Executive Functioning and Learning Skills of Adolescent Children Born at Fewer than 26 Weeks of Gestation

• Published in: PloS one 2016-03, Vol.11 (3), p.e0151819-e0151819
• Main Authors: Farooqi, A, Adamsson, M, Serenius, F, Hägglöf, B
• Format: Article
• Language: English
• Subjects: Adolescent; Age; Analysis; Behavior; Biology and Life Sciences; Birth weight; Child; Child & adolescent psychiatry; Child development; Children; Children & youth; Cognition; Cognitive ability; Covariance; Demography; Disabilities; Executive Function; Executive function (Psychology); Families & family life; Female; Gestation; Gestational Age; Health aspects; Humans; Infant, Extremely Premature; Infant, Newborn; Information processing; Intelligence; Intensive care; Language; Learning; Learning ability; Learning disabilities; Mathematics; Medicine and Health Sciences; Neurodevelopmental disorders; Newborn babies; Parents; Parents & parenting; Pediatrics; People and Places; Pregnancy; Premature Birth - physiopathology; Premature infants; Questionnaires; Regression analysis; Short term memory; Skills; Social Sciences; Teachers; Teenagers
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0151819

To assess the cognitive and behavioral aspects of executive functioning (EF) and learning skills in extremely preterm (EPT) children compared with term control children aged 10 to 15 years. A total of 132 of 134 (98% of all eligible survivors) EPT children born at the 2 Swedish regional tertiary care centers from 1992 to 1998 (mean age = 12 years, mean birth weight = 718 g, and mean gestational age = 24.4 weeks) and 103 matched term controls were assessed. General intelligence was assessed using the Wechsler Intelligence Scale for Children (WISC-III-R), and cognitive aspects of EF were analyzed using EF-sensitive subscales of the WISC-III-R and Tower test of the Delis-Kaplan Executive Function Scale (D-KEFS). Behaviors related to EF and learning skills were assessed using the Five to Fifteen questionnaire, which is a validated parent and teacher instrument. Academic performance in school was assessed by teachers' responses on Achenbach's Teachers Report Form. Analyses performed included multivariate analyses of covariance (ANCOVA and MANCOVA) and logistic regression analyses. The EPT children displayed significant deficits in cognitive aspects of EF compared with the controls, exhibiting decreases on the order of 0.9 SD to 1.2 SD for tasks of verbal conceptual reasoning, verbal and non-verbal working memory, processing speed and planning ability (P 70 and without major NSI revealed no interactions, but significant main effects were observed for the behavioral composite executive function score, group status (EPT vs control) and FSIQ, for which all effect sizes were medium to large. The corresponding findings of MANCOVA of the parent-reported learning skills were very similar. According to the teachers' ratings, the EPT children were less well adjusted to the school environment. EPT children born in the 1990s who received active perinatal care are at an increased risk of executive dysfunction, even after excluding children with significant neurodevelopmental disabilities. Even mild to moderate executive dysfunctions has a significant impact on learning skills. These findings suggest