European Journal of Pediatrics

, Volume 172, Issue 4, pp 473–483 | Cite as

Executive functions of children born very preterm—deficit or delay?

  • Barbara Catherine Ritter
  • Mathias Nelle
  • Walter Perrig
  • Maja Steinlin
  • Regula Everts
Original Article


This cross-sectional study examined the performance of children born very preterm and/or at very low birth weight (VPT/VLBW) and same-aged term-born controls in three core executive functions: inhibition, working memory, and shifting. Children were divided into two age groups according to the median (young, 8.00–9.86 years; old, 9.87–12.99 years). The aims of the study were to investigate whether (a) VPT/VLBW children of both age groups performed poorer than controls (deficit hypothesis) or caught up with increasing age (delay hypothesis) and (b) whether VPT/VLBW children displayed a similar pattern of performance increase in executive functions with advancing age compared with the controls. Fifty-six VPT/VLBW children born in the cohort of 1998–2003 and 41 healthy-term-born controls were recruited. All children completed tests of inhibition (Color-Word Interference Task, Delis–Kaplan Executive Function System (D-KEFS)), working memory (Digit Span Backwards, HAWIK-IV), and shifting (Trail Making Test, Number–Letter Sequencing, D-KEFS). Results revealed that young VPT/VLBW children performed significantly poorer than the young controls in inhibition, working memory, and shifting, whereas old VPT/VLBW children performed similar to the old controls across all three executive functions. Furthermore, the frequencies of impairment in inhibition, working memory and shifting were higher in the young VPT/VLBW group compared with the young control group, whereas frequencies of impairment were equal in the old groups. In both VPT/VLBW children and controls, the highest increase in executive performance across the ages of 8 to 12 years was observed in shifting, followed by working memory, and inhibition. Conclusions: This study provides evidence that (a) poor performance in inhibition, working memory, and shifting of young VPT/VLBW children might reflect a delay rather than a deficit and (b) that VPT/VLBW children are likely to display a similar pattern of performance increase in these three executive functions compared with that of controls.


Children Preterm Working memory Inhibition Shifting Catch-up 



Born very preterm or at very low birth weight


Executive functions


Working memory



We thank the Swiss National Neonatal Follow- Up Group for their collaboration. The research was funded by the Swiss National Science Foundation (PZ00P1_126309).


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Copyright information

© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  • Barbara Catherine Ritter
    • 1
  • Mathias Nelle
    • 2
  • Walter Perrig
    • 3
    • 4
  • Maja Steinlin
    • 1
    • 4
  • Regula Everts
    • 1
    • 4
  1. 1.Division of Neuropaediatrics, Development and RehabilitationChildren’s University Hospital, InselspitalBernSwitzerland
  2. 2.Division of NeonatologyChildren’s University Hospital, InselspitalBernSwitzerland
  3. 3.Institute of PsychologyUniversity of BernBernSwitzerland
  4. 4.Center for Cognition, Learning and MemoryUniversity of BernBernSwitzerland

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