Article summary of Executive function deficits in children born preterm or at low birthweight: a meta-analysis by Van Houdt et al. - Chapter

Why is it necessary to investigate the relationship between executive function deficits and preterm birth and/or low birth weight?

Preterm birth and low birth weight co-occur frequently. Many children born preterm are also born with a low birth weight and vice versa. These children are at high risk of adverse cognitive, academic, and behavioral outcomes. They often show impairments in executive functions, which play a crucial role in the onset of academic and behavioral problems.

Which three core executive functions were examined in the meta-analyses of Van Houdt et al. (2019)?

• Working memory is the ability to hold information in mind and actively manipulate this information. Visual-spatial working memory was examined using the Cambridge Neuropsychological Test Automated Battery Spatial Working Memory task. Verbal working memory was examined using the Digit Span Task and the Letter Number Sequencing task.
• Inhibition is the ability to deliberately inhibit a prepotent response or stop an ongoing response or suppress disruption by competing responses. Response inhibition was examined using the Go/No-Go task and the Test of Everyday Attention for Children Opposite Worlds task. Inference control was examined using the Test of Everyday Attention for Children Sky Search task.
• Cognitive flexibility is the ability to shift between multiple tasks or mental sets. This was examined using the Trail Making Test/Trails Preschool Revised.

Based on the meta-analyses, what results were found with regards to the relationship between preterm birth/low birth weight and executive functions?

Children born preterm/low birth weight scored lower on working memory and cognitive flexibility measures, as well as inhibition measures. There were no differences between these executive functions, meaning that they were all affected to a similar degree. In previous research, executive function deficits have been described to be proportional to decreasing gestational age, but those studies featured children at the extreme ends of the gestational age range. More research is necessary, specifically including children born extremely preterm.

Do executive function deficits in children born preterm/low birth weight represent a stable deficit?

Researchers are investigating whether or not executive function deficits in children born preterm or with low birth weight represent a stable deficit, meaning a deficit that increases during development, or a delay in maturation in which children catch up over time. In the current research, the difficulties appear to be stable and do not diminish as the children grow older. However, the children examined were no older than 14 years, and it´s possible that there may be catch up in executive functions after that age.