title: Early visual attention in preterm and fullterm infants in relation to cognitive and motor outcomes at school age: an exploratory study.
abstract: OBJECTIVE
  Preterm infants are exposed to the visual environment earlier than fullterm infants, but whether early exposure affects later development is unclear. Our aim was to investigate whether the development of visual disengagement capacity during the first 6 months postterm was associated with cognitive and motor outcomes at school age, and whether associations differed between fullterms and low-risk preterms.
  
  
  METHODS
  Seventeen fullterms and ten low-risk preterms were tested in a gaze shifting task every 4 weeks until 6 months postterm. The longitudinal data were converted into single continuous variables by fitting the data with an S-shaped curve (frequencies of looks) or an inverse model (latencies of looks). Neuropsychological test results at school age were converted into composite z scores. We then performed linear regression analyses for each functional domain at school age with the variables measuring infant visual attention as separate predictors and adjusting for maternal level of education and group (fullterms versus preterms). We included an interaction term, visual attention*group, to determine whether predictive relations differed between fullterms and preterms.
  
  
  RESULTS
  A slower development of disengagement predicted poorer performance on attention, motor skills, and handwriting, irrespective of fullterm or preterm birth. Predictive relationships differed marginally between fullterms and preterms for inhibitory attentional control (P = 0.054) and comprehensive reading (P = 0.064).
  
  
  CONCLUSIONS
  This exploratory study yielded no indications of a clear advantage or disadvantage of the extra visual exposure in healthy preterm infants. We tentatively conclude that additional visual exposure does not interfere with the ongoing development of neuronal networks during this vulnerable period of brain development.
authors.affiliation: Division of Neonatology, Department of Pediatrics, Beatrix Children's Hospital, University Medical Center Groningen, University of Groningen , Groningen , Netherlands.
authors.forename: Marrit M
authors.initials: MM
authors.lastname: Hitzert
authors.affiliation: Division of Neonatology, Department of Pediatrics, Beatrix Children's Hospital, University Medical Center Groningen, University of Groningen , Groningen , Netherlands.
authors.forename: Koenraad N J A
authors.initials: KN
authors.lastname: Van Braeckel
authors.affiliation: Division of Neonatology, Department of Pediatrics, Beatrix Children's Hospital, University Medical Center Groningen, University of Groningen , Groningen , Netherlands.
authors.forename: Arend F
authors.initials: AF
authors.lastname: Bos
authors.affiliation: Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen , Nijmegen , Netherlands.
authors.forename: Sabine
authors.initials: S
authors.lastname: Hunnius
authors.affiliation: Department of Clinical and Developmental Neuropsychology, University of Groningen , Groningen , Netherlands.
authors.forename: Reint H
authors.initials: RH
authors.lastname: Geuze
keywords: cognition; frequency of looks; functional development; longitudinal study; low-risk preterm infants; motor skills; response latencies; visual competing stimuli