Executive functions in everyday life in children born small for gestational age - a pilot study of pre-term to full-term children 3 years and younger.

backgroundChildren born small for gestational age (SGA) have shown an increased risk of developing cognitive impairment and more difficulties regarding academic performance later in life. However, it is not known whether cognitive impairment can be detected in very young children. This study aimed to investigate whether children born SGA, with a birthweight of ≤ 3 SD, aged 2:6-3:0 years, showed impairments of executive functions in everyday life based on parental ratings, compared to children born appropriate for gestational age (AGA).

methodsThirty children with birth week 33-41, 15 in each group, were included. The children in the groups were matched based on gender, age at testing (± 3 months), and parental educational level. Cognitive development was measured with the Bayley-III assessment. The BRIEF-P was used for parental ratings of the children's executive functioning.

resultsIn terms of development a statistically significant difference between groups was shown regarding language ability, where the SGA group performed slightly worse compared to the AGA group (MD = -10.5 index points; 95% CI = -18.7-2.2; t(14) = -2.7; p = 0.02). No statistically significant differences were found between groups regarding parental ratings on the BRIEF-P.

conclusionsThe study found no significant differences in EF between children born SGA and AGA based on parental ratings. Given the small sample the lower language ability in the SGA group suggests potential EF impairments, which could be detected at a younger age than is presently customary. These findings underscore the need for further research using varied assessment methods and larger samples to better understand EF development in this population. Early discovery of EF impairment is important for enabling adequate interventions for family, school, and health care.