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The Effect of Bilingual Exposure on Executive Function Skills in Preterm and Full-Term Preschoolers

Loe, Irene M., MD; Feldman, Heidi M., MD, PhD

Journal of Developmental & Behavioral Pediatrics: September 2016 - Volume 37 - Issue 7 - p 548–556
doi: 10.1097/DBP.0000000000000318
Original Articles

Objective: To evaluate the effects of bilingual exposure on executive function (EF) skills, measured by parent-rating and performance-based instruments, in preterm and full-term preschoolers.

Method: Children age 3 to 5 years (mean 4.4) born preterm (PT; n = 82) and full term (FT; n = 79) had monolingual (PT-M, n = 51; FT-M, n = 53) or bilingual (PT-B, n = 31; FT-B, n = 26) language exposure. Groups were similar in age, gender and race, but PT children had lower socioeconomic status (SES) than FT children. Parents completed a language questionnaire and diary and a standardized parent rating of EF skills. Children completed EF tasks that tap response inhibition, working memory, and cognitive flexibility. ANCOVA and logistic regression examined effects on EF of birth group (PT/FT), language status (M/B), and birth group by language status interaction, controlling for age and SES.

Results: Compared to children born FT, children born PT had significantly higher parent-rated EF scores and poorer performance on all but one EF task, both indicating more EF problems. No main effects of language status and no birth group by language status interactions were significant.

Conclusion: PT status was clearly associated with poorer EF skills, similar to many other studies. In this sample, bilingual exposure conferred neither an advantage nor disadvantage in the FT and PT group. This information may prove useful in counseling families of both PT and FT children about the impact of bilingual exposure on their children's cognitive skills.

Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA.

Address for reprints: Irene M. Loe, MD, Stanford University, 750 Welch Rd, Suite 315, Palo Alto, CA 94304; e-mail:

This investigation was supported by the Lucile Packard Foundation for Children's Health under a Pilot Early Career Grant, the Society for Developmental-Behavioral Pediatrics under the Young Investigator Award, and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, under the Mentored Patient-oriented Research Career Development Award Grant K23HD071971 to I. M. Loe. This work was also supported by the Stanford Clinical and Translational Science Award (CTSA) to Spectrum (UL1 TR0001085). The CTSA program is led by the National Center for Advancing Translational Sciences (NCATS) at the National Institutes of Health (NIH).

Disclosure: The authors declare no conflict of interest.

The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. The sponsors had no involvement in the study design; or in the collection, analysis and interpretation of data; in the writing of the manuscript; or in the decision to submit the manuscript for publication.

Received January , 2016

Accepted April , 2016

Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.