Attention problems in a representative sample of extremely preterm/extremely low birth weight children

Peter J. Anderson, Cinzia R. de Luca, Esther Hutchinson, Megan M. Spencer-Smith, Gehan Roberts, Lex W Doyle

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172 Citations (Scopus)


The aim of this study was to examine attention in a large, representative, contemporary cohort ofchildren born extremely preterm (EP) and/or extremely low birth weight (ELBW). Participantsincluded 189 of 201 surviving children born EP (<28 weeks’ gestation) or ELBW (<1,000 g) in1997 in the state of Victoria, Australia. A comparison group of 173 of 199 children born full termand normal birth weight (FT/NBW) were randomly selected matching for birth hospital, expecteddue date, gender, mother’s country of birth, and health insurance status. Participants were assessedat 8 years of age on subtests from the Test of Everyday Attention for Children (TEA-Ch) and theWechsler Intelligence Scale for Children–4th Edition (WISC–IV). Measures of selective attention,sustained attention, attention encoding, and executive attention (inhibition, shifting attention, anddivided attention) were administered. To assess behavioral elements of inattention, the primary caregivercompleted the Behavior Rating Inventory of Executive Function (BRIEF) and the Conners’ADHD/DSM-IV Scale (CADS-P). The EP/ELBW group performed more poorly across all cognitiveand behavioral measures than the FT/NBW group, with the exception of inhibition. TheEP/ELBW group also had significantly elevated rates of impairment in selective, sustained, shiftingand divided attention, as well as attention deficit hyperactivity disorder (ADHD) symptoms. Nosignificant gender or gradient effects (e.g., <26 weeks’ gestation vs. ≥26 weeks’ gestation) wereidentified. Neonatal medical factors were not strong predictors of attention, although necrotizingenterocolitis (NEC) and cystic periventricular leukomalacia (PVL) were independent predictors ofselective attention. In conclusion, our comprehensive assessment of attention provides strong evidencethat children born EP/ELBW are at increased risk for attentional impairments, and as such,this population should be monitored closely during early and middle childhood with a focus onattention functioning.
Original languageEnglish
Pages (from-to)57-73
Number of pages17
JournalDevelopmental Neuropsychology
Issue number1
Publication statusPublished - 19 Jan 2011
Externally publishedYes

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