-nine children born full-term and 43 low-risk preterm children provided useable ERP data. Similar to prior studies with adults and older children, preschool-aged children showed modulation of ERP components (N2, P3) by cognitive conflict. Effects of trial type were also present for early attentional components (N1 and P2). Exploratory analyses demonstrated that ERP measures of EF were correlated with individual differences in cognitive and behavioral functioning in both full-term and low-risk preterm populations. Future research investigating the neural correlates of early measures of EF in low-risk preterm children and other at-risk groups is warranted to better understand how trajectories of EF development are altered in the first years of life.     

Prereading skills of very-low-birth-weight prematurely born Finnish children

Our objective was to study the prereading skills of very-low-birth-weight (VLBW; ≤ 1500 g) prematurely born children at the age of five years. A regional cohort of 89 VLBW children and 152 full-term (FT) born children was assessed for letter knowledge, phonological processing, and speeded naming. Full-scale IQ (FSIQ) was assessed using a short version of WPPSI-R. The associations of parental and neonatal factors, and FSIQ with prereading skills were assessed. VLBW group had poorer prereading skills, and there were more VLBW children at-risk (performing < ?1 SD) compared to FT children in phonological processing (23% vs. 9%, p = .002), letter knowledge (27% vs. 14%, p = .017), and the accuracy of speeded naming (26% vs. 13%, p = .020). VLBW children had lower average FSIQ and Performance IQ (both comparisons p < .001) than FT controls, but Verbal IQ did not differ. When FSIQ was used as a covariate, VLBW children did not differ from the FT group in prereading skills indicating that they are at risk for more global developmental problems. Lower parental level of education as well as parent's reading problems were negatively associated with VLBW children's prereading skills. Positively, about 75% of VLBW children performed within the normal range in each individual prereading skill.     

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.     

Developmental and medical factors associated with parenting stress in mothers of toddlers born very preterm in a neonatal follow-up clinic

The purpose of this exploratory, cross-sectional study was to identify child-related factors associated with maternal parenting stress in toddlers born very preterm and followed in a neonatal follow-up (NFU) clinic. The study aimed to describe the associations of current medical complications and presence of developmental delays with total parenting stress. Participants were 53 mother–child dyads presenting in a NFU clinic. Mothers completed the Parenting Stress Index-Short Form (PSI-SF), and children were administered the Brigance Early Head Start Screen II. Medical variables were also collected from the child's medical record. Approximately 24% of mothers had at least one elevated subscale score on the PSI-SF. Regression analyses indicated that receipt of early intervention services was associated with increased parenting stress among mothers of toddlers born very preterm, though number of current medical complications was not. Parents of children born very preterm are at increased risk for parenting stress that extends beyond discharge from the neonatal intensive care unit . Clinicians working in NFU clinics are positioned to monitor for increased parenting stress, particularly among families of children with emerging signs of developmental delay.     

How do you think she feels? Vulnerability in empathy and the role of attention in school‐aged children born extremely preterm

The aim of this study was to examine empathic competence in children born extremely preterm (EP, <28 weeks) given vulnerabilities in social relationships. Empathy in typically developing children is mediated by executive functions. Executive functioning is also impaired in preterm children. Of particular interest in this study are the attentional components of executive functioning as mediators of empathic development. Thirty‐two 7‐year‐old EP children and 40 age‐matched term children participated in the Project K.I.D.S program and completed the Kids Empathy Development Scale (KEDS), Wechsler Intelligence Scale for Children (WISC‐IV), and Test of Everyday Attention for Children (TEA‐Ch). Children born extremely preterm exhibited poorer performance on all measures. The mediating role of attention in empathy competence was not supported by mediation modelling when FSIQ was controlled. As predicted, the EP group showed weaker empathic development relative to typically developing children. They also showed poorer attentional abilities. However, the effect of preterm birth on empathy was not mediated by executive‐level attention. The cognitive mechanisms underpinning poor empathy competence in EP children remain unclear. Future research needs to examine the role of inhibition, social–emotional recognition, and regulation.