Executive function deficits mediate the association between very preterm birth and behavioral problems at school-age

Schnider, Barbara; Disselhoff, Vera; Held, Ulrike; Latal, Beatrice; Hagmann, Cornelia; Wehrle, Flavia M.

doi:10.1016/j.earlhumdev.2020.105076

Cited by 14 publications

(20 citation statements)

References 74 publications

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“…Difficulties in executive functioning can lead to maladaptive behaviours and outcomes, which can in turn impact academic, social and communication skills and influence general quality of life. 12,45,46 Some previous reports on VLBW adult outcomes have highlighted lower educational attainment, earning potential and greater reliance on social welfare and benefits 21,47-52 causing concern that this may lead to longer term social disparities between VLBW adults and their FT-born peers. Consistent with these findings, we also found that by age 28, VLBW adults had, on average, lower socio-economic status and were less likely to own a home compared with their FT counterparts.…”

Section: Discussionmentioning

confidence: 99%

Self‐reported executive function problems in adults born very low birthweight

Kim

Horwood

Harris

et al. 2022

Paediatric Perinatal Epid

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Background: Executive function difficulties are common among children born very preterm and/or very low birthweight (<1500 g; VLBW), but little is known about whether they persist into adulthood.Objectives: Examine the nature and pattern of self-reported executive functioning at 23 and 28 years of age using data from a national cohort study of adults born VLBW and a comparison group of same-age full-term (FT) born adults. Also examined were associations between executive function difficulties and socio-economic outcomes.Methods: All infants born VLBW in New Zealand during 1986 were prospectively included in an audit of retinopathy of prematurity (n = 413), with 250 (77% of survivors) followed to median age 28 years. A comparison group of FT adults was also recruited at age 23 and followed to 28 years (n = 100). Across both adult assessments, executive functioning was assessed using the Behaviour Rating Inventory of Executive Function-Adult Version (BRIEF-A) and analysed with semi-parametric models to examine the effects of age and group on executive function.Results: At 23 and 28 years, VLBW adults had increased risk of executive function impairment compared with FT adults in behaviour regulation (relative risk [CI] 2.37, 95% confidence interval (CI)1.27, 4.45), meta-cognition (RR 6.03, 95% CI 2.18, 16.78) and global functioning (RR 3.20, 95% CI 1.40, 7.28). Impaired global executive functioning was associated with lower socio-economic status (regression estimate [b] = −0.43, 95% CI −0.59, −0.27) and a reduced likelihood of home ownership by age 28 years (RR 0.98, 95% CI 0.96, 1.00), even after controlling for sex, ethnicity and parental socioeconomic backgrounds for both groups. Conclusion(s):VLBW-born adults continue to experience more executive function difficulties in their everyday life relative to term controls at age 28 years. These difficulties were negatively associated with their socio-economic opportunities as young adults.

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Section: Discussionmentioning

confidence: 99%

Self‐reported executive function problems in adults born very low birthweight

Kim

Horwood

Harris

et al. 2022

Paediatric Perinatal Epid

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“…Besides, consistent with previous findings, overall executive function was associated with behaviour problems reported by parents. 2 Addressing the differential contributions of executive functions to behaviour problems in different social contexts is important as it may help parents and teachers to adjust their expectations and to identify targets for intervention in specific contexts.…”

Section: Discussionmentioning

confidence: 99%

“…Many studies have reported that infants born very preterm are at risk of long-term behavioural and emotional sequelae during childhood. 1,2 They show more symptoms of inattention and impulsivity 3 as well as display more internalising problems than term-born children. 4 Furthermore, there may be an effect of sex on problem behaviours.…”

Section: Introductionmentioning

confidence: 99%

The contributions of intelligence and executive function to behaviour problems in school‐age children born very preterm

et al. 2021

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Aim: To examine the contributions of specific neurocognitive skills to behaviour problems in children born very preterm. Methods:We assessed children born <30 weeks' gestation or <1500 g at age 7 years using subtests of the Wechsler Intelligence Scale for Children Fourth Edition, performance and questionnaire-based measures of executive function, and Child Behavior Checklist and Teacher Rating Form. We evaluated the contributions of IQ and executive function to behaviour problems and the moderating effect of sex using multiple regression. Results:The 129 children (mean age = 7.2 years) had lower IQ, inferior executive function and increased internalising problems compared with normative samples. Verbal comprehension skills and working memory were associated with total, internalising and externalising problems at school. Performance-based and questionnaire-based executive function were associated with total and externalising behaviour problems both at home and school. Sex moderated the relationships between information processing and parent-reported total problems, and between teacher-rated executive function and total problems. Conclusion:Both IQ and executive function are related to behaviour problems in children born very preterm, but the relationships are different in boys and girls. Executive function may be a useful target for intervention. K E Y W O R D S childhood behaviour, executive control, intellectual ability, internalising problem, very premature birth How to cite this article: Dai DW, Franke N, Wouldes TA, et al. The contributions of intelligence and executive function to behaviour problems in school-age children born very preterm.

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“…As these subtests cover the verbal domain and aspects of fluid reasoning, these have been more frequently used for short-form combinations. However, the assessment of executive functions such as working memory and processing speed is particularly compromised in children with neurodevelopmental vulnerability, as in the case of very preterm children (Houdt et al, 2019;Schnider et al, 2020), and is not included in these abbreviated instruments. According to some authors, this could lead to an IQ overestimation of very preterm children (Nosarti et al, 2007).…”

Section: Discussionmentioning

confidence: 99%

A Validated WISC-V Short-Form to Estimate Intellectual Functioning in Very Preterm Children at Early School Age

et al. 2021

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Very preterm children (gestational age < 32 weeks) frequently show neurodevelopmental difficulties (Inattention/dysexecutiveness) throughout their life-stages. A scarcity of resources, along with this population’s cognitive vulnerability, makes the neuropsychological evaluation of these children both complicated and time-consuming. This study aimed to develop a specific and valid Wechsler Intelligence Scale for Children-Fifth Edition (WISC-V) short-form to estimate intellectual functioning in this population. Eighty-four very preterm children (39 female; mean age = 6.50; SD: 0.06) were assessed with the WISC-V. Short-forms were developed following two independent strategies: a) multiple linear regressions for each index; b) correlational analyses between scores on all administered subtests and Full-Scale IQ. Validity of short-forms was analyzed. A short-form (Vocabulary, Matrix Reasoning, Picture Span, and Symbol Search) that satisfied 2/3 validation criteria was proposed. This validated short-form could facilitate the identification of cognitive difficulties in very preterm children, so that they could benefit from early care and support services, avoiding long assessment procedures.

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Executive function deficits mediate the association between very preterm birth and behavioral problems at school-age

Cited by 14 publications

References 74 publications

Self‐reported executive function problems in adults born very low birthweight

Self‐reported executive function problems in adults born very low birthweight

The contributions of intelligence and executive function to behaviour problems in school‐age children born very preterm

A Validated WISC-V Short-Form to Estimate Intellectual Functioning in Very Preterm Children at Early School Age

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