Toddler skills predict moderate-to-late preterm born children’s cognition and behaviour at 6 years of age

OBJECTIVE: To compare moderate-to-late preterm born (32–36 weeks’ gestation) to full term born (≥37 weeks’ gestation) children in cognitive and behavioural functioning at the age of 6 years and assess which toddler skills predict later cognitive and behavioural functioning. DESIGN: A prospective longitudinal study with a cohort of 88 moderate-to-late preterm and 83 full term born Dutch children, followed from 18 months to 6 years of age. Orienting, alerting and executive attention skills were assessed at 18 months (corrected for prematurity), and cognitive, motor and language skills (Bayley-III-NL) at 24 months (corrected for prematurity). At 6 years (corrected for prematurity), cognitive (indices of IQ; WPPSI-III-NL) and behavioural functioning (CBCL/6-18) were assessed. Group differences and potential predictors were examined with MANCOVAs and hierarchical regression analyses. RESULTS: At 6 years, moderate-to-late preterm born children performed poorer than full term born children on cognitive processing speed, and they showed more behavioural attention problems. Attention problems at 6 years were predicted by poorer orienting attention skills at 18 months, while lower performance IQ was predicted by poorer alerting attention skills at 18 months. Full Scale IQ and Verbal IQ at 6 years were predicted by language skills at 24 months. Moderate-to-late preterm and full term born children showed some differing correlational patterns in the associations between early skills and later functioning, although in further analyses predictors appeared the same for both groups. CONCLUSIONS: Moderate-to-late preterm born children show specific vulnerabilities at primary school-age, particularly in cognitive processing speed and behavioural attention problems. Cognitive and behavioural functioning at 6 years can be predicted by differentiated attention skills at 18 months and language skills at 24 months.