Motor skills and executive functions of 3- to 5-year old preterm children

Background and aim In the last decades mild motor problems and specific cognitive difficulties without major deficits are the most dominant neurodevelopmental sequelae in children born preterm. This study aimed to explore motor skills and executive functions (EF) and their relationship in a group of preterm children 3- to 5-year old. In addition, we considered the comparison between Very Preterm (VP), born equal or less than 32 gestational weeks (GW) and Late Preterm (LP; 33-37 GW) children in each performance domain. Method The study was conducted on 48 preterms (76.6% males; Mean GW= 31.9 weeks, SD 2.6) at preschool age (M= 48.27 months of age, SD=6.9). Developmental assessment included: Coloured Progressive Matrices (CPM); the verbal intelligence Quotient (VIQ) from WPPSI-III; Battery for the Assessment of Executive Functions (BAFE) comprising measures of cognitive, attention flexibility, inhibition control and visual-spatial working memory; Developmental Test of Visual-Motor Integration (VMI); and Movement Assessment Battery for Children-2 (MABC-2) to identify motor function impairment. Data were analysed by using independent t-test of each measure; Chi-square to determine the occurrence of delayed performances into groups; and Pearson correlations among all variables. Results In the whole sample most of children gathered performances within the normal range for cognitive, motor abilities and EF. However, we found that 17.5% of children had potential motor problems, getting an MABC-2 ”Total Score” that falls below the 16th percentile. In particular, 25%, 23.3% and 7.5% scored below the 16th percentile on ”Manual Dexterity” (MD), ”Aiming & Catching” (A&C) and ”Balance” subtests respectively. Moreover, 30% reached a low performance at the motor coordination test of VMI. There are no significant differences between VP and LP on the percentage of children with potential motor problems. Considering the mean differences, we found that VP achieved significant lower scores than LP on MABC-2 ”Total Score” (t=1.19; p=.04) and BAFE ”visual-spatial working memory” task (t=2.08; p=.04). In addition, we found the following significant correlations: CPM related negatively to A&C (r=-.38, p<.05); VMI integration test related positively to MD (r=.43, p< .05). Discussion and conclusion Children born preterm seem to be at risk for motor problems, at pre-school age, in a considerable percentage. VP performed significantly poorer than LP in MABC-2 Total Score and visual-spatial working memory, whereas they are likely to display similarly across other domains. We suggest the importance to evaluate motor skills and EF at preschool age to detect difficulties earlier than primary school entrance and to plan earlyintervention.