Inattentive behaviour is associated with poor working memory and slow processing speed in very pre-term children in middle childhood

Background. Problem behaviour is common following pre-term birth, but the underlying nature of these difficulties is not well known. Aims. We sought to establish the mechanisms underpinning behavioural difficulties in very pre-term (VPT) children in middle childhood by comparing their performance to that of term born peers on tasks of working memory, inhibition, and processing speed, and relating these to parent and teacher assessments of their behaviour. Particular focus was given to inattention and overactive/impulsive behaviour, as these behaviours have been associated with different neuropsychological problems in term children. Samples. A group of VPT children (gestational age < 31 weeks, N = 56) aged 9-10 years and term controls (N = 22) participated in the study. Method. Children were assessed with measures of working memory, inhibition, and processing speed. Parents and teachers reported behavioural problems using the Strengths and Difficulties Questionnaire and two additional scales measuring overactive/impulsive behaviour and inattention. Results. Results revealed increased rates of problem behaviour in VPT compared to term children for parent-rated total difficulties, hyperactivity, emotional problems, peer problems, prosocial behaviour, overactive/impulsive behaviour, and parent- and teacher-rated inattention. Processing speed and working memory, but not inhibition, were significantly related to inattentive and overactive/impulsive behaviour. Conclusions. The increased rates of inattention and overactive/impulsive behaviour in VPT children may be explained by impairment in processing speed and working memory. Expected links between overactive/impulsive behaviour and inhibitory control were not identified, suggesting the nature of such difficulties may be different in VPT compared to term children.