Preterm Toddlers' Inhibitory Control Abilities Predict Attention Regulation and Academic Achievement at Age 8 Years

Abstract

To determine if adverse effects of preterm birth on attention and academic abilities at age 8 years are mediated by children's inhibitory control abilities. Five hundred fifty-eight children born at 26-41 weeks gestation were studied as part of a prospective geographically defined longitudinal investigation in Germany. Toddlers' inhibitory control abilities were observed at age 20 months. At 8 years, attention and academic abilities were assessed. Preterm birth negatively affected children's inhibitory control abilities (B = .25, 95% CI [.11, .39], P < .001) and directly predicted subsequent low attention regulation (B = .23, 95% CI [.07, .38], P < .001) and academic achievement (B = .10, 95% CI [.03, .17], P < .001), after adjusting for other factors. Higher ability to inhibit unwanted behaviors predicted better later attention regulation (B = .24, 95% CI [.07, .41], P < .001) and academic achievement (B = .10, 95% CI [.03, .17], P < .001). The lower a child's gestational age, the lower the inhibitory control and the more likely that the child had poor attention regulation and low academic achievement. Adverse effects of preterm birth on attention and academic outcomes are partially mediated by toddlers' inhibitory control abilities. These findings provide new information about the mechanisms linking preterm birth with long-term attention difficulties and academic underachievement.