Subproject III represents an extension into a new effort that has evolved from our ongoing studies. By extending the participation of our present cohort of children, this study not only uses earlier data on arousal and attention regulation, but provides a much needed dimension into school-age outcome. The primary aim is to study the relationship between early performance on tasks that assess the regulation of attention and arousal and the subsequent development of executive function skills. It is based on the fact that neonatal risk factors related to CNS injury have been associated with later cognitive and behavioral problems, but the neuropsychological basis of such outcome remains poorly understood. Many of the problems experienced by these at-risk children may be the result of executive function deficits that can be traced back to their perinatal injury. According to the proposed model, early autoregulatory control systems that modulate attention and arousal are precursors to systems that mature during childhood and underlie many executive functions. Perinatal CNS injury may interfere with this developmental process, however, leaving affected individuals without the necessary executive function resources and skills to effectively cope with age-appropriate social and educational demands. Specific hypotheses derived from the conceptual model will be tested using a longitudinal research design that incorporates both new and previously collected data. It is expected that the disruption of early attention/arousal modulation mechanisms, secondary to perinatal CNS injury, can affect the rate and pattern of executive function skill acquisition during childhood, resulting in varying profiles of deficits. Specific hypotheses that relate early performance on autoregulatory tasks to later impairments in specific executive function domains will be tested. The knowledge derived from this study will assist educators in creating intervention programs that more specifically address the anticipated academic and social problems associated with neonatal neurological risk, and that are more sensitive to the underlying neuropsychological causes of those problems. The ultimate objective is to help high-risk children develop the age-appropriate competencies necessary for normal educational and social development.
