Early Visual Attention in Preterm and Fullterm Infants in Relation to Cognitive and Motor Outcomes at School Age: An Exploratory Study

Abstract

Objective: Preterm infants are exposed to the visual environment earlier than fullterm infants, but whether early exposure affects later development is unclear. Our aim was to investigate whether the development of visual disengagement capacity during the first 6 months postterm was associated with cognitive and motor outcomes at school age, and whether associations differed between fullterms and low-risk preterms.Method: Seventeen fullterms and ten low-risk preterms were tested in a gaze shifting task every 4 weeks until 6 months postterm. The longitudinal data were converted into single continuous variables by fitting the data with an S-shaped curve (frequencies of looks) or an inverse model (latencies of looks). Neuropsychological test results at school age were converted into composite z scores. We then performed linear regression analyses for each functional domain at school age with the variables measuring infant visual attention as separate predictors and adjusting for maternal level of education and group (fullterms versus preterms). We included an interaction term, visual attention*group, to determine whether predictive relations differed between fullterms and preterms.Results: A slower development of disengagement predicted poorer performance on attention, motor skills, and handwriting, irrespective of fullterm or preterm birth. Predictive relationships differed marginally between fullterms and preterms for inhibitory attentional control (P = 0.054) and comprehensive reading (P = 0.064).Conclusion: This exploratory study yielded no indications of a clear advantage or disadvantage of the extra visual exposure in healthy preterm infants. We tentatively conclude that additional visual exposure does not interfere with the ongoing development of neuronal networks during this vulnerable period of brain development.

Gender affects early psychomotor milestones and long‐term neurodevelopment of preterm infants

“…In 80 low-risk late PT with a GA between 34.0 and 36.9 weeks assessed at birth and at term equivalent age, some aspects of visual abilities at term equivalent age such as attention at distance and ability to discriminate black/white stripes showed more mature findings in late PT infants than FT infants. This interesting point of view was reported by several authors that emphasized how the effects of the early visual "hyperstimulation" were a driving force to promote visual development (Sansavini, Guarini, & Caselli, 2011;Hitzert, van Braeckel, Bos, & Hunnius, 2014). Our findings might suggest an influence on visual and visuomotor skills achievement played by gender rather than prematurity, being these skills poorer not only in male infants born with moderate prematurity but also in FT ones.…”

Executive function deficits in children born preterm or at low birthweight: a meta‐analysis

“…A total of 45 studies met all the inclusion criteria. Executive function data were provided by 35 of these studies (3360 children born preterm/low birthweight and 2812 term‐born controls) either in the study paper or after a request for additional data sent to the authors . The characteristics and main study results are given in (Tables SI, SII, and SIII, online supporting information; working memory, inhibition, and cognitive flexibility respectively).…”

Rapid infant prefrontal cortex development and sensitivity to early environmental experience

“…Longitudinal studies have also convincingly demonstrated that infant measures of complex attention, memory, and inhibition skills are predictive of EF measures in later childhood. For example, individual differences in infant measures reflecting the ability to both sustain and flexibly shift attention are predictive of EF during childhood and adolescence (Cuevas & Bell, 2014; Johansson, Marciszko, Gredebäck, Nyström, & Bohlin, 2015; Papageorgiou et al, 2014; Sigman, Cohen, & Beckwith, 1997; Sigman, Cohen, Beckwith, Asarnow, & Parmelee, 1991), both in typically developing infants and in at-risk populations (Hitzert, Van Braeckel, Bos, Hunnius, & Geuze, 2014; Rose, Feldman, Jankowski, & Van Rossem, 2012). These predictive relationships typically remain even after controlling for general intellectual ability (e.g.…”

“…In a series of elegant, longitudinal studies beginning in infancy, Rose, Feldman, and Jankowski demonstrated that higher-level attentional processes are altered across the first years of life in higher-risk PT infants, contributing to later differences in adolescent EF skills (see Rose, Feldman, & Jankowski, 2016 for summary). Interestingly, lower-risk PT infants may show a slight “benefit” in attentional processing earlier in development; lower-risk PT infants are faster at disengaging and shifting attention than their full-term peers, although this “benefit” in attention typically disappears by 4–6 months of age (Hitzert et al, 2015, 2014; Hunnius, Geuze, Zweens, & Bos, 2008). Other studies have also found that lower-risk PT infants perform better on early attention measures than their higher-risk PT peers (Landry & Chapieski, 1988; Reuner, Weinschenk, Pauen, & Pietz, 2015).…”