Object permanence and the development of attention capacity in preterm and term infants: an eye-tracking study

The neuropsychology of early childhood and infancy

OBJECTIVES

Piaget's theory emphasizes the biological structures children utilize to make sense of their environment and based on those experiences become able to adapt. Many factors can intervene in the gradual and complex process of development, causing an array of issues both acute and chronic.

METHOD

Several studies have found that disability in the early months is a strong predictor of cognitive impairment in preschool. The presence of early functional anomalies may represent developmental delay and/or neurodevelopmental disorders.

RESULTS

Understanding the risk factors and detecting such signs early on is important to prevent or minimize later cognitive, behavioral, and psychosocial problems. The study aims to emphasize how critical the early years are to a child's future cognitive, physical, emotional, and social development as well as their overall well-being.

DISCUSSION

In addition, the fact that crucial developmental stages can be hampered or obstructed by a variety of factors is highlighted.

Eye-Movements in a Text Reading Task: A Comparison of Preterm Children, Children with Dyslexia and Typical Readers

Preterm birth is associated with weaknesses in reading skills that are usually less severe than those of children with dyslexia. To understand the characteristics of reading processes in preterm children, we adopted a cross-population and multi-modal approach comparing eye movements in reading tasks among three groups: children with preterm birth, children with a diagnosis of dyslexia, and children with typical development. The study involved 78 participants (10.5 years). Eye movements (number and duration of fixations, amplitude and number of saccades, number of regressions) were recorded during the silent reading of two texts; cognitive and reading standardized tasks were also administered. Children with dyslexia had more fixations and more frequent and smaller saccades compared to the preterm group and children with typical development. They also showed more regressions compared to the control group. Preterm children showed shorter fixations compared to the other groups. Cognitive and reading standardized tasks confirmed severe delays in reading in children with dyslexia and some weaknesses in text reading speed and comprehension in preterm children. These results are discussed with reference to candidate mechanisms that underlie reading processes in preterm children and considering possible implications for research.

Eye tracking based assessment of lexical processing and early lexical development in very preterm children

BACKGROUND

Associations between lexical processing and lexical development during the second year of life have been little studied in preterm children.

AIMS

To evaluate associations between lexical processing at 18 months and lexical development between 12 and 18 months in very preterm children.

STUDY DESIGN

Correlational study.

SUBJECTS

25 Finnish-speaking children born <32 gestational weeks.

OUTCOME MEASURES

Lexical processing (reaction time RT; correct looking time CLT) was measured with an eye tracking technology-based task at 18 months' corrected age. Lexical development was measured longitudinally at 12-, 15- and 18-months' corrected age using the following screening instruments: the short form version of the MacArthur Communicative Development Inventories and the Communication and Symbolic Behavior Scale: Infant-Toddler Checklist.

RESULTS

The longer the RT of the child, the weaker expressive skills the child had at 12 and 15 months (correlations coefficient values -0.45 to -0.51). The more the child looked at the target image compared to the distractor (CLT), the stronger expressive skills the child had at 18 months (r = 0.45-0.52). A linear regression model with RT and gender as independent variables explained 33 % of the variance in lexical skills at 18 months. A model with CLT explained 40 % of expressive skills at 18 months.

CONCLUSIONS

Lexical processing at 18 months was associated with expressive lexical development in very preterm children. The results suggest eye tracking technology based methods may have utility in the assessment of early lexical growth in preterm children, although further research is needed to assess psychometric properties and predictive value of the method.

Very preterm infants engage in an intervention to train their control of attention: results from the feasibility study of the Attention Control Training (ACT) randomised trial

Background

Very premature birth (gestational age between 28 and 31 + 6 weeks) is associated with increased risk of cognitive delay and attention deficit disorder, which have been linked to anomalies in the development of executive functions (EFs) and their precursors. In particular, very preterm (VP) infants display anomalies in controlling attention and gathering task-relevant information. Early interventions that support attention control may be pivotal in providing a secure base for VP children’s later attainments. The Attention Control Training (ACT) is a cognitive training intervention that targets infants’ abilities to select visual information according to varying task demands but had not been tested in VP infants. We conducted a feasibility study to test the processes we intend to use in a trial delivering the ACT to VP infants.

Methods and design

We tested recruitment and retention of VP infants and their families in a randomised trial, as well as acceptability and completion of baseline and outcome measures. To evaluate these aims, we used descriptive quantitative statistics and qualitative methods to analyse feedback from infants’ caregivers. We also investigated the quality of eye-tracking data collected and indicators of infants’ engagement in the training, using descriptive statistics.

Results

Twelve VP infants were recruited, and 10 (83%) completed the study. Participants’ parents had high education attainment. The rate of completion of baseline and outcome measures was optimal. VP infants demonstrated engagement in the training, completing on average 84 min of training over three visits, and displaying improved performance during this training. Eye-tracking data quality was moderate, but this did not interfere with infants’ engagement in the training.

Discussion

The results suggest the ACT can be delivered to VP infants. However, challenges remain in recruitment of numerous and diverse samples. We discuss strategies to overcome these challenges informed by results of this study.

Trial registration

Registered Registration ID: NCT03896490. Retrospectively registered at Clinical Trials Protocol Registration and Results System (clinicaltrials.gov).

Supplementary Information

The online version contains supplementary material available at 10.1186/s40814-021-00809-z.

Training attention control of very preterm infants: protocol for a feasibility study of the Attention Control Training (ACT)

BACKGROUND

Children born preterm may display cognitive, learning, and behaviour difficulties as they grow up. In particular, very premature birth (gestation age between 28 and less than 32 weeks) may put infants at increased risk of intellectual deficits and attention deficit disorder. Evidence suggests that the basis of these problems may lie in difficulties in the development of executive functions. One of the earliest executive functions to emerge around 1 year of age is the ability to control attention. An eye-tracking-based cognitive training programme to support this emerging ability, the Attention Control Training (ACT), has been developed and tested with typically developing infants. The aim of this study is to investigate the feasibility of using the ACT with healthy very preterm (VP) infants when they are 12 months of age (corrected age). The ACT has the potential to address the need for supporting emerging cognitive abilities of VP infants with an early intervention, which may capitalise on infants' neural plasticity.

METHODS/DESIGN

The feasibility study is designed to investigate whether it is possible to recruit and retain VP infants and their families in a randomised trial that compares attention and social attention of trained infants against those that are exposed to a control procedure. Feasibility issues include the referral/recruitment pathway, attendance, and engagement with testing and training sessions, completion of tasks, retention in the study, acceptability of outcome measures, quality of data collected (particularly, eye-tracking data). The results of the study will inform the development of a larger randomised trial.

DISCUSSION

Several lines of evidence emphasise the need to support emerging cognitive and learning abilities of preterm infants using early interventions. However, early interventions with preterm infants, and particularly very preterm ones, face difficulties in recruiting and retaining participants. These problems are also augmented by the health vulnerability of this population. This feasibility study will provide the basis for informing the implementation of an early cognitive intervention for very preterm infants.

TRIAL REGISTRATION

Registered Registration ID: NCT03896490. Retrospectively registered at Clinical Trials Protocol Registration and Results System (clinicaltrials.gov).