Identifying Relations between Premature Birth, Parental Factors, and the Neural Basis of Numerical Development

Over 10% of infants are born preterm (gestational age < 37 weeks), and these rates are on the rise. Preterm-born (PTB) children face an increased risk of academic difficulties compared to Term peers, with specific and persistent difficulties in mathematical development. Success in math is consequential – higher math skill predicts greater school success, wealth, health, and life satisfaction. Despite their prevalence and importance, however, the underlying mechanisms of math difficulties in PTB children remain poorly understood. The goal of this project is to pinpoint the mechanisms that underlie mathematical difficulties in PTB children during the transition to formal schooling. Our central hypothesis is that early mathematical difficulties arise from cascading effects of prematurity on foundational verbal skills that affect specialization of critical neural systems and in turn lead to difficulties in numerical performance, and that these difficulties can be offset by an enriched home environment. The rationale is that better understanding of the mechanisms of PTB children’s math difficulties will improve early identification and intervention efforts, ultimately improving academic outcomes and decreasing societal financial burdens. The central hypothesis will be tested by pursuing two specific aims: 1) Test a serial mediation model that links gestational age to numerical skill through verbal skills and neural systems, and 2) Determine the role of the home verbal environment as a moderator of the link between prematurity and numerical skills. These aims will be pursued through an accelerated longitudinal study of 240 children from diverse backgrounds across the full spectrum of gestational age (23-41 weeks gestational age at birth). We will administer standardized and lab-based measures to assess numerical, verbal, and spatial skills throughout the pivotal transition to formal schooling (pre-K to 1st grade). We will measure brain activity during numerical processing using functional near-infrared spectroscopy (fNIRS). We will assess home environment via parent-child lab observations and questionnaires. Key covariates, including pregnancy factors (e.g., birth complications) and child characteristics (e.g., medical morbidities, sex, executive function) will be considered. The proposed research is innovative, in the applicant’s opinion, because it represents a substantive departure from the status quo by integrating multiple levels of analysis (environmental, behavioral and neural), leveraging a wide range of neuroimaging, behavioral, and observational measures, assessing a broad spectrum of early numerical skills during the significant transition to formal schooling, and incorporating the full spectrum of gestational age. The proposal is significant as it will provide the conceptual foundation for much-needed and effective early prevention and intervention efforts that leverage neural markers and home support to prevent mathematical difficulties in at-risk PTB children and thereby maximize their future potential. Project Number: 1R01HD116831-01A1 | Fiscal Year: 2025 | NIH Institute/Center: Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) | Principal Investigator: Ece Demir-Lira | Institution: UNIVERSITY OF IOWA, IOWA CITY, IA | Award Amount: $425,662 | Activity Code: R01 | Study Section: Child Psychopathology and Developmental Disabilities Study Section[CPDD] View on NIH RePORTER: https://reporter.nih.gov/project-details/1R01HD11683101A1