Executive function development in preterm children

Introduction Prematurity is a major public health issue given the increasing rate of preterm births, the improved survival rate for children born extremely preterm, and the substantial costs associated with caring for these children in the neonatal period and beyond [1]. For the families of preterm children, the most common concern is the long-term intellectual, educational, and behavioral outcome for their child, as these issues greatly affect social and adaptive functioning and vocational opportunities. The concerns of parents are warranted, as many preterm children will develop an impairment in at least one of these areas, with the rate of impairment increasing with decreasing weight and gestational age at birth [2-4]. In the past 20 years a number of outcome studies have focused on children born very preterm (VPT; born prior to 32 completed weeks’ gestation) or very low birth weight (VLBW; birth weight < 1500 g). Research indicates that VPT/VLBW children frequently display cognitive impairment [3], with the rate of intellectual impairment being approximately three times greater in VPT/VLBW children compared with full-term-born peers [2]. An array of cognitive deficits have been reported in this population including visuomotor problems [5], attentional difficulties [6], impaired memory [7], delayed language skills [8], and executive dysfunction [9]. Consistent with this profile of cognitive impairment, relatively high rates of learning disabilities are cited (see also Chapter 16) [2, 4].