Executive functions in preschool children born preterm: application of cognitive neuroscience paradigms.

Although children born preterm are at risk for neuropsychological impairments at school age and adolescence, including difficulties with visual motor integration, spatial/constructional skills, attention, arithmetic, and nonverbal executive functions, specific neuropsychological outcome has not been investigated adequately in preschoolers. Application of cognitive neuroscience tasks offers the opportunity to characterize early executive functions in young children born preterm. In a preliminary sample of 29 preschool children born preterm (M birth gestational age = 32.4 weeks), executive function outcome was compared to that of fullterm controls by contrasting performance on two prototypic delayed-response-type paradigms, Delayed Alternation and Spatial Reversal. Preschoolers born preterm correctly retrieved the reward on fewer trials on Delayed Alternation than did matched controls. Furthermore, preschool children born preterm used problem-solving strategies that included more perseverative errors than controls. These preliminary findings highlight the utility of cognitive neuroscience paradigms to understand neuropsychological outcome in preschool children born preterm and suggest areas of developmental vulnerability that may include dorsolateral prefrontal circuits.