Executive function and mealtime behavior among preschool-aged children born very preterm.
OBJECTIVE
To determine whether executive function in preschool-aged children born very preterm was associated with problematic mealtime behavior.


METHODS
Executive function of 41 preschool-aged children (mean age=47 months) born at <30 weeks' gestation was assessed using a standardized protocol (gift bag) and by parent-report (Behavior Rating Inventory of Executive Function-Preschool). The gift bag assessment was video-recorded and good executive function defined as the child not touching the gift bag and remaining seated for >2 min. Parent-reported frequency and severity of child mealtime behavior problems was assessed with a 20-item index (Meals in Our Household, α=0.94). Multivariable regression was used to model associations between executive function and mealtime behavior problems.


RESULTS
BRIEF-P global executive composite t-scores [mean (standard deviation [SD])=53.5 (15.7)] and mealtime behavior problems scores [mean (SD) =18.5 (13.6)] were correlated (r=0.57, P<0.0001). Adjusted for child sex, age, birth weight, weeks' gestation, parent education, and neonatal intensive care unit length of stay, a 10-unit difference in BRIEF-P t-score was associated with a 7.2-unit difference in mealtime behavior problems score (P<0.0001). Ten children (24%) demonstrated good executive function during the gift bag assessment. Parents reported these children displayed better executive function on the BRIEF-P and had fewer mealtime behavior problems (mean 11.2 vs. 20.8, P=0.02). Adjusted for covariates, good performance on the gift bag task was associated with 14.1 unit lower mealtime behavior problems score (P=0.03).


CONCLUSIONS
Among preschool-aged children born very preterm, difficulties with executive function may manifest as mealtime behavior problems. Larger studies are needed to help parents anticipate and manage these behaviors.
Division of Epidemiology, The Ohio State University College of Public Health, 1841 Neil Ave., Columbus, OH 43210, USA. Electronic address: sanderson@cph.osu.edu.
Sarah E
SE
Anderson
Center for Biobehavioral Health, The Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, USA.
Kelly
K
McNamara
Division of Biostatistics, The Ohio State University College of Public Health, 1841 Neil Ave., Columbus, OH 43210, USA.
Rebecca
R
Andridge
Division of Epidemiology, The Ohio State University College of Public Health, 1841 Neil Ave., Columbus, OH 43210, USA; Center for Biobehavioral Health, The Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, USA; Department of Pediatrics, The Ohio State University College of Medicine, 700 Children's Drive, Columbus, OH 43205, USA.
Sarah A
SA
Keim
D002653:Child Behavior Disorders / Q000453:epidemiology / Q000523:psychology*; D002675:Child, Preschool; D056344:Executive Function / Q000502:physiology*; D005260:Female; D006801:Humans; D062071:Infant, Extremely Premature; D008297:Male; D062407:Meals / Q000523:psychology*; D010290:Parents / Q000523:psychology; D057566:Self Report
Behavior Rating Inventory of Executive Function; Family meals; Low birth weight; Premature birth; Self-regulation