Hot and cool executive functions in very and extremely preterm preschool children
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Submission date: 2017-05-19
Final revision date: 2017-10-06
Acceptance date: 2017-10-06
Online publication date: 2017-12-01
Publication date: 2017-11-22
Health Psychology Report 2018;6(1):40–49
In most countries, premature deliveries constitute 5% to 18% of births. Some preterm children, especially those born before 32 weeks of pregnancy, experience serious medical complications, which can affect their subsequent development and functioning. Even those who have an IQ within the normal range can be at risk of worse functioning. This study aimed to investigate the differences in development of hot and cool aspects of executive functions in children born prematurely in comparison to those born on time. It is also focused on evaluating relationships between executive functions in premature children and their socio-emotional competences.

Participants and procedure
All children participating in the study were preschoolers. The sample consisted of 20 children born before 32 weeks of gestation and 28 term controls (children born on time). Hot and cool aspects of executive functions were examined in both groups using tasks extracted from the Preschool Self-Regulation Assessment (PSRA). Parents of children born prematurely also completed the Strengths and Difficulties Questionnaire (SDQ), which is a brief behavioral screening questionnaire that consists of five scales: emotional symptoms, conduct problems, hyperactivity/inattention, peer relationship problems and prosocial behavior.

Premature children scored lower for both hot and cool executive functions in comparison to the children born at term in two of the five tasks. In addition, an association between worse executive functioning and more severe problems was found in the preterm group. This link applies to both general and specific problems, such as hyperactivity/inattention and behavioral problems.

Prematurely born children may have larger deficits both in hot and cool aspects of executive functions compared to their peers born at term. Deficits in hot aspect may be reflected in hyperactivity/inattention symptoms and conduct problems, whereas difficulties in cool aspect may be more related to the general picture of problems in prematurely born children.
Aarnoudse‐Moens, C. S., Duivenvoorden, H. J., Weis­glas‐Kuperus, N., Van Goudoever, J. B., & Oosterlaan, J. (2012). The profile of executive function in very preterm children at 4 to 12 years. Developmental Medicine & Child Neurology, 54, 247–253.
Aarnoudse-Moens, C. S. H., Smidts, D. P., Oosterlaan, J., Duivenvoorden, H. J., & Weisglas-Kuperus, N. (2009). Executive function in very preterm children at early school age. Journal of Abnormal Child Psychology, 37, 981–993. doi: 10.1007/S10802-009-9327-Z19488851.
Anderson, P. J. (2014). Neuropsychological outcomes of children born very preterm. Seminars in Fetal and Neonatal Medicine, 19, 90–96. doi: 10.1016/J.Siny.2013.11.012.
Andrews-Espy, K., Sheffield, T. D., Wiebe, S. A., Clark, C. A. C., & Moehr, M. J. (2011). Executive control and dimensions of problem behaviors in preschool children. Journal of Child Psychology and Psychiatry, 52, 33–46.
Barkley, R. A. (1997). Behavioral inhibition, sustained attention, and executive functions: constructing a unifying theory of ADHD. Psychological Bulletin, 121, 65–94.
Biederman, J., Monuteaux, M. C., Doyle, A. E., Seidman, L. J., Wilens, T. E., & Ferrero, F. (2004). Impact of executive function deficits and attention-deficit/hyperactivity disorder (ADHD) on academic outcomes in children. Journal of Consulting and Clinical Psychology, 72, 757–766.
Bhutta, A. T., Cleves, M. A., Casey, P. H., Cradock, M. M., & Anand, K. J. (2002). Cognitive and behavioral outcomes of school-aged children who were born preterm: a meta-analysis. Journal of the American Medical Association, 288, 728–737. doi: 10.1001/jama.288.6.72812169077.
Brock, L. L., Rimm-Kaufman, S. E., Nathanson, L., & Grimm, K. J. (2009). The contributions of ‘hot’ and ‘cool’ executive functions to children’s academic achievements, learning-related behaviors, and engagement in kindergarten. Early Childhood Research Quarterly, 24, 337–349.
Brzezińska, A. I., & Nowotnik, A. (2012). Funkcje wykonawcze a funkcjonowanie dziecka w środowisku przedszkolnym i szkolnym [Executive functions and the functioning of a child in the preschool and school environment]. Edukacja, 1, 61–74.
Castellanos, F. X., Sonuga-Barke, E. J., Milham, M. P., & Tannock, R. (2006). Characterizing cognition in ADHD: beyond executive dysfunction. Trends in cognitive sciences, 10, 117–123.
Chrzan-Dętkoś, M., & Karasiewicz, K. (2014). Mother’s perception of preterm preschoolers in a sample of Polish women. Journal of Reproductive and Infant Psychology, 32, 270–281. doi: 10.1080/02646838.2013.879567.
Chrzan-Dętkoś, M. (2012). Wcześniaki. Rozwój psychoruchowy w pierwszych latach życia [Premature children. Psychomotor development in the first years of life]. Gdańsk: Harmonia Universalis.
Cole, P. M., Usher, B. A., & Cargo, A. P. (1993). Cognitive risk and its association with risk for disruptive behavior disorder in preschoolers. Journal of Clinical Child Psychology, 22, 154–164.
Dempster, F. N. (1992). The rise and fall of the inhibitory mechanism: Toward a unified theory of cognitive development and aging. Developmental review, 12, 45–75.
Diamond, A., & Lee, K. (2011). Interventions shown to aid executive function development in children 4–12 years old. Science, 333, 959–964.
Elgen, S. K., Leversen, K. T., Grundt, J. H., Hurum, J., Sundby, A. B., Elgen, I. B., & Markestad, T. (2012). Mental health at 5 years among children born extremely preterm: a national population-based study. European Child and Adolescent Psychiatry, 21, 583–589.
Friedman, N. P., & Miyake, A. (2004). The relations among inhibition and interference control functions: a latent-variable analysis. Journal of experimental psychology: General, 133, 101–135.
Goodman, R., Ford, T., Simmons, H., Gatward, R., & Meltzer, H. (2000). Using the Strengths and Difficulties Questionnaire (SDQ) to screen for child psychiatric disorders in a community sample. The British Journal of Psychiatry, 177, 534–539.
Goodman, A., & Goodman, R. (2009). Strengths and Difficulties Questionnaire as a Dimensional Measure of Child Mental Health. Journal of the American Academy of Child and Adolescent Psychiatry, 48, 400–403.
Hack, M., Taylor, H. G., Schluchter, M., Andreias, L., Drotar, D., & Klein, N. (2009). Behavioral outcomes of extremely low birth weight children at age 8 years. Journal of Developmental & Behavioral Pediatrics, 30, 122–130. doi: 10.1097/DBP.0b013e31819e6a1619322106.
Hughes, C., Dunn, J., & White, A. (1998). Trick or treat? Uneven understanding of mind and emotion and executive dysfunction in ‘hard-to-manage’ preschoolers. Journal of Child Psychology and Psychiatry, 39, 981–994.
Johnson, S., & Marlow, N. (2011). Preterm birth and childhood psychiatric disorders. Pediatric Research, 69, 11R–18R.
Kerr, A., & Zelazo, P. D. (2004). Development of “hot” executive function: The children’s gambling task. Brain and cognition, 55, 148–157.
Kinney, H. C. (2006). The near-term (late preterm) human brain and risk for periventricular leukomalacia: a review. Seminars in perinatology, 30, 81–88.
Lee, E. S., Yeatman, J. D., Luna, B., & Feldman, H. M. (2011). Specific language and reading skills in school-aged children and adolescents are associated with prematurity after controlling for IQ. Neuropsychologia, 49, 906–913.
Lucassen, N., Kok, R., Bakermans-Kranenburg, M. J., Van IJzendoorn, M. H., Jaddoe, V. W., Hofman, A., …Tiemeier, H. (2015). Executive functions in early childhood: The role of maternal and paternal parenting practices. British Journal of Developmental Psychology, 33, 489–505.
Luria, A. R. (1973). The working brain: An introduction to neuropsychology. New York: Basic Books.
Marlow, N., Hennessy, E. M., Bracewell, M. A., & Wolke, D. (2007). Motor and executive function at 6 years of age after extremely preterm birth. Pediatrics, 120, 793–804.
Marlow, N., Wolke, D., Bracewell, M. A., & Samara, M. (2005). Neurologic and developmental disability at six years of age after extremely preterm birth. The New England Journal of Medicine, 352, 9–19.
McGlamery, M. E., Ball, S. E., Henley, T. B., & Besozzi, M. (2007). Theory of mind, attention, and executive function in kindergarten boys. Emotional and Behavioural Difficulties, 12, 29–47.
Miyake, A., Friedman, N. P., Emerson, M. J., Witzki, A. H., Howerter, A., & Wager, T. D. (2000). The unity and diversity of executive functions and their contributions to complex “frontal lobe” tasks: A latent variable analysis. Cognitive psychology, 41, 49–100.
Mulder, H., Pitchford, N. J., Hagger, M. S., & Marlow, N. (2009). Development of Executive Function and Attention in Preterm Children: A Systematic Review. Developmental Neuropsychology, 34, 393–421.
Poehlmann, J., Miller Schwichtenberg, A. J., Shlafer, R. J., Hahn, E., Bianchi, J. P., & Warner, R. (2011). Emerging self-regulation in toddlers born preterm or low birth weight: differential susceptibility to parenting? Developmental Psychology, 23, 177–193.
Pritchard, V. E., Clark, C. A. C., Liberty, K., Champion, P. R., Wilson, K., & Woodward, L. J. (2009). Early school-based learning difficulties in children born very preterm. Early Human Development, 85, 215–224.
Raju, T. N., Higgins, R. D., Stark, A. R., & Leveno, K. J. (2006). Optimizing care and outcome for late-preterm (near-term) infants: a summary of the workshop sponsored by the National Institute of Child Health and Human Development. Pediatrics,118, 1207–1214.
Reijneveld, S. A., de Kleine, M. J. K., van Baar, A. L., Kollée, L. A. A., Verhaak, C. M., Verhulst, F. C., & Verloove-Vanhorick, S. P. (2006). Behavioural and emotional problems in very preterm and very low birthweight infants at age 5 years. Archive of Diseases in Childhood (Fetal and Neonatal Edition), 91, F423–F428.
Rokita, M. (2017). Neonatolodzy i pediatrzy powinni współpracować [Neonatologists and pediatricians should work together]. Ogólnopolski Przegląd Medyczny, 3, 26–29.
Salonen, P., Lepola, J., & Vauras, M. (2007). Scaffolding interaction in parent-child dyads: multimodal analysis of parental scaffolding with task and non-task oriented children. European Journal of Psychology of Education, 22, 77–96.
Shapiro-Mendoza, C. K., & Lackritz, E. M. (2012). Epidemiology of late and moderate preterm birth. Seminars in Fetal and Neonatal Medicine, 17, 120–125.
Skiöld, B. (2011). Brain imaging and outcome in extremely preterm infants. Institutionen för kvinnors och barns hälsa [Department of Women’s and Children’s Health].
Smith-Donald, R., Raver, C. C., Hayes, T., & Richardson, B. (2007). Preliminary construct and concurrent validity of the Preschool Self-Regulation Assessment (PSRA) for field-based research. Early Childhood Research Quarterly, 22, 173–187.
World Health Organization. (2015). WHO recommendations on interventions to improve preterm birth outcomes. Geneva: World Health Organization. Retrieved from: http://www.who.int/mediacentre....
World Health Organization. (1950). Expert Group on Prematurity: final report [on a meeting held in].
Geneva, 17-21 April 1950. Geneva: World Health Organization.
Wolke, D. (2010). Small beginnings – large impact: development of preterms and implications for early childhood intervention. Presentation to the Complex Learning Difficulties and Disabilities Research Project, Wolverhampton.
Woythaler, M. A., McCormick, M. C., & Smith, V. C. (2011). Late preterm infants have worse 24-month neurodevelopmental outcomes than term infants. Pediatrics, 127, e622–e629.
Wygotski, L. S. (1971). Wybrane prace psychologiczne [Selected psychological works]. Warszawa: Wydawnictwo Naukowe PWN.
Yeniad, N., Malda, M., Mesman, J., van IJzendoorn, M. H., & Pieper, S. (2013). Shifting ability predicts math and reading performance in children: A meta-analytical study. Learning and Individual Differences, 23, 1–9.
Zelazo, P. D. (2006). The Dimensional Change Card Sort (DCCS): A method of assessing executive function in children. Nature Protocols, 1, 297.
Zelazo, P. D., Carter, A., Reznick, J. S., & Frye, D. (1997). Early development of executive function: A problem-solving framework. Review of General Psychology, 1, 198–226.
Zelazo, P. D., & Müller, U. (2010). Executive function in typical and atypical development. In U. Goswami (ed.), The Wiley-Blackwell Handbook of Childhood Cognitive Development, Second edition (pp. 574–603). Blackwell Publishing.