Impaired picture sequencing ability in children with premature birth

Abstract

Background: Children born preterm are at increased risk for executive dysfunction, which affects learning outcomes. Picture sequencing ability is considered as executive function (EF) that requires skills in working memory and organizing the pictures. Children born preterm might have difficulties in these skills. The present study aimed to develop practical Picture Sequencing test (PS test) and examine the sequencing ability in preterm children comparing with term children. Material and Method: The PS test was developed to assess the child's ability to arrange pictures into a sequence. It consisted of three conditions, which were daily activities, social interaction routines, and feeling expressions. Each story had four cartoon styles cards. The child had to rearrange picture cards into the correct sequence positions. Thirty preterm children aged five to six years with gestational ages of ≤32 weeks and birth weights of <1,500 grams, and thirty-five term children matched age, gender, child's education, parental education, and socioeconomic status were performed the PS test. The total scores were compared between the preterm group and the term group. Results: The PS test scores on the daily activities domain of the preterm and term group were 18 and 25 (p = 0.03), respectively. The scores on the social interaction routines domain of the preterm and term group were 20 and 28 (p = 0.01) and the scores on the feeling expression domain were 18.5 and 25 (p = 0.03), respectively. There was no significant correlation between perinatal complications and the PS test scores. Conclusion: The preterm children with IQs in the average range showed impairment in sequencing ability compared with the term children. The results underline the need for follow-up care with more comprehensive assessment of EF.