Attention Problems of Very Preterm Children Compared with Age-Matched Term Controls at School-Age

Objectives To clarify the severity, specificity, and neurocognitive underpinnings of attention problems in very preterm children. Study design A sample of 66 preterm (< 32 weeks gestation), mean (SD) age 7.5 (0.4) years, and 66 age-matched term controls participated. Symptoms of inattention were assessed using parent and teacher-rated questionnaires, and neurocognitive measures included speed and consistency in speed of information processing, lapses of attention (tau), alerting, orienting, and executive attention, as well as verbal and visuospatial working memory. Group differences were investigated using ANOVA, and Sobel tests were used to clarify the mediating role of neurocognitive impairments on attention problems. Results There was a large decrease in visuospatial working memory abilities (P < .001, d = .87), and medium increases in tau (P = .002, d = 0.55) as well as parent and teacher ratings of inattention (range d = 0.40-0.56) in very preterm children compared with term peers. Tau and visuospatial working memory were significant predictors of parent (R-2 = .161, P < .001 and R-2 = .071, P = .001; respectively) and teacher (R-2 = .152, P < .001 and R-2 = .064, P = .002; respectively) ratings of inattention, and completely explained the effects of very preterm birth on attention problems. Conclusions Increased lapses of attention and poorer visuospatial working memory fully account for the attention problems in very premature children at school-age. (J Pediatr 2012;161:824-9).