Individual variability in neural correlates of visual engagement in premature toddlers.

Prematurity disrupts in-utero processes that support neurocognitive development, with children born preterm at increased risk for long-term difficulties. Little is known about how prematurity affects early development of neural systems supporting visual engagement, or whether early variability in engagement relates to later attention outcomes. The present study examined behavioral and neural correlates of visual engagement in toddlers born prematurely using a developmentally appropriate computerized attention paradigm, involving attention capturing stimuli varying in duration, location, and motion while EEG was recorded. Visual engagement based on looking time and alpha power, a neural marker of cortical activation modulated by visual attention, were quantified in response to task stimuli and a resting baseline. Toddlers whose parents reported higher education levels showed greater overall looking time to visual stimuli. There was not a significant effect of gestational status on this behavioral response. In contrast, gestational status was associated with greater alpha power during rest relative to visual engagement. Toddlers born closer to term showed a larger rest-engagement difference in alpha power, whereas toddlers born at earlier gestational ages showed a smaller difference driven by lower resting alpha. This pattern in earlier-born toddlers may reflect delayed or disrupted maturation of this neural signature and may represent a neural substrate of prospective attention difficulties.