Compromised approximate number system acuity in extremely preterm school-aged children.

Aim: The aim of this study was to compare the approximate number system acuity in children born extremely preterm aged 6 years 6 months and typically developing, age-matched peers.

Method: This population-based follow-up study included 65 children born before 27 gestational weeks (35 males, 30 females; mean gestational age 25.4 wks [SD 1.1 wk]; mean birthweight 789 g [SD 158 g]) and 47 typically developing children (24 females, 23 males) at the age of 6 years 6 months. A battery of cognitive tests was administered, including a computerized test for measuring approximate number system acuity and tests for general cognition, working memory, processing speed, and visual attention. Approximate number system outcome measures were means of Weber fraction (w) values and response time in milliseconds.

Results: The 43 extremely preterm children in whom usable data were obtained performed significantly worse than the typically developing children on the approximate number system task (w=0.30 [SD 0.23] vs. 0.17 [SD 0.13]; p=0.003) and were significantly slower (response time=2934 ms [SD 1102 ms] vs 2376 ms [SD 310 ms]; p=0.002). The differences remained when adjusting for differences in other cognitive functions (p=0.03).

Interpretation: Preterm birth has a negative impact on an individual's ability to rapidly approximate and compare numbers of visually presented items. This deficiency is thought to be a consequence of dorsal stream dysfunction. Future studies will investigate whether this deficiency is correlated with lower mathematical proficiency in this group of children.