Executive Function and IQ Predict Mathematical and Attention Problems in Very Preterm Children

Aarnoudse-Moens, Cornelieke Sandrine Hanan; Weisglas-Kuperus, Nynke; Duivenvoorden, Hugo Joseph; van Goudoever, Johannes Bernard; Oosterlaan, Jaap · 2013 · Crossref

DOI: 10.1371/journal.pone.0055994

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Summary

This study investigates the specific contributions of executive function (EF) and intelligence quotient (IQ) to mathematical and attention problems in very preterm children (gestational age ≤30 weeks). While most very preterm survivors avoid severe physical disabilities, they frequently exhibit academic and behavioral difficulties, particularly in mathematics and attention. The research aimed to determine whether impaired EF predicts these outcomes independently of processing speed and IQ, addressing a gap in understanding the neurocognitive mechanisms underlying these common deficits. The study included 200 very preterm children and 230 term-born controls, aged 4 to 12 years, without severe disabilities. Participants were divided into preschool and primary school subsamples. Executive functions assessed included verbal fluency, verbal working memory, visuospatial span, planning, and impulse control. Mathematics was evaluated using standardized tests from the Dutch Pupil Monitoring System, while attention problems were rated by parents and teachers using standardized behavior questionnaires (e.g., CBCL, TRF). Hierarchical linear regression analyses were conducted to calculate the unique variance contributed by EF and IQ, adjusting for processing speed, age, gender, and parental education. Results indicated that very preterm children performed significantly worse on mathematics tests and exhibited more attention problems than term controls. In preschool, IQ uniquely predicted mathematical performance, while impulse control uniquely predicted parent-rated inattention. In primary school, both IQ and EF contributed unique variance to mathematical performance, with visuospatial span being a significant predictor. For attention problems in primary school, IQ showed a stronger predictive effect for very preterm children than for term children. Furthermore, EF components—specifically visuospatial span and impulse control—uniquely predicted teacher-rated inattention, while visuospatial span also predicted parent-rated inattention. Processing speed indices did not significantly predict outcomes once IQ and EF were accounted for. The findings conclude that impaired executive function is an important predictor of poor mathematics and attention problems in very preterm children, independent of IQ deficits. This suggests that mathematical and attentional difficulties in this population are not solely due to lower general intelligence but are also driven by specific higher-order neurocognitive impairments. These results highlight the need for interventions targeting executive functions, such as working memory and impulse control, to mitigate academic and behavioral challenges in very preterm survivors.

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• cognitive capacity variation