Impaired Picture Sequencing Ability in Children with Premature Birth
Jariya Chuthapisith MD*, Kakanang Jantarapagdee MD*, Rawiwan Roongpraiwan MD*, Pracha Nunnarumit MD*
Affiliation : * Department of Pediatrics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
Background : Children born preterm are at increased risk for executive dysfunction, which affects learning outcomes. Picture
sequencing ability is considered as executive function (EF) that requires skills in working memory and organizing the
pictures. Children born preterm might have difficulties in these skills. The present study aimed to develop practical Picture
Sequencing test (PS test) and examine the sequencing ability in preterm children comparing with term children.
Material and Method: The PS test was developed to assess the child’s ability to arrange pictures into a sequence. It consisted
of three conditions, which were daily activities, social interaction routines, and feeling expressions. Each story had four
cartoon styles cards. The child had to rearrange picture cards into the correct sequence positions. Thirty preterm children
aged five to six years with gestational ages of ≤32 weeks and birth weights of <1,500 grams, and thirty-five term children
matched age, gender, child’s education, parental education, and socioeconomic status were performed the PS test. The total
scores were compared between the preterm group and the term group.
Results : The PS test scores on the daily activities domain of the preterm and term group were 18 and 25 (p = 0.03),
respectively. The scores on the social interaction routines domain of the preterm and term group were 20 and 28 (p = 0.01)
and the scores on the feeling expression domain were 18.5 and 25 (p = 0.03), respectively. There was no significant correlation
between perinatal complications and the PS test scores.
Conclusion : The preterm children with IQs in the average range showed impairment in sequencing ability compared with
the term children. The results underline the need for follow-up care with more comprehensive assessment of EF.
Keywords : Preterm infants, Executive function (EF), Sequencing ability
