by Madison Scott

“Don’t worry about it!”

This is what parents are often told when they express concerns over their young child’s development and/or behavior when that child was born early and low birth weight. Most children do well on typical infant and toddler tests, but these tests may be missing more subtle indicators of executive function (EF) concerns. EF refers to a particular set of skills developing in children. These skills include working memory, self-inhibition, self-regulation or emotional control, attention, planning and organizing, and the ability to shift between parts of a task. Project EF: Executive Function in Infants and Toddlers Born Low Birth Weight (LBW) and Preterm was funded in 2014 by the U.S. Department of Health and Human Services. The project is currently projected to continue through September of 2018. I sat down with the Principal Investigator, Dr. Patti Blasco, to find out where the project is now.

Project EF is a research grant seeking to identify early indicators of executive function (EF) concerns in young children, especially those born premature with low birth weight (LBW), which makes them much more susceptible to these EF deficits. Typically, EF issues aren’t noticed until a child reaches school age and struggles. Project EF aims to identify EF problems before school age. If the project is successful, this would pave the way for future projects to develop testing and supports for young children before they reach school-age and allow them to excel.

Project EF’s primary method of research is through a research design that includes two groups of children: one low birth weight (LBW) and preterm group and one group of full-term children who serve as the control group. Researchers meet with the children from both groups three times: at age 6 months, 18 months, and 3 years old. Each time they meet, the children go through a series of assessments to test their EF skills.

Dr. Blasco reported that by 6 months of age, the LBW children were already exhibiting signs of EF in their attention, planning, and organizing skills. This trend continued to 18 months and at that point also included reduced inhibitory skills. Although the researchers haven’t looked at their recent three-year data yet, Dr. Blasco noted that throughout the research she’s been “learning other indicators of executive function that aren’t necessarily on the test” from observation of the children’s behaviors.

One example of these behaviors, Dr. Blasco reported, is from “one young boy who was taking the blocks on the table … and he’d put his hand down and he would drop them on the floor.” After his mother told him not to do that, Dr. Blasco said he “took a block and put his hand down but didn’t release the block, which to me was an excellent example of inhibit, but that’s not on the test.” Dr. Blasco noted that since she began noticing these behaviors, she has kept track of her observations.

A challenge that this project has faced is families in the LBW group not being able to make the third assessment visit due to moving or other circumstances.This can make collecting enough data more difficult. However, Dr. Blasco said, “The families that have stuck with us have been wonderful and just very supportive and very interested [in the outcomes].” Dr. Blasco noted that the families often comment that it is hard to believe their 3 year-old was 6 months at the start of the project.

Project EF has already received much recognition in the past few years. This is especially important since this is a topic that hasn’t been well-researched in young children up to this point. Dr. Blasco said that the research team is hoping to seek more funding to develop an EF assessment for younger children and do an intervention study. These further projects would allow parents of children that are not yet school-age to find answers for their concerns earlier. This could lead to more satisfaction for families and ultimately successful outcomes for the child that would last a lifetime! These studies could reduce the number of parents frustrated by their children struggling in school while thinking to themselves “I knew it!”

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