TRI's Patricia M. Blasco, Ph.D. presented at the Children’s Rights and Early Intervention Conference, International Society on Early Intervention, which took place in Stockholm, Sweden, June 8 - 10, 2016.

Executive Function in Infants and Toddlers Born Low Birth Weight and Preterm

Dr. Blasco has been working in early childhood development for more than three decades, contributing to the breadth and depth of knowledge and understanding in the field of Early Intervention and Early Childhood Special Education (EI/ECSE).

Her current research is designed to explore “executive function (EF) in infants and toddlers born low birth weight (LBW) and preterm. This study examines whether traditional infant and toddler assessment methods that have components of EF in their structure can discern early indicators of executive functioning in three subgroups of children ages six months to three years,” according to the project's website.

This ongoing study (Project EF) is a partnership between The Research Institute at Western Oregon University and Oregon Health & Science University.

Dr. Blasco has just returned from the Children’s Rights and Early Intervention Conference, International Society on Early Intervention, in Stockholm, Sweden, where she was asked to present the preliminary results from that study.

Click here for more information about the conference.

TRI's Carol Dennis asked Dr. Blasco to share her thoughts and observations from the conference.

Here is that interview.

WHAT LED TO YOU PRESENTING ON PROJECT EF AT THIS INTERNATIONAL CONFERENCE?

I have been a member of the Society [the International Society on Early Intervention] for many years, but because my children were young, I didn't get to take advantage of going to the conferences. This year, the timing was perfect. And the fact that it was in Stockholm was great. I had been to Stockholm before and wanted to go back. So, Sybille Guy [Director of TRI's Center on Research, Evaluation and Analysis] and I sent a proposal and we were selected to present by the conference committee. I was very excited.

WHAT ABOUT THIS ORGANIZATION ATTRACTS YOU?

The whole Society was developed around the idea of early intervention, and the importance of early intervention. Every once in a while, they'll send out an article that someone has published that addresses early intervention and inclusion - or they might send out a question from someone in, say, Poland about how to work with families, and people respond. It was designed so that people are helping each other from all over the world, in terms of early intervention.

THIS YEAR YOU'VE BEEN PRESENTING ON PROJECT EF AT A NUMBER OF CONFERENCES IN THE US. WAS PRESENTING AT THIS CONFERENCE DIFFERENT?

Preparing for the conference was a bit different because we were asked to do a 15 minute presentation. As it turned out Sybille was unable to go, so I prepared a 15 minute session following the [conference] guidelines. This meant much of the information had to be compressed - our typical presentations were approximately an hour and a half. 

I was also asked to be the session leader, which meant I had to keep the other presenters to their time requirement so there would be time for questions. As it turned out, one of the presenters from Spain was unable to make the conference at the last minute, so the presenter from Sweden and I divided the time between us. 

YOU PRESENTED PRELIMINARY DATA FROM YOUR STUDY. CAN YOU DESCRIBE WHAT THOSE RESULTS ARE TELLING YOU?

In terms of the data, so far we have found that children who were born full term scored significantly higher on Expressive Language on the Bayley Scales of Infant and Toddler Development III (Bayley, 2005) than the children who were born low birth weight. We examined the components of Executive Function and found that Attention was significant with children who were full term scoring higher on the items. And, according to a questionnaire completed by parents, children who were born full term were rated higher on a scale of general competence.

[Note: In research parlance, the term "significant" means that the difference found is large enough to show a scientifically valid result.]

DOES THIS TELL YOU ANYTHING ABOUT WHERE THE RESULTS ARE HEADED, IN REGARDS TO YOUR RESEARCH QUESTION? (Whether traditional assessment methods that have components of EF in their structure can discern early indicators of executive function in three subgroups of children ages six months to three years.)

Yes. That children born low birth weight are scoring lower, particularly in areas of language and motor skills. From the cognitive subset, we have pulled out items to make what we call "core components". We are looking at Attention, Working Memory, Emotional Control, Inhibit, Planning and Organize, and Shift (when a child pays attention to one attribute of something and then is able to pay attention to a different attribute of the same item. For example, first the child is asked to identify the color, and then the shape).

Attention is the only one so far that's showing a significant difference with the children born low birth weight having more difficulty with attention, but the other components are trending toward significance. We don't think we're going to see Shift too much with this group until they're older. Developmentally, Shift comes in around three years of age. In Project EF, we're following these children until age 3, so we'll be able to look at this and Planning and Organizing in the three year old assessment. We've just started the 18-month old assessments, so we're a little way away from that.

WHAT DOES THIS MEAN FOR THE FAMILIES OF CHILDREN BORN LOW BIRTH WEIGHT?

We know from some of our fellow researcher at the University of North Carolina, who have actually tried an intervention with families of children born low birth weight, that they have seen positive results. So that's the next step for us - looking for funding for a study where we would look at Executive Function activities that we recommend for families of children born low birth weight, and then seeing if there's an improvement in the child's skills.

I CAN REALLY SEE HOW YOUR STUDY FITS RIGHT INTO THE MISSION OF THE INTERNATIONAL SOCIETY ON EARLY INTERVENTION. HOW WERE YOU AND YOUR WORK RECEIVED?

I was so excited to see that so many international colleagues came to our session.  Also, many folks lined up to sign a request to receive an extended version of the data.  After the session, I spoke with colleagues from Great Britain and the Netherlands who also had presented on Executive Function. We exchanged business cards and agreed to follow each other's research.  I also exchanged cards with a researcher from New Zealand who was very interested in our population and our work in terms of early intervention.

DID ANYTHING AT THE CONFERENCE SURPRISE YOU?

I was amazed at how easy it was to understand the research of colleagues all over the world. All sessions were in English, which of course, made it easy for me, but I found that we are all dedicated to the same ideas about supporting young children and their families. It was so exciting to hear from students of Piaget and also many of my mentors who are still active in worldwide work in early intervention.

[NOTE: Jean Piaget (1896-1980) - Piaget's theory of cognitive development is a comprehensive theory about the nature and development of human intelligence. Piaget believed that one's childhood plays a vital and active role in a person's development. Piaget's idea is primarily known as a developmental stage theory. Wikipedia]

WHY IS PROJECT EF SO IMPORTANT TO YOU?

For many years, I've had the opportunity to work in the neo-natal (NICU) clinic at Oregon Health Science University. But I also had the opportunity, for a short time - for about a year back in 2004, to help out doing some development testing of children who were being tested for learning disabilities. I remember thinking that this is not what I want to be doing with my career. I'm an early childhood person. But it made a connection for me.

I would be sitting there testing these children who were in second grade, third grade, and parents would say, "I knew right from when they were 3 and 4 that there was something different compared to my other children or compared to other children. And the teachers wouldn't listen" because the child was walking, talking, being happy. So that's how I started an interest.

It was a natural connection because I was working with babies born low birth weight in the NICU clinic - where I wanted to be. It was natural for me to say, okay, is there research on these babies in terms of some of the issues we notice? They do not qualify for Early Intervention, but seem to have deficits. And, sure enough, there was huge research - mostly retrospective studies that were done by colleagues in England and Amsterdam who looked at children who were born low birth weigh and were now school-age. They looked at what those children were doing in terms of Executive Function and were able to identify that they were having problem with attention, they were having problems with emotional control, they were having problems with working memory. And many of them ended up in special education.

So, I thought, does that have to happen? Because we know the "snowball effect" - if you don't do something in those early years, then by the time they get to kindergarten it starts to snowball. And by the time they're in first grade, it really starts to snowball because everyone is expected to be reading - and they're still not reading, and the teacher says, oh well, some children start late, let's wait until second grade. That's why it's important to understand what's going on early.

It was exciting to hear about Dr. Blasco's time at this international convention, and so encouraging to hear the progress she is making with her study of executive function in babies born low birth weight. I walked away thinking, let's melt those snowballs! and give all children an even playing field right from the start!

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