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Age in weeks at which the infant reached a relative frequency of looks of 50% (50%-looks) under the non-competitive condition in fullterm-born (dotted) and preterm-born children (hatched) with normal (Levels I–III) and abnormal (Levels IV–V) scores on the Cito comprehensive reading test. The data in the graphs are presented as box and whisker plots. Boxes represent the individual values between the 25th and 75th centiles (interquartile range); whiskers represent the range of the values, with the exception of outliers. The outliers are represented by the circles and defined as values between 1.5 interquartile range and 3 interquartile ranges from the end of a box.
Source publication
Objective: Preterm infants are exposed to the visual environment earlier than fullterm infants, but whether early exposure affects later development is unclear. Our aim was to investigate whether the development of visual disengagement capacity during the first 6 months postterm was associated with cognitive and motor outcomes at school age, and wh...
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Citations
... Motor assessment tools have been used for discrimination, prediction, and/or evaluation [8]. Discrimination compares the current level of motor development with a reference group [9]. Future performance could be predicted by classifying infants based on potential future status [10]. ...
The Alberta Infant Motor Scale (AIMS) was developed to evaluate the motor development of infants up to 18 months of age. We studied 252 infants in three groups (105 healthy preterm infants (HPI), 50 preterm infants with brain injury (PIBI), and 97 healthy full-term infants (HFI) under 18 months, corrected age (CoA)) using AIMS. No significant differences were found among HPI, PIBI, and HFI in infants less than 3 months old, yet significant differences were noted in positional scores (p < 0.05) and total scores for those four to six months of age and seven to nine months of age. A significant difference was also found in standing items for infants over 10 months (p < 0.05). After four months, there was a difference in motor development between preterm (with and without brain injury) and full-term infants. In particular, there was a significant difference in motor development between HPI and HFI and between PIBI and HFI at four to nine months, when motor skills developed explosively (p < 0.05). After four months, motor developmental delays (10th ≥) were observed in HPI and PIBI at rates of 26% and 45.8%, respectively. Midline supine development, a representative indicator of early motor development, was slower even in healthy preterm infants than in full-term infants. AIMS has a good resolution to discriminate preterm infants who are showing insufficient motor development from 4 months to 9 months.
... Since the outcome measures in the studies summarised above are considered to rely in part on the executive attention system (Hendry et al 2016), these data do not support the argument that early orienting processes underpin later development of the executive attention system. Yet, in a cohort of pre-term and full-term infants, a slower decrease in latency to disengage between 10 and 26 weeks in the Overlap condition is predictive of poorer performance on a measure of executive attention ability at age 9-11 years (the Opposite Worlds inhibitory control task) (Hitzert et al 2014). Previously it was observed that, as a group, pre-term infants tend to show faster development of attentional disengagement compared with full-term infants of equivalent gestational age -a phenomenon thought to be linked to their additional visual experience (Hunnius et al 2008). ...
... Previously it was observed that, as a group, pre-term infants tend to show faster development of attentional disengagement compared with full-term infants of equivalent gestational age -a phenomenon thought to be linked to their additional visual experience (Hunnius et al 2008). Hitzert et al (2014) went on to show however that the pre-terms who benefit least from their additional visual exposure have the lowest executive attention scores at school age. This preliminary evidence of an association between early orienting and later executive processes merits further research, and illustrates the importance of taking a longitudinal individual differences approach to research with clinical populations. ...
... In the section on Orienting above we referred to studies showing how infants of less than 2 months of age (gestational age of around 48 weeks) are susceptible to sticky fixation. Infants who take longer to outgrow sticky fixation -i.e., who continue to show long latencies to disengage from a target -show executive attention difficulties later in life (Hitzert et al 2014). Thus, the long look durations to habituation stimuli shown by some pre-term infants in the Sigman et al., (1991) study may have been driven by disengagement difficulties as well as by poor processing efficiency. ...
Visual attention is a basic mechanism of information gathering and environment selection and consequently plays a fundamental role in influencing developmental trajectories. Here, we highlight evidence for predictive associations from early visual attention to emotion regulation, executive function, language and broader cognitive ability, mathematics and literacy skills, and neurodevelopmental conditions. Development of visual attention is also multifaceted and nonlinear. In daily life, core functions such as orienting, selective filtering, and processing of visual inputs are intertwined and influenced by many other cognitive components. Furthermore, the demands of an attention task vary according to the experience, motivation, and cognitive and physical constraints of participants, while the mechanisms underlying performance may change with development. Thus, markers of attention may need to be interpreted differently across development and between populations. We summarize research that has combined multiple measurements and techniques to further our understanding of visual attention development and highlight possibilities for the future. Expected final online publication date for the Annual Review of Developmental Psychology, Volume 1 is December 16, 2019. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.
... In 80 low-risk late PT with a GA between 34.0 and 36.9 weeks assessed at birth and at term equivalent age, some aspects of visual abilities at term equivalent age such as attention at distance and ability to discriminate black/white stripes showed more mature findings in late PT infants than FT infants. This interesting point of view was reported by several authors that emphasized how the effects of the early visual "hyperstimulation" were a driving force to promote visual development (Sansavini, Guarini, & Caselli, 2011;Hitzert, van Braeckel, Bos, & Hunnius, 2014). Our findings might suggest an influence on visual and visuomotor skills achievement played by gender rather than prematurity, being these skills poorer not only in male infants born with moderate prematurity but also in FT ones. ...
Temporal differences of neurodevelopmental milestones' achievement are commonly taken into account in preterm infant assessment during the first year of life, especially when minor or none neurological signs arise from clinical examination. The influence of gender on neurodevelopment in preterm infants was examined by a milestones‐based neurological approach. Two‐hundred twenty‐seven moderate and late preterm and full‐term infants (51.9% male), without evidence of severe white matter insults, were early assessed by classic neurological examination. Griffiths Mental Developmental Scale was used at long‐term observation. Children were sorted into three gestational age groups (Group 1: 32–33 weeks, Group 2: 34–36 weeks, and Group 3: ≥37 weeks) and compared according to their neurodevelopmental pathways and gender. The achievement of head control was slightly earlier in females. The pointing, one of the main communicative hand gesture, appeared significantly earlier in females across all the groups. At the Griffiths Scale, the majority of gender‐related differences emerged in personal–social and eye and hand coordination subscale. An independent role of male gender was evidenced in personal–social, language, and eye and hand coordination subscales. Gender and gestational age likely addressed different temporal profiles of neurodevelopment in early and late assessments in preterm and full‐term infants. The role of gender and gestational age on these findings has been discussed.
Highlights
• A classic, milestones‐based neurological evaluation disclosed different developmental profiles in males versus females preterm infants.
• Moderate preterm and full‐term infants showed similar developmental profiles.
• Gender and gestational age may influence neurodevelopment.
... In many other studies, varying attentional deficits have been found as a particular, long-lasting effect of very preterm birth and/or very low birth weight (VLBW; e.g., van de Weijer-Bergsma, Wijnroks, & Jongmans, 2008;Mulder, Pitchford, Hagger, & Marlow, 2009;Anderson et al., 2011;Lindström, Lindblad, & Hjern, 2011;Hitzert, Van Braeckel, Bos, Hunnius, & Geuze, 2014;Geldof et al., 2016;Johnson et al., 2016;Johnson & Marlow, 2017), although not all of these studies have assessed deficits of attention independently from the general level of intellectual disability found in many of these children. In contrast, there is at least one study (Hunnius, Geuze, Zweens, & Bos, 2008) testing healthy preterm-born infants, showing that the development of the ability to disengage and switch attention is accelerated in development compared to term-born infants. ...
Research in the Visual Development Unit on “dorsal stream vulnerability' (DSV) arose from research in two somewhat different areas. In the first, using cortical milestones for local and global processing from our neurobiological model, we identified cerebral visual impairment in infants in the first year of life. In the second, using photo/videorefraction in population refractive screening programs, we showed that infant spectacle wear could reduce the incidence of strabismus and amblyopia, but many preschool children, who had been significantly hyperopic earlier, showed visuo-motor and attentional deficits. This led us to compare developing dorsal and ventral streams, using sensitivity to global motion and form as signatures, finding deficits in motion sensitivity relative to form in children with Williams syndrome, or perinatal brain injury in hemiplegia or preterm birth. Later research showed that this “DSV” was common across many disorders, both genetic and acquired, from autism to amblyopia. Here, we extend DSV to be a cluster of problems, common to many disorders, including poor motion sensitivity, visuo-motor spatial integration for planning actions, attention, and number skills. In current research, we find that individual differences in motion coherence sensitivity in typically developing children are correlated with MRI measures of area variations in parietal lobe, fractional anisotropy (from TBSS) of the superior longitudinal fasciculus, and performance on tasks of mathematics and visuo-motor integration. These findings suggest that individual differences in motion sensitivity reflect decision making and attentional control rather than integration in MT/V5 or V3A. Its neural underpinnings may be related to Duncan's “multiple-demand” (MD) system.
Visual attention plays a key role in infants’ interaction with the environment, and shapes their behavioral and brain development. As such, early problems with flexibly switching gaze from one stimulus to another (visual disengagement) have been hypothesized to lead to developmental difficulties (e.g. joint attention and social skills) over time. This study aimed to identify cross-sectional associations between performance in the Gap task (gaze shift latencies and visual attention disengagement) and measures of development and adaptive behavior in conjunction to any sex or socioeconomic status effects in infancy. We measured visual attention disengagement in 436 5-month-old infants and calculated its association with cognitive developmental level, adaptive behaviours, socioeconomic status (SES) and biological sex. In the Gap task, participants must redirect their gaze from a central stimulus to an appearing peripheral stimulus. The three experimental conditions of the task (Gap, Baseline and Overlap) differ on the timepoint when the central stimuli disappears in relation to the appearance of the peripheral stimulus: 200 ms before the peripheral stimulus appears (Gap), simultaneously to its appearance (Baseline), or with peripheral stimulus offset (Overlap). The data from the experimental conditions showed the expected pattern, with average latencies being the shortest in the Gap and longest in the Overlap condition. Females were faster (p = .004) than males in the Gap condition, which could indicate that arousal-related effects differ as a function of biological sex. Infants from higher SES were slower (p = .031) in the Overlap condition compared to lower SES infants. This suggests that basic visual attention may differ by socio-cultural background, and should be considered when studying visual attention and its developmental correlates. We observed no significant association to concurrent developmental level or adaptive function. Given its large sample size, this study provides a useful reference for future studies of visual disengagement in early infancy.
Aim
To investigate the magnitude of executive function deficits and their dependency on gestational age, sex, age at assessment, and year of birth for children born preterm and/or at low birthweight.
Method
PubMed, PsychINFO, Web of Science, and ERIC were searched for studies reporting on executive functions in children born preterm/low birthweight and term controls born in 1990 and later, assessed at a mean age of 4 years or higher. Studies were included if five or more studies reported on the same executive function measures.
Results
Thirty‐five studies (3360 children born preterm/low birthweight, 2812 controls) were included. Children born preterm/low birthweight performed 0.5 standardized mean difference (SMD) lower on working memory and cognitive flexibility and 0.4 SMD lower on inhibition. SMDs for these executive functions did not significantly differ from each other. Meta‐regression showed that heterogeneity in SMDs for working memory and inhibition could not be explained by study differences in gestational age, sex, age at assessment, or year of birth.
Interpretation
Children born preterm/low birthweight since 1990 perform half a SMD below term‐born peers on executive function, which does not seem to improve with more recent advances in medical care or with increasing age.
What this paper adds
Children born preterm/low birthweight perform below term‐born children on core executive functions.
Lower gestational age or male sex are not risk factors for poorer executive functions.
Executive function difficulties in children born preterm/low birthweight remain stable across childhood.
Executive function difficulties are similar for children born recently and children born in earlier eras.
Over the last fifteen years, the emerging field of developmental cognitive neuroscience has described the relatively late development of prefrontal cortex in children and the relation between gradual structural changes and children's protracted development of prefrontal-dependent skills. Widespread recognition by the broader scientific community of the extended development of prefrontal cortex has led to the overwhelming perception of prefrontal cortex as a "late developing" region of the brain. However, despite its supposedly protracted development, multiple lines of research have converged to suggest that prefrontal cortex development may be particularly susceptible to individual differences in children's early environments. Recent studies demonstrate that the impacts of early adverse environments on prefrontal cortex are present very early in development: within the first year of life. This review provides a comprehensive overview of new neuroimaging evidence demonstrating that prefrontal cortex should be characterized as a "rapidly developing" region of the brain, discusses the converging impacts of early adversity on prefrontal circuits, and presents potential mechanisms via which adverse environments shape both concurrent and long-term measures of prefrontal cortex development. Given that environmentally-induced disparities are present in prefrontal cortex development within the first year of life, translational work in intervention and/or prevention science should focus on intervening early in development to take advantages of this early period of rapid prefrontal development and heightened plasticity.
Individuals who are born very preterm (< 32 weeks gestation) show differential development of prefrontal cortex structure, function, and dependent behaviors, including executive function (EF) skills, beginning during late infancy and extending into adulthood. Preschool-aged children born moderate-to-late preterm (PT; 32–36 weeks gestation) show smaller discrepancies in EF development, but it is unclear whether these differences first emerge during the early childhood years, when EF is rapidly developing, or if they arise from alterations in complex cognitive skills measurable in late infancy. In the current study, we examined whether differences in complex attention, memory, and inhibition skills (precursor skills to EF) are altered in healthy infants born moderate-to-late PT at 9-months corrected age. Infants born PT demonstrated poorer memory at test following habituation than their full-term peers. Furthermore, lower gestational age at birth was associated with poorer performance on five of the six early EF tasks. Results indicate that even in the context of low medical and environmental risk, performance on the Bayley within the normal range, and no group-level differences in processing speed, infants born moderate-to-late PT show subtle alterations in cognitive skills presumed to be dependent on prefrontal cortex by 9-months of age, likely setting the stage for long-term differences in EF development.
Background:
Developmental milestones are useful signposts developed to assess the pace and the trajectory of maturation occurring during specific time-windows called critical periods. The predictive role of their clinical assessment in premature infants is challenging, however, it actually represents an easy and reliable tool at follow-up.
Aim and study design:
Relying on a milestone-based neurological examination, we aimed to detect the interdependence between time of achievement of each milestone with long-term neuropsychological and neurodevelopmental outcomes. The influence of pre-perinatal events was also considered.
Patients & methods:
Two-hundred-eighty patients (53.2% M) were serially assessed by classic neurological examination during the first 18months and subsequently evaluated by Griffiths Developmental Mental Scale. Children were sorted by ranges of gestational age and compared according to their different profiles.
Results:
The Extremely PreTerms appeared to have a globally delayed development with subsequent attentional and behavioral troubles. Differently, the older peers, from Moderately to Full Term ones, although did not show significant differences in achievement of gross motor skills, had a stable delay of visual and social skills across the age ranges. This gap was not evidenced at the long-term evaluation, except for the Extremely PreTerm children. Pre-perinatal factors played a significant role on short and long term neurodevelopmental outcome.
Conclusions:
Early assessed classic neurological examination might address neurodevelopmental trajectories in PreTerm children in which visual and social skills appear to be the mostly affected. It remains the easiest and most reliable tool of evaluation throughout the follow-up programs.
