Abstract
Background/Aim: Adolescents with low birth weight are reported to have an increased prevalence of ADHD. Few studies have reported on executive functions in these children. The aim of this study was to examine attention and executive functions in two groups of low birth weight adolescents compared to controls.
Design/methods: At age 14, two groups of adolescents with low birth weight (54 prematures with birth weight <1500 g (VLBW) and 60 small for gestational age born at term (SGA)) were compared to 83 controls with normal birth weight at term. Intellectual abilities were assessed using vocabulary and block design from the WISC-III. Attention was assessed by Conners' Continuos Performance Test (CPT-II), the Stroop Colour-Word test, Trail Making Test A&B (TMT A&B), and the Knox Cube test. Executive functions were assessed with Wisconsin card sorting test (WCST).
Results: On the CPT-II there were no differences in the scores of attention, impulsivity or vigilance between the groups and all were within normal limits. In contrast, the performances on Stroop, TMT A&B and the Knox Cube indicated problems with divided attention, active attention control and attention span among VLBW, but not SGA and controls. The differences persisted when adolescents with low IQ were excluded. In contrast to CPT-II, these tests demand mobilising initiative, scanning and active attention control. These abilities are elements of executive functions. To what extent tests of attention demands executive abilities may therefor be crucial to the outcome. The results on WCST suggests unsystematic problem solving, repetition of errors, and a poor ability to adjust responses to feedback in the VLBW but not in the other groups and thus problems with executive functions.
Conclusion: Our results suggest that attention problems in VLBW adolescents are not in the ADHD spectrum as assessed by the CPT-II, but may reflect dysfunctions in various aspects of executive abilities. We speculate that attention problems in VLBW adolescents may reflect a combination of attention and executive problems rather than classical ADHD.
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Kulseng, S., Vik, T., Skranes, J. et al. 140 Are Attention Problems Associated with Executive Dysfunctions in Adolescents with Low Birthweight?. Pediatr Res 56, 488 (2004). https://doi.org/10.1203/00006450-200409000-00163
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DOI: https://doi.org/10.1203/00006450-200409000-00163