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Processing Speed Mediates Executive Function Difficulties in Very Preterm Children in Middle Childhood

Published online by Cambridge University Press:  28 March 2011

Hanna Mulder*
School of Clinical Sciences, University of Nottingham, Nottingham, United Kingdom
Nicola J. Pitchford
School of Psychology, University of Nottingham, Nottingham, United Kingdom
Neil Marlow
School of Clinical Sciences, University of Nottingham, Nottingham, United Kingdom
Correspondence and reprint requests to: Hanna Mulder, Faculty of Social Sciences, Department of Pedagogical Sciences, Utrecht University, PO Box 80.140, 3508 TC Utrecht, The Netherlands. E-mail:


Executive function and attention difficulties are reported in very preterm (VPT) children at school entry, but it is unclear if these remain at later ages and/or if these difficulties are mediated by more basic functions, such as processing speed. Processing speed has been shown to underlie academic and behavioral problems in VPT children in middle childhood (Mulder, Pitchford, & Marlow, 2010, 2011), so may also underpin executive function and attention difficulties. We investigated this by comparing VPT (gestational age <31 weeks; N = 56) to term children (N = 22) aged 9–10 years on a comprehensive battery of executive function and attention tasks from the Test of Everyday Attention for Children (Manly, Robertson, Anderson, & Nimmo-Smith, 1999) and NEPSY (Korkman, Kirk, & Kemp, 1998). Selective and sustained attention, inhibition, working memory, shifting, verbal fluency, planning, and processing speed were examined. Group differences favoring term children were shown on most executive function tasks (i.e., inhibition, working memory, verbal fluency, and shifting), all of which were mediated by slow processing speed in the VPT group, except response inhibition. Seemingly, processing speed is an important determinant underpinning many neuropsychological deficits seen in VPT children in middle childhood. (JINS, 2011, 17, 445–454)

Research Articles
Copyright © The International Neuropsychological Society 2011

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