Very preterm children are at high risk for neurodevelopmental impairments. Academic achievement and educational outcomes are significantly lower than expected, particularly in the area of mathematics. Even children with relatively benign neonatal courses who are deemed normal at infant/toddler follow-up remain at risk for significant math difficulties. In addition, these "healthy preterm" children are at risk fr significant attention, visual, perceptual, motor, and executive function deficits, but little is knwn about how the emergence of these deficits in preterm preschoolers may be related to later math difficulties. There are currently no data examining the neural basis of selective neuropsychological deficits and early academic difficulties, yet this is a critical period of dynamc neurocognitive development when intervention may have the best potential for mitigating later deficits. This longitudinal study aims to evaluate the emergence of neuropsychological and math deficits in healthy preterm children, map the impact of preterm birth on brain development during early childhood, and examine the relationship between math and neuropsychological development and developmental brain abnormalities in healthy preterm children. Participants will be 60 healthy preterm children (born 25-32 gestational weeks) with average intelligence and 40 full term children matched for age, sex, SES, and verbal IQ. Children will enter the study within 6 months prior to kindergarten entry. We will integrate multimodal neuroimaging (whole brain morphometric measures using structural MRI and indices of white matter integrity using diffusion weighted imaging) with neuropsychological and academic measures across three annual time points. We predict that specific early perceptual and cognitive deficits will be relate to emerging math deficits. We will examine whether later math deficits are related to early non-symbolic and symbolic processing deficits. Our longitudinal study design aims to elucidate the links between the most affected cortical surface areas and underlying fiber tracts and level of performance on a set of implicated neurocognitive and math functions, and to acquire more information about how these effects impact ongoing biological development in neural systems less directly affected early in development. We will also examine other mediating factors, such as degree of prematurity and medical and demographic variables. The results from this project will greatly enhance our understanding of why certain skills appear more vulnerable to preterm birth, how these skills are related to the early emergence of math deficits, and how the underlying neuropathology accounts for extensive variations in neurodevelopmental outcome in healthy preterm children. These results will provide the critical foundation for identifying the deficits most amenable to effective interventions.

Public Health Relevance

Children born very preterm are at significant risk for math difficulties, despite average intelligence. This longitudinal study will provide a unique opportuniy to track the developmental trajectory in cognitive, academic, and brain measures as very preterm children transition from preschool to formal schooling. Results will advance our understanding of the variability in outcomes and provide the foundation for designing appropriate interventions.

National Institute of Health (NIH)
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Research Project (R01)
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Child Psychopathology and Developmental Disabilities Study Section (CPDD)
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Mann Koepke, Kathy M
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University of California San Diego
Schools of Arts and Sciences
La Jolla
United States
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