Early identification of cerebral visual impairments in infants born extremely preterm

Pel, J.J.M.; Dudink, Jeroen; Vonk, Mark; Plaisier, Annemarie; Steen, J. van der

doi:10.1111/dmcn.13115

Cited by 20 publications

(23 citation statements)

References 25 publications

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“…In the present study, we focus on children born very or extremely preterm (i.e., born < 30 weeks of gestation) from 1 year of corrected age (CA). In an ongoing longitudinal study, we found elevated risks of visual attention and processing problems in this population [15,16], driving the urgency for interventions. However, we expect outcomes to be applicable to other young children at risk of brain damage-related VPD.…”

Section: Introductionmentioning

confidence: 89%

“…There are no thorough estimates of the prevalence of VPD in preterm children. A previous study using the eye tracking-based assessment in extremely preterm children identified visual processing delays in 48% of preterm children without evidence for brain damage [16], and in 9% to 23% of children in a cross section of the preterm population at 1 year CA [15]. In addition, between 25% and 33% of children with CVI have prematurity as a contributing factor [32].…”

Section: Sample Size Calculationmentioning

confidence: 95%

“…It is expected that 25-50% of the very preterm population is at risk of VPD at 1 year CA [15,16]. Therefore, all infants who have been born before 30 weeks gestational age and who participate in the clinical follow-up program of the Department of Neonatology, will be available for inclusion around 1 year CA.…”

Section: Participant Characteristics and Timelinementioning

confidence: 99%

“…Building on these innovations, our group developed a method to quantify visual processing efficiency in a non-verbal manner in children, using an eye tracking-based approach [12,13]. We showed that children with (a high risk of) brain damage or dysfunction (e.g., children with visual disorders or children born extremely preterm) are prone to developing VPD [14][15][16]. These VPD were particularly strongly correlated with diagnosed CVI [17,18].…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Early intervention for children at risk of visual processing dysfunctions from 1 year of age: a randomized controlled trial protocol

Kooiker

Linden

Dijk

et al. 2020

Trials

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Background: An increasing number of children are suffering from brain damage-related visual processing dysfunctions (VPD). There is currently a lack of evidence-based intervention methods that can be used early in development. We developed a visual intervention protocol suitable from 1 year of age. The protocol is structured, comprehensive and individually adaptive, and is paired with quantitative outcome assessments. Our aim is to investigate the effectiveness of this first visual intervention program for young children with (a risk of) VPD. Methods: This is a single-blind, placebo-controlled trial that is embedded within standard clinical care. The study population consists of 100 children born very or extremely preterm (< 30 weeks) at 1 year of corrected age (CA), of whom 50% are expected to have VPD. First, children undergo a visual screening at 1 year CA. If they are classified as being at risk of VPD, they are referred to standard care, which involves an ophthalmic and visual function assessment and a (newly developed) visual intervention program. This program consists of a general protocol (standardized and similar for all children) and a supplement protocol (adapted to the specific needs of the child). Children are randomly allocated to an intervention group (starting upon inclusion at 1 year CA) or a control group (postponed: starting at 2 years CA). The control group will receive a placebo treatment. The effectiveness of early visual intervention will be examined with follow-up visual and neurocognitive assessments after 1 year (upon completion of the direct intervention) and after 2 years (upon completion of the postponed intervention). Discussion: Through this randomized controlled trial we will establish the effectiveness of a new and early visual intervention program. Combining a general and supplement protocol enables both structured comparisons between participants and groups, and custom habilitation that is tailored to a child's specific needs. The design ensures that all included children will benefit from participation by advancing the age at which they start receiving an intervention. We expect results to be applicable to the overall population of children with (a risk of) VPD early in life.

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Section: Introductionmentioning

confidence: 89%

Section: Sample Size Calculationmentioning

confidence: 95%

Section: Participant Characteristics and Timelinementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Early intervention for children at risk of visual processing dysfunctions from 1 year of age: a randomized controlled trial protocol

Kooiker

Linden

Dijk

et al. 2020

Trials

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“…In addition to the reproducibility of individual differences, we examined whether these differences were associated with risk factors that are common in low‐resource settings, particularly preterm birth, but also malnutrition, and psychosocial risk factors. The possibility that infants early attentional behaviors are sensitive to these risk factors is suggested by previous studies in high‐resource settings showing slower visual orientation (Landry, Leslie, Fletcher, & Francis, ; Pel et al., ; Shah et al., ; however, see also Foreman, Fielder, Price, & Bowler, ; Hunnius, Geuze, Zweens, & Bos, ; Rose, Feldman, Jankowski, & Caro, for contrary evidence), slower attention shifts between two competing objects (Atkinson et al., ; Butcher, Kalverboer, Geuze, & Stremmelaar, ; de Jong, Verhoeven, & van Baar, ), and reduced attention to faces (Telford et al., ) in preterm infants. Further, various sources of evidence from high‐ and low‐resource settings point to poorer cognitive function in growth‐stunted children (Champakam, Srikantia, & Gopalan, ; Galler et al., ; Rose, ; Thompson et al., ) and in children raised in low socioeconomic status households (Hackman, Gallop, Evans, & Farah, ).…”

Section: Early Development Of Visual Attention In Infants In Rural Mamentioning

confidence: 99%

Early development of visual attention in infants in rural Malawi

Pyykkö

Forssman

Maleta

et al. 2018

Developmental Science

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Eye tracking research has shown that infants develop a repertoire of attentional capacities during the first year. The majority of studies examining the early development of attention comes from Western, high‐resource countries. We examined visual attention in a heterogeneous sample of infants in rural Malawi (N = 312–376, depending on analysis). Infants were assessed with eye‐tracking‐based tests that targeted visual orienting, anticipatory looking, and attention to faces at 7 and 9 months. Consistent with prior research, infants exhibited active visual search for salient visual targets, anticipatory saccades to predictable events, and a robust attentional bias for happy and fearful faces. Individual variations in these processes had low to moderate odd‐even split‐half and test‐retest reliability. There were no consistent associations between attention measures and gestational age, nutritional status, or characteristics of the rearing environment (i.e., maternal cognition, psychosocial well‐being, socioeconomic status, and care practices). The results replicate infants’ early attentional biases in a large, unique sample, and suggest that some of these biases (e.g., bias for faces) are pronounced in low‐resource settings. The results provided no evidence that the initial manifestation of infants’ attentional capacities is associated with risk factors that are common in low‐resource environments.

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Preterm Birth and the Development of Visual Attention During the First 2 Years of Life

2021

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IMPORTANCE Preterm birth is associated with an increased risk for long-lasting attention deficits.Early-life markers of attention abnormalities have not been established to date but could provide insights into the pathogenesis of attention abnormalities and could help identify susceptible individuals.OBJECTIVE To examine whether preterm birth is associated with visual attention impairments in early life, and if so, in which attention functions and at which developmental period during the first 2 years of life.DATA SOURCES PubMed and PsycINFO were searched on November 17, 2019, to identify studies involving visual attention outcomes in infants born preterm vs full term. STUDY SELECTION Peer-reviewed studies from the past 50 years met the eligibility criteria if they directly assessed visual attention outcomes until the age of 2 years in generally healthy infants born preterm or full term. The selection process was conducted by 2 independent reviewers. DATA EXTRACTION AND SYNTHESISThe Meta-analysis of Observational Studies in Epidemiology (MOOSE) reporting guideline was followed. Random-effects models were used to determine standardized mean differences. The risk of bias was assessed both within and between studies. MAIN OUTCOMES AND MEASURES Five nascent indices of visual attention were analyzed,including very basic functions-namely, the abilities to follow and fixate on visual targets-and more complex functions, such as visual processing (ie, habituation), recognition memory (ie, novelty preference), and the ability to effortfully focus attention for learning. RESULTS A total of 53 studies were included, with 69 effect sizes and assessing a total of 3998 infants (2047 born preterm and 1951 born full term; of the 3376 for whom sex was reported, 1693 [50.1%] were girls). Preterm birth was associated with impairments in various attention indices, including visual-following in infancy (Cohen d, −0.77; 95% CI, −1.23 to −0.31), latency to fixate (Cohen d, −0.18; 95% CI, −0.33 to −0.02), novelty preference (Cohen d, −0.20; 95% CI, −0.32 to −0.08), and focused attention (Cohen d, −0.28; 95% CI, −0.45 to −0.11). In the neonatal period, preterm birth was associated with superior visual-following (Cohen d, 0.22; 95% CI, 0.03 to 0.40), possibly owing to the additional extrauterine exposure to sensory stimulation. However, this early association waned rapidly in infancy (Cohen d, -0.77; 95% CI, -1.23 to -0.31). CONCLUSIONS AND RELEVANCEThe findings suggest that preterm birth is associated with impingements to visual attention development in early life, as manifested in basic and then complex (continued) Key Points Question Is preterm birth associated with visual attention impairments in early life, and if so, in which attention functions? Findings This systematic review and meta-analysis of 53 studies including 2047 preterm-born and 1951 full-termborn neonates and infants found that preterm birth was significantly associated with impairments in visual attention functioning. Despite a shortterm advantage in visual-following in...

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Early identification of cerebral visual impairments in infants born extremely preterm

Cited by 20 publications

References 25 publications

Early intervention for children at risk of visual processing dysfunctions from 1 year of age: a randomized controlled trial protocol

Early intervention for children at risk of visual processing dysfunctions from 1 year of age: a randomized controlled trial protocol

Early development of visual attention in infants in rural Malawi

Preterm Birth and the Development of Visual Attention During the First 2 Years of Life

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