Hot and cool executive functions in very and extremely preterm preschool children

BACKGROUND In most countries, premature deliveries constitute 5% to 18% of births. Some preterm children, especially those born before 32 weeks of pregnancy, experience serious medical complications, which can affect their subsequent development and functioning. Even those who have an IQ within the normal range can be at risk of worse functioning. This study aimed to investigate the differences in development of hot and cool aspects of executive functions in children born prematurely in comparison to those born on time. It is also focused on evaluating relationships between executive functions in premature children and their socio-emotional competences. PARTICIPANTS AND PROCEDURE All children participating in the study were preschoolers. The sample consisted of 20 children born before 32 weeks of gestation and 28 term controls (children born on time). Hot and cool aspects of executive functions were examined in both groups using tasks extracted from the Preschool Self-Regulation Assessment (PSRA). Parents of children born prematurely also completed the Strengths and Difficulties Questionnaire (SDQ), which is a brief behavioral screening questionnaire that consists of five scales: emotional symptoms, conduct problems, hyperactivity/inattention, peer relationship problems and prosocial behavior. RESULTS Premature children scored lower for both hot and cool executive functions in comparison to the children born at term in two of the five tasks. In addition, an association between worse executive functioning and more severe problems was found in the preterm group. This link applies to both general and specific problems, such as hyperactivity/inattention and behavioral problems. CONCLUSIONS Prematurely born children may have larger deficits both in hot and cool aspects of executive functions compared to their peers born at term. Deficits in hot aspect may be reflected in hyperactivity/inattention symptoms and conduct problems, whereas difficulties in cool aspect may be more related to the general picture of problems in prematurely born children.