Executive and non-executive functions in low birthweight/preterm adolescents with differing temporal patterns of inattention.

Marisa N Spann,Anna Silberman,J Blake Turner,Agnes H Whitaker,Steven J Korzeniewski,Judith Feldman

doi:10.1371/journal.pone.0231648

Abstract

ObjectiveThis study assesses whether low birthweight/preterm (LBW/PT) adolescents with persistent inattention (PIA) have neuropsychological deficits that distinguish them from adolescents with school age limited inattention (SAL) and those largely unaffected (UA).MethodThree latent classes (PIA, SAL, UA), derived from an earlier analysis of a LBW/PT birth cohort were compared on non-executive and executive functioning measures assessed at age 16.ResultsThe PIA class displayed the poorest performance on executive functioning, which was exaggerated in the context of lower IQ. The PIA and the SAL classes had poorer performance on non-executive functioning relative to the UA class. Both types of functioning mediated the relationship of class to school service use and grade retention.ConclusionNeuropsychological impairment characterizes children and adolescents with inattention problems. Problems in executive functioning characterize the subset whose inattention persists through adolescence. Subsequent research can examine the potential for remediating these deficits to address academic and social problems.

Highlights

Attention Deficit Hyperactivity Disorder (ADHD), a clinical diagnosis typically first made in childhood, is defined as the presence of a minimum number of inattentive (IA) and hyperactive-impulsive (HI behaviors, in varying proportions termed Predominantly HI, Predominantly IA and Combined presentations), accompanied by cross-situational impairment
The persistent inattention (PIA) class displayed the poorest performance on executive functioning, which was exaggerated in the context of lower intellectual quotient (IQ)
Subsequent research can examine the potential for remediating these deficits to address academic and social problems

Summary

Introduction

Attention Deficit Hyperactivity Disorder (ADHD), a clinical diagnosis typically first made in childhood, is defined as the presence of a minimum number of inattentive (IA) and hyperactive-impulsive (HI behaviors, in varying proportions termed Predominantly HI, Predominantly IA and Combined presentations), accompanied by cross-situational impairment. ADHD is a public health concern: it affects 9% of school-age children [1, 2], and is associated with suboptimal educational and occupational outcomes in adolescence and adulthood [3,4,5,6] This is true even for the large majority (up to 70%) of children whose IA and HI symptoms fall below threshold for diagnosis by adolescence, and even more so for the substantial minority (30%) who still have an ADHD diagnosis, most commonly the Predominantly Inattentive presentation, as adolescents [7]. Often termed ‘non-executive’ (basic, not effortful), includes processing speed, memory, and sustained attention (see Table 1 for detailed description of these functions) These functions emerge early in development and appear to be dependent on subcortical structures [13]. The findings have been inconsistent [4, 15,16,17,18,19,20]

Methods

Results

Conclusion