Development of Executive Function and Attention in Preterm Children: A Systematic Review

Abstract

We report on a systematic review of studies of executive function and attention in preterm children. Using meta-analysis, we confirm this is an area of weakness for preterm children, and show that the extent of difficulties is influenced by gestational age (GA), age at test, and skill under investigation. Effect size for selective and sustained attention and inhibition is related to GA. For studies with mean GA ≥ 26 weeks, selective attention skills catch up with age, phonemic fluency skills are increasingly delayed, and ongoing deviance is shown for shifting skills (when assessed with specific measures). Implications for research and practice are discussed.

Notes

The authors acknowledge the support of the Medical Research Council.

Note: ^aFor explanation see text.

*p < .05.

**p< .01.

***p < .001.

^aInspection of scatter plots showed that selective attention effect sizes are best described as an interaction between age and gestational age, therefore studies are split according to GA and age.

^bThe results are strongly influenced by a large study that selected children on the basis of birth weight (BW < 2500 g) rather than gestational age and thus includes some children with gestational ages up to 42 weeks (Breslau et al., 1996). Excluding this study results in R² = .84 (p < .001) for selective attention and R² = .038 (p = .618) for phonemic fluency for the relation with GA.

^aSubgroups in italic are the subgroups entered in meta-analysis. Corresponding cohort information in the table is only represented for the specific subgroup mentioned.

^bAge 15.5 years subsample of Nosarti et al. (2008).