Dataset Information

Executive function and behaviour problems in school-age children born at risk of neonatal hypoglycaemia.

ABSTRACT:

Aim

To examine the relationship between neonatal hypoglycaemia and specific areas of executive function and behaviour in mid-childhood.

Method

Participants in a prospective cohort study of infants born late preterm or at term at risk of neonatal hypoglycaemia were assessed at 9 to 10 years. We assessed executive function using performance-based (Cambridge Neuropsychological Tests Automated Battery) and questionnaire-based (Behavior Rating Inventory of Executive Function) measures and behaviour problems with the Strengths and Difficulties Questionnaire. Data are reported as adjusted odds ratio (aOR) with 95% confidence intervals, and standardized regression coefficients.

Results

We assessed 480 (230 females, 250 males; mean age 9 years 5 months [SD 4 months, range 8 years 8 months-11 years 0 months]) of 587 eligible children (82%). There were no differences in performance-based executive function between children who did and did not experience neonatal hypoglycaemia (blood glucose <2.6 mmoL/L). However, children who experienced hypoglycaemia, especially if severe or recurrent, were at greater risk of parent-reported metacognition difficulties (aOR 2.37-3.71), parent-reported peer (aOR 1.62-1.89) and teacher-reported conduct (aOR 2.14 for severe hypoglycaemia) problems. Both performance- and questionnaire-based executive functions were associated with behaviour problems.

Interpretation

Neonatal hypoglycaemia may be associated with difficulties in specific aspects of parent-reported executive functions and behaviour problems in mid-childhood.

SUBMITTER: Dai DWT

PROVIDER: S-EPMC10387501 | biostudies-literature | 2023 Sep

REPOSITORIES: biostudies-literature

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Publications

Executive function and behaviour problems in school-age children born at risk of neonatal hypoglycaemia.

Dai Darren W T DWT Franke Nike N McKinlay Christopher J D CJD Wouldes Trecia A TA Brown Gavin T L GTL Shah Rajesh R Nivins Samson S Harding Jane E JE

Developmental medicine and child neurology 20230131 9

<h4>Aim</h4>To examine the relationship between neonatal hypoglycaemia and specific areas of executive function and behaviour in mid-childhood.<h4>Method</h4>Participants in a prospective cohort study of infants born late preterm or at term at risk of neonatal hypoglycaemia were assessed at 9 to 10 years. We assessed executive function using performance-based (Cambridge Neuropsychological Tests Automated Battery) and questionnaire-based (Behavior Rating Inventory of Executive Function) measures ...[more]

PMID: 36722028

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Project description:BackgroundExecutive function deficits in children born very preterm (VPT) have been linked to anatomical abnormalities in white matter and subcortical brain structures. This study aimed to investigate how altered brain metabolism contributes to these deficits in VPT children at school-age.MethodsFifty-four VPT participants aged 8-13 years and 62 term-born peers were assessed with an executive function test battery. Brain metabolites were obtained in the frontal white matter and the basal ganglia/thalami, using proton magnetic resonance spectroscopy (MRS). N-acetylaspartate (NAA)/creatine (Cr), choline (Cho)/Cr, glutamate + glutamine (Glx)/Cr, and myo-Inositol (mI)/Cr were compared between groups and associations with executive functions were explored using linear regression.ResultsIn the frontal white matter, VPT showed lower Glx/Cr (mean difference: -5.91%, 95% CI [-10.50, -1.32]), higher Cho/Cr (7.39%, 95%-CI [2.68, 12.10]), and higher mI/Cr (5.41%, 95%-CI [0.18, 10.64]) while there were no differences in the basal ganglia/thalami. Lower executive functions were associated with lower frontal Glx/Cr ratios in both groups (β = 0.16, p = 0.05) and higher mI/Cr ratios in the VPT group only (interaction: β = -0.17, p = 0.02).ConclusionLong-term brain metabolite alterations in the frontal white matter may be related to executive function deficits in VPT children at school-age.ImpactVery preterm birth is associated with long-term brain metabolite alterations in the frontal white matter. Such alterations may contribute to deficits in executive function abilities. Injury processes in the brain can persist for years after the initial insult. Our findings provide new insights beyond structural and functional imaging, which help to elucidate the processes involved in abnormal brain development following preterm birth. Ultimately, this may lead to earlier identification of children at risk for developing deficits and more effective interventions.

Project description:BackgroundExecutive function difficulties are common among children born very preterm and/or very low birthweight (<1500 g; VLBW), but little is known about whether they persist into adulthood.ObjectivesExamine the nature and pattern of self-reported executive functioning at 23 and 28 years of age using data from a national cohort study of adults born VLBW and a comparison group of same-age full-term (FT) born adults. Also examined were associations between executive function difficulties and socio-economic outcomes.MethodsAll infants born VLBW in New Zealand during 1986 were prospectively included in an audit of retinopathy of prematurity (n = 413), with 250 (77% of survivors) followed to median age 28 years. A comparison group of FT adults was also recruited at age 23 and followed to 28 years (n = 100). Across both adult assessments, executive functioning was assessed using the Behaviour Rating Inventory of Executive Function-Adult Version (BRIEF-A) and analysed with semi-parametric models to examine the effects of age and group on executive function.ResultsAt 23 and 28 years, VLBW adults had increased risk of executive function impairment compared with FT adults in behaviour regulation (relative risk [CI] 2.37, 95% confidence interval (CI)1.27, 4.45), meta-cognition (RR 6.03, 95% CI 2.18, 16.78) and global functioning (RR 3.20, 95% CI 1.40, 7.28). Impaired global executive functioning was associated with lower socio-economic status (regression estimate [b] = -0.43, 95% CI -0.59, -0.27) and a reduced likelihood of home ownership by age 28 years (RR 0.98, 95% CI 0.96, 1.00), even after controlling for sex, ethnicity and parental socio-economic backgrounds for both groups.Conclusion(s)VLBW-born adults continue to experience more executive function difficulties in their everyday life relative to term controls at age 28 years. These difficulties were negatively associated with their socio-economic opportunities as young adults.

Project description:PurposeThis article reviews research on executive function (EF) skills in children with autism spectrum disorder (ASD) and the relation between EF and language abilities. The current study assessed EF using nonverbal tasks of inhibition, shifting, and updating of working memory (WM) in school-age children with ASD. It also evaluated the association between children's receptive and expressive language abilities and EF performance.MethodIn this study, we sought to address variables that have contributed to inconsistencies in this area of research-including task issues, group comparisons, and participant heterogeneity. EF abilities in children with ASD (n = 48) were compared to typically developing controls (n = 71) matched on age, as well as when statistically controlling for group differences in nonverbal cognition, socioeconomic status, and social communication abilities. Six nonverbal EF tasks were administered-2 each to evaluate inhibition, shifting, and WM. Language abilities were assessed via a standardized language measure. Language-EF associations were examined for the ASD group as a whole and subdivided by language status.ResultsChildren with ASD exhibited significant deficits in all components of EF compared to age-mates and showed particular difficulty with shifting after accounting for group differences in nonverbal cognition. Controlling for social communication-a core deficit in ASD-eliminated group differences in EF performance. A modest association was observed between language (especially comprehension) and EF skills, with some evidence of different patterns between children on the autism spectrum with and without language impairment.ConclusionsThere is a need for future research to examine the direction of influence between EF and language. It would be beneficial for EF interventions with children with ASD to consider language outcomes and, conversely, to examine whether specific language training facilitates aspects of executive control in children on the autism spectrum.Presentation videohttps://doi.org/10.23641/asha.7298144.

Project description:A growing number of babies are born with perinatal risk factors that may impair later development. These children are often assessed at 2 years to help predict outcome and direct support services. Executive function is an important predictor of academic achievement and behavior, but there are limited assessments of executive function in 2-year-olds and few have been tested in at-risk populations. Therefore, we developed a battery of four age-appropriate tasks to assess executive function in 2-year-olds. At 24 months' corrected age 368 children completed tasks assessing attention, inhibition, working memory and cognitive flexibility. Scores on different tasks were weakly correlated, suggesting that they measured separate aspects of executive function, with combined scores for this cohort approximating a normal distribution. Significantly more boys (67%) than girls (57%) were unable to inhibit their behavior on the Snack Delay Task and girls (M = 3.24, SD = 2.4) had higher mean scores than boys (M = 2.7, SD = 2.7) on the Ducks and Buckets Reverse Categorization Task of working memory. Performance was significantly affected by family socioeconomic status. Mean scores were lower on all four individual tasks and on the global score of overall performance in children from a low household income (<$40,000) compared to those from medium ($40,001-$70,000) and high income households (>$70,001). Maternal education was only associated with scores on the working memory task and the global score; and a measure of neighborhood deprivation was only associated with scores on the two inhibitory tasks and the global score. Our findings confirm the feasibility of assessing executive function in 2-year-olds, and its ability to discriminate effects of socioeconomic status, a common confounder in child development research. Further development and standardization of this test battery comparing at-risk children with a normative population would provide a much-needed measure of executive function in early childhood.

Project description:BackgroundChildren born extremely preterm (gestational age < 28 weeks) show reduced visual function even without any cerebral or ophthalmological neonatal diagnosis. In this study, we aimed to assess the retinal structure with optical coherence tomography (OCT) and visual function with pattern-reversal visual evoked potentials (PR-VEPs) in a geographically defined population-based cohort of school-aged children born extremely preterm. Moreover, we aimed to explore the association between measures of retinal structure and visual pathway function in this cohort.MethodsAll children born extremely preterm from 2006-2011 (n = 65) in Central Norway were invited to participate. Thirty-six children (55%) with a median age of 13 years (range = 10-16) were examined with OCT, OCT-angiography (OCT-A), and PR-VEPs. The foveal avascular zone (FAZ) and circularity, central macular vascular density, and flow were measured on OCT-A images. Central retinal thickness, circumpapillary retinal nerve fibre layer (RNFL) and inner plexiform ganglion cell layer (IPGCL) thickness were measured on OCT images. The N70-P100 peak-to-peak amplitude and N70 and P100 latencies were assessed from PR-VEPs.ResultsParticipants displayed abnormal retinal structure and P100 latencies (≥ 2 SD) compared to reference populations. Moreover, there was a negative correlation between P100 latency in large checks and RNFL (r = -.54, p = .003) and IPGCL (r = -.41, p = .003) thickness. The FAZ was smaller (p = .003), macular vascular density (p = .006) and flow were higher (p = .004), and RNFL (p = .006) and IPGCL (p = .014) were thinner in participants with ROP (n = 7).ConclusionChildren born extremely preterm without preterm brain injury sequelae have signs of persistent immaturity of retinal vasculature and neuroretinal layers. Thinner neuroretinal layers are associated with delayed P100 latency, prompting further exploration of the visual pathway development in preterms.

Dataset Information

Executive function and behaviour problems in school-age children born at risk of neonatal hypoglycaemia.

Aim

Method

Results

Interpretation

Publications

Executive function and behaviour problems in school-age children born at risk of neonatal hypoglycaemia.

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