| 1. |
- Kaul, Ylva Fredriksson, et al.
(author)
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Visual tracking in very preterm infants at 4 mo predicts neurodevelopment at 3 y of age
- 2016
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In: Pediatric Research. - : Springer Science and Business Media LLC. - 0031-3998 .- 1530-0447. ; 80:1, s. 35-42
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Journal article (peer-reviewed)abstract
- BACKGROUND: Typically developing infants track moving objects with eye and head movements in a smooth and predictive way at 4 mo of age, but this ability is delayed in very preterm infants. We hypothesized that visual tracking ability in very preterm infants predicts later neurodevelopment. METHOD: In 67 very preterm infants (gestational age<32wk), eye and head movements were assessed at 4 mo corrected age while the infant tracked a moving object. Gaze gain, smooth pursuit, head movements, and timing of gaze relative the object were analyzed off line. Results of the five subscales included in the Bayley Scales of Infant Development (BSID-III) at 3 y of age were evaluated in relation to the visual tracking data and to perinatal risk factors. RESULTS: Significant correlations were obtained between gaze gain and cognition, receptive and expressive language, and fine motor function, respectively, also after controlling for gestational age, severe brain damage, retinopathy of prematurity, and bronchopulmonary dysplasia. CONCLUSION: This is the first study demonstrating that the basic ability to visually track a moving object at 4 mo robustly predicts neurodevelopment at 3 y of age in children born very preterm.
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| 2. |
- Bolk, Jenny, et al.
(author)
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National population-based cohort study found that visual-motor integration was commonly affected in extremely preterm born children at six-and-a-half years
- 2018
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In: Acta Paediatrica. - : WILEY. - 0803-5253 .- 1651-2227. ; 107:5, s. 831-837
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Journal article (peer-reviewed)abstract
- Aim: This study aimed to explain the relationship between visual-motor integration (VMI) abilities and extremely preterm (EPT) birth, by exploring the influence of perinatal variables, cognition, manual dexterity and ophthalmological outcomes. Methods: This was part of the population-based national Extremely Preterm Infant Study in Sweden (EXPRESS) study. We studied 355 children, born at a gestational age of <27 weeks from April 2004 to March 2007, and 364 term-born controls. At six-and-a-half years of age, we assessed VMI, cognitive function, motor skills and vision. VMI impairment was classified as <-1 standard deviation (SD). Results: The mean (SD) VMI score was 87 (+/- 12) in preterm children compared to 98 (+/- 11) in controls (p < 0.001). VMI impairment was present in 55% of preterm infants and in 78% of children born at 22-23 weeks. Male sex and postnatal steroids showed a weak association with poorer visual-motor performance, whereas low manual dexterity and cognitive function showed a stronger association. Conclusion: Poor VMI performance was common in this EXPRESS cohort of children born EPT. Its strong association to cognition and manual dexterity confirms that all of these factors need to be taken into account when evaluating risks in preterm born children.
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| 3. |
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| 4. |
- Fredriksson Kaul, Ylva
(author)
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From Eye to Mind : Early Visuomotor Performance and Developmental Trajectories in Children Born Preterm
- 2022
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Doctoral thesis (other academic/artistic)abstract
- Children born very preterm, at less than 32 weeks of gestation, have an increased risk of developing problems with attention, cognition, perception and motor function. Despite this, the developmental trajectories leading from preterm birth to later impairments are not fully understood.This thesis focused on investigating the development of the visuomotor system in infants born very preterm, in relation to neurodevelopment at 2.5-3 years (including cognitive, language and motor functions) and 6.5 years (including cognitive functions and attention). Two early visuomotor functions were investigated: at 4 months of corrected age we looked at their visual tracking of moving objects and at 8 months of corrected age we examined how they reached for moving objects. Visual tracking performance is the ability to follow, sustain attention on and predict the future positions of a moving object. When infants reach for moving objects, these requirements are enhanced by movements of the arm and hand.This was a prospective, population-based cohort study of children born very preterm in 2004-2007, who were longitudinally assessed from the neonatal period until 6.5 years of age. The results showed that the two most important early visual tracking parameters were gaze gain, which is effectively combining eye and head movements to follow the trajectory of the object, and timing of gaze to the motion of the object. Gaze gain correlated with neurodevelopment at 2.5-3 years and with cognition and attention at 6.5 years. Early reaching was also related to outcomes at 2.5-3 years, but the pattern differed for children born before and after 28 weeks of gestation. Parameters of prediction and movement planning were the most important factors for the children of the lowest gestational age, but strategies and success had greater associations with later function in those who were less premature.The results confirmed that children born very preterm in the first decade of the 2000’s still faced increased risks of developmental delays. Early visual tracking performance, and reaching for moving objects, were shown to be important visuomotor functions in the developmental process of children born very preterm. The studies in this thesis illustrate how early basic functions were related to different neurodevelopmental areas at a later stage and offer important new insights into developmental trajectories of children at risk of developmental impairments. These findings suggest that attention and predictive elements of adjusting one´s movements to motion, may be key mechanisms and possible targets in future intervention studies.
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| 5. |
- Fredriksson Kaul, Ylva, et al.
(author)
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Visual tracking at 4 months in preterm infants predicts 6.5-year cognition and attention
- 2022
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In: Pediatric Research. - : Springer Nature. - 0031-3998 .- 1530-0447. ; 92:4, s. 1082-1089
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Journal article (peer-reviewed)abstract
- BACKGROUND: Visual tracking of moving objects requires sustained attention and prediction of the object’s trajectory. We tested the hypothesis that measures of eye-head tracking of moving objects are associated to long-term neurodevelopment in very preterm infants.METHODS: Visual tracking performance was assessed at 4 month’s corrected age in 57 infants with gestational age <32 weeks. An object moved in front of the infant with sinusoidal or triangular (i.e. abrupt) turns of the direction. Gaze gain, smooth pursuit gain, and timing of gaze to object motion were analyzed. At 6.5 years the Wechsler Intelligence Scale for Children (WISC-IV), the Brown Attention Deficit Disorder (Brown ADD), and visual examination were performed. RESULTS: Gaze gain and smooth pursuit gain at 4 months were strongly related to all WISC-IV parameters at 6.5 years. Gaze gain for the triangular and sinusoidal motion patterns related similarly to the cognitive scores. For the sinusoidal motion pattern, timing related to most Brown ADD parameters. There were no statistically significant differences in associations dependent on motion pattern. Visual function did not influence the results. CONCLUSION: The ability to attend to and smoothly track a moving object in infancy is an early marker of cognition and attention at 6.5 years.
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| 6. |
- Hreinsdottir, Jonina, et al.
(author)
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Impaired cognitive ability at 2.5 years predicts later visual and ophthalmological problems in children born very preterm
- 2018
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In: Acta Paediatrica. - : Wiley. - 0803-5253 .- 1651-2227. ; 107:5, s. 822-830
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Journal article (peer-reviewed)abstract
- Aim: To identify possible predictive factors for visual problems at 6.5 years in children born very preterm.Methods: During 2004–2007, all very preterm infants (gestational age [GA] <32 weeks) in Uppsala County, Sweden were screened for retinopathy of prematurity (ROP) neonatally; at four months, visual tracking was tested; at 2.5 years, visuospatial and cognitive tests were carried out. At 6.5 years, 84 preterm children and a reference group of 64 full‐term children underwent ophthalmological testing.Results: Mean visual acuity (VA) did not differ between the groups, but subnormal VA (≤0.8) was more common in the preterm group (31% vs 14%; p < 0.05). More often than full‐term children, preterm children had impaired contrast sensitivity (<0.5) (36% vs 19%; p < 0.05) and strabismus (8% vs 0%; p < 0.05). Low GA, ROP, intraventricular haemorrhage 3‐4/periventricular leukomalacia and cognitive disability at 2.5 years predicted ophthalmological and visual problems at 6.5 years. Visual tracking ability at four months was not predictive of ophthalmological outcome.Conclusion: Children born preterm had more ophthalmological problems at 6.5 years of age, including subtle dysfunctions. ROP, early brain injury and impaired cognitive function around 2.5 years predicted later ophthalmological dysfunctions.
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| 7. |
- Johansson, Martin, et al.
(author)
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Different aspects of visual perception are important for 12-year social functioning depending on gestational age
- 2023
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In: Acta Paediatrica. - : John Wiley & Sons. - 0803-5253 .- 1651-2227. ; 112:7, s. 1537-1547
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Journal article (peer-reviewed)abstract
- AimPerceptual mechanisms in social functioning might promote interventions. We investigated relations between visual perception and social functioning, in preterm children.MethodsA prospective preterm cohort born in Uppsala County, Sweden, in 2004–2007 and 49 full-term controls were examined at 12 years. Aspects of visual perception, including static shapes, emotions and time to detect biological motion, were related to social functioning and visual acuity.ResultsThe preterm group comprised 25 extremely preterm children, EPT, born below 28 gestational weeks and 53 children born between 28 and 31 weeks. Preterm children had difficulties in perception of static shapes (p = 0.004) and biological motion (p < 0.001), but not in emotion perception, compared to controls. In the EPT children, poorer shape perception and lower scores on emotion perception were associated with more social problems (p = 0.008) and lower visual acuity (p = 0.004). Shape perception explained more variance in social functioning than emotion perception. In controls, fewer social problems were linked to faster biological motion perception (p = 0.04).ConclusionStatic shape and biological motion perception was affected in the preterm groups. Biological motion perception was relevant for social functioning in full-term children. In EPT children, only shape perception was linked to social functioning, suggesting differential visual perception mechanisms for social deficits.
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| 8. |
- Karimi, Annette, et al.
(author)
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Brain MRI findings and their association with visual impairment in young adolescents born very preterm
- 2024
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In: Neuroradiology. - : Springer. - 0028-3940 .- 1432-1920. ; 66:1, s. 145-154
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Journal article (peer-reviewed)abstract
- PurposeVery preterm birth increases risk for neonatal white matter injury, but there is limited data on to what extent this persists into adolescence and how this relates to ophthalmological outcomes. The aim of this study was to assess brain MRI findings in 12-year-old children born very preterm compared to controls and their association with concurrent ophthalmological outcomes.MethodsWe included 47 children born very preterm and 22 full-term controls (gestational age <32 and >37 weeks, respectively). Brain MRI findings were studied in association with concurrent ophthalmological outcomes at 12-year follow-up.ResultsEvans index (0.27 vs 0.25, p<0.001) and a proposed “posterior ventricle index” (0.47 vs 0.45, p=0.018) were increased in children born very preterm. Higher gestational age associated with larger corpus callosum area (β=10.7, 95%CI 0.59–20.8). Focal white matter lesions were observed in 15 (32%) of very preterm children and in 1 (5%) of full-term controls. Increased posterior ventricle index increased risk for visual acuity ≤1.0 (OR=1.07×1011, 95%CI=7.78–1.48×1021) and contrast sensitivity <0.5 (OR=2.6×1027, 95%CI=1.9×108–3.5×1046). Decreased peritrigonal white matter thickness associated with impaired visual acuity (β=0.04, 95%CI 0.002–0.07).ConclusionMore white matter lesions and evidence of lower white matter volume were found in children born very preterm compared with full-term controls at 12-year follow-up. The association between larger posterior ventricle index and reduced visual acuity and contrast sensitivity suggests disturbances of the posterior visual pathway due to diffuse white matter lesions.
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| 9. |
- Kaul, Ylva Fredriksson, et al.
(author)
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Cognitive profiles of extremely preterm children : Full-Scale IQ hides strengths and weaknesses
- 2021
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In: Acta Paediatrica. - : John Wiley & Sons. - 0803-5253 .- 1651-2227. ; 110:6, s. 1817-1826
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Journal article (peer-reviewed)abstract
- Aim: To study whether a specific cognitive profile can be identified for children born extremely preterm (EPT) by investigating: 1) strengths and weaknesses not revealed by Full-Scale IQ, 2) overlap between different cognitive deficits and 3) proportion of EPT children with multiple deficits.Methods: We analysed data from the 4th version of Wechsler Intelligence Scales for Children in EPT children (n = 359) and matched controls (n = 367), collected within the 6.5-year follow-up of a population-based prospective cohort study.Results: Extremely preterm children performed worse than controls on all measures. Group differences were the largest in Perceptual Reasoning (PRI) and Working Memory (WMI), but differences between indices were small. However, when conducting categorical analyses, deficits in PRI and/or WMI were not more common than other combinations. Many EPT children had no or mild cognitive deficits, although often in multiple domains.Conclusion: Extremely preterm children had greater weaknesses in working memory and perceptual abilities. However, detailed analyses of cognitive subscales showed large heterogeneity and provided no support for a specific cognitive profile. In conclusion, Full-Scale IQ scores hide strengths and weaknesses and individual profiles for EPT children need to be considered in order to provide appropriate support.
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| 10. |
- Kaul, Ylva Fredriksson, et al.
(author)
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Reaching skills of infants born very preterm predict neurodevelopment at 2.5 years
- 2019
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In: Infant Behavior and Development. - : Elsevier. - 0163-6383 .- 1879-0453. ; 57
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Journal article (peer-reviewed)abstract
- The purpose was to investigate associations between quality of reaching for moving objects at 8 months corrected age and neurodevelopment at 2.5 years in children born very preterm (gestational age (GA), 24–31 weeks). Thirtysix infants were assessed while reaching for moving objects. The movements were recorded by a 3D motion capture system. Reaching parameters included aiming, relative length of the reach, number of movement units, proportion of bimanual coupled reaches and number of hits. Neurodevelopment was assessed at 2.5 years by the Bayley Scales of Infant Development III. There were strong associations between infant reaching kinematics and neurodevelopment of cognition and language but the patterns differed: in children born extremely preterm (GA < 28 weeks), planning and control of reaching was strongly related to outcome, while in children born very preterm (GA 28–31 weeks) number of hits and bimanual strategies were of greater relevance. In conclusion, for extremely preterm infants, basic problems on how motion information is incorporated with action planning prevail, while in very preterm infants the coordination of bimanual reaches is more at the focus. We conclude that the results reflect GA related differences in neural vulnerability and that early motor coordination deficits have a cascading effect on neurodevelopment.
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