Self-regulation task in young school age children born preterm: Correlation with early academic achievement

Background: Children born preterm are at risk for difficulties in executive function (EF), however there are limited tools to assess EF in young children and it is not fully understood how these early deficits are related to emerging academic skills. Aims: To examine (a) early EF differences in young children born preterm, (b) how a measure of behavioral selfregulation correlates with other measures of EF in children born preterm, and (c) how this measure relates to academic outcomes in children born preterm. Study design: Longitudinal cohort study. Subjects: Thirty-three healthy children born preterm (25-32 weeks gestation) and 14 children born full term were assessed before starting kindergarten at age 5 and again at ages 6 and 7 years. Outcome measures: Each assessment included a measure of behavioral self-regulation, the Head Toes Knees Shoulders task (HTKS), performance-based measures of EF, parent rating scales of EF and behavior problems, a measure of motor ability, and academic measures. Results: Children born preterm performed worse on all measures of self-regulation, EF, parent-report, academic outcomes, and motor ability across time. The HTKS had weak to moderate correlations with parent-report and performance-based measures of EF, moderate to strong correlations with academic performance, and was not correlated with motor ability. Conclusion: This study shows the predictive value of early EF measures on functional academic outcomes and their potential as targets of effective interventions in this high-risk population.