Poor attention rather than hyperactivity/impulsivity predicts academic achievement in very preterm and full-term adolescents

Abstract

(2013) Poor attention rather than hyperactivity/impulsivity predicts academic achievement in very preterm and full-term adolescents. Psychological Medicine, Vol.43 (No.1). pp. 183-196. ISSN 0033-2917 Permanent WRAP url: http://wrap.warwick.ac.uk/52783/ Copyright and reuse:The Warwick Research Archive Portal (WRAP) makes this work by researchers of the University of Warwick available open access under the following conditions. Copyright © and all moral rights to the version of the paper presented here belong to the individual author(s) and/or other copyright owners. To the extent reasonable and practicable the material made available in WRAP has been checked for eligibility before being made available.Copies of full items can be used for personal research or study, educational, or not-forprofit purposes without prior permission or charge. Provided that the authors, title and full bibliographic details are credited, a hyperlink and/or URL is given for the original metadata page and the content is not changed in any way. Publisher's statement: Copyright © Cambridge University Press 2012 A note on versions:The version presented in WRAP is the published version or, version of record, and may be cited as it appears here. Background. Very preterm (VP) children are at particular risk for attention deficit/hyperactivity disorder (ADHD) of the inattentive subtype. It is unknown whether the neurodevelopmental pathways to academic underachievement are the same as in the general population. This study investigated whether middle childhood attention or hyperactivity/impulsivity problems are better predictors of VP adolescents' academic achievement.Method. In a geographically defined prospective whole-population sample of VP (<32 weeks gestation) and/or very low birth weight (<1500 g birth weight) (VLBW/VP ; n=281) and full-term control children (n=286) in South Germany, ADHD subtypes were assessed at 6 years 3 months and 8 years 5 months using multiple data sources. Academic achievement was assessed at 13 years of age.Results. Compared with full-term controls, VLBW/VP children were at higher risk for ADHD inattentive subtype [6 years 3 months : odds ratio (OR) 2.8, p<0.001 ; 8 years 5 months : OR 1.7, p=0.020] but not for ADHD hyperactiveimpulsive subtype (6 years 3 months : OR 1.4, p=0.396 ; 8 years 5 months : OR 0.9, p=0.820). Childhood attention measures predicted academic achievement in VLBW/VP and also full-term adolescents, whereas hyperactive/ impulsive behaviour did not.Conclusions. Attention is an important prerequisite for learning and predicts long-term academic underachievement. As ADHD inattentive subtype and cognitive impairments are frequent in VLBW/VP children, their study may help to identify the neurofunctional pathways from early brain development and dysfunction to attention problems and academic underachievement.

Preterm Toddlers' Inhibitory Control Abilities Predict Attention Regulation and Academic Achievement at Age 8 Years

“…Firstly, child behavior during a challenging cognitive assessment lasting 1 h 20 min was evaluated by psychologists with the Tester's Rating of Child Behavior (TRCB) Task Orientation index scale (Cronbach's α =.85; subscale inter-rater reliabilities ICC (intra-class correlation coefficient) =.63 to .97) [3]. Secondly, child attention across the whole assessment day was evaluated as a consensus rating by the whole research team (TEAM rating of psychologist, assistant psychologist, and pediatrician, α =.98) [3]. These two attention ratings correlated highly with each other (r=.62, p<0.01) and were thus z-scored and combined into a single scale of attention regulation.…”

“…Preterm birth increases the risk for attention difficulties [1][2][3][4] as well as long-term academic underachievement [3,5,6]. Studies have suggested that early self-control abilities (e.g.…”

Attention problems in relation to gestational age at birth and smallness for gestational age

“…First, the assistant psychologist rated children's behaviour during a cognitive assessment that lasted on average 80 minutes using the Tester Ratings of Child Behaviour (TRCB (1,27)). Six of 13 items were combined to create a Task Orientation subscale including attention, robustness/endurance, demandingness (reversed score), cooperativeness, compliance and difficulty (reversed score).…”

“…Second, adapting a consensus model, the whole research team (psychologist, assistant psychologist and paediatrician) evaluated children's behaviour based on their observations during the whole assessment day. They rated children's behaviours using three items of the TRCB: attention, robustness/endurance and demandingness (reversed score) (1). An index score of attention Attention problems and gestational age 6 was computed using the Team ratings.…”

“…Attention skills are a fundamental prerequisite of learning and attention problems predict lower academic success (1,2). Attention skills have been regularly reported to be impaired in children and adolescents who were born very preterm (gestational age at birth <32 weeks) (3)(4)(5)(6).…”