Multimodal Executive Function Measurement in Preschool Children Born Very Low Birth Weight and Full Term: Relationships Between Formal Lab-Based Measure Performance, Parent Report, and Naturalistic Observational Coding

The aim of this study was to compare executive function (EF) in preschoolers born very low birth weight (VLBW ≤ 1500 g) and full term (FT) using performance measures of EF, parent report of EF, and naturalistic child behaviors. Examining the relationship between multimodal measures of EF may elucidate the interrelations between EF measurement methods. Participants included 61 preschoolers born VLBW and 40 born FT between the ages of 3 and 4.5 years. Performance measures of EF (Bear Dragon, Dimensional Change Card Sort-Separated Dimensions (DCCSS), Gift Peek, and Gift Touch), parent report of EF (BRIEF-P), and naturalistic child behaviors (NICHD Cleanup Child Defiant Noncompliance) were utilized. FT preschoolers showed superior EF over VLBW preschoolers across all types of EF measures. These differences remained after correcting for age, maternal education, and WPPSI-III FSIQ. While performance measures of EF correlated highly in both FT and VLBW groups, different patterns by birth weight group emerged with parent report and naturalistic behavioral coding. In the VLBW group, BRIEF-P GEC correlated with working memory, switching, and inhibition-based tasks, while better compliance during a cleanup task was associated with better performance in the inhibition-based tasks. In contrast, in the FT sample, parent report and naturalistic behavioral coding scores were not correlated with any other EF measures. Children born VLBW had poorer EF outcomes than the FT group, regardless of measurement method. Correlations among multi-method measures of EF demonstrated different patterns of association in the VLBW and FT groups; BRIEF-P and compliance scores were only associated with other EF measures in the VLBW group.