All ETDs from UAB

Advisory Committee Chair

Fred J Biasini

Advisory Committee Members

William W Andrews

Sylvie R Mrug

David C Schwebel

Despina Stavrinos

Document Type

Dissertation

Date of Award

2012

Degree Name by School

Doctor of Philosophy (PhD) College of Arts and Sciences

Abstract

Children born prematurely and/or with low birth weight (LBW) are at significantly higher risk than their full-term peers for developing cognitive, behavioral, attention, and executive functioning (EF) difficulties by school-age. The difficulties experienced by this population typically persist well into adolescence and vary as a function of birth weight, with infants weighing less at significantly higher risk for long-term problems. However, there is little consensus with regard to the specific factors that place preterm and LBW children at greatest risk for EF and behavioral impairments. A primary purpose of the current study was to examine the degree to which neonatal/ medical and social/environmental variables influence very low birth weight (VLBW) children's EF and behavioral abilities at school-age. Results indicated that (1) length of time on mechanical ventilation in the neonatal period was related to children's mental flexibility, (2) maternal marital status was related to children's hyperactive/impulsive behavior, and (3) SES was related to children's physical symptoms at school-age. A secondary purpose of the current study was to explore the degree to which performance-based (objective) and parent rating (subjective) measures of EF are related to one another. Research has shown that objective and subjective measures of EF and behavior often yield different results and lack significant intercorrelations. However, the majority of research examining the relationship between these measures employed samples of children or adolescents with brain disease/injury, ADHD, or who were typically-developing. Comparisons between the D-KEFS (objective) and BRIEF (subjective) among VLBW school-aged children in the current study yielded similar results as previously reported. Specifically, results indicate that (1) more children were identified as having significant EF difficulties on the D-KEFS than those identified on the BRIEF and (2) moderate, yet significant, correlations existed between some of the D-KEFS and BRIEF scales. These and the results of a chi-square test of independence suggest that there is a modest relationship between these measures and more children are identified as having EF impairments according to a performance-based measure than those identified according to parent report. The limitations and implications of these results are discussed.

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