Preterm children with very low birthweight (VLBW) / extremely low birthweight (ELBW) with normal early development had been found poorer executive functions (EFs) at preschool-age (Ni, Huang & Guo, 2011). The previous study found that the risks of deficits in EFs at preschool-age of preterm children can be attenuated by more supportive home environment (Taylor & Clark, 2016). However, former studies didn't investigate the effect of birthweight and home environment on cognitive EFs of preterm children simultaneously, especially those with normal early development. The present study aims to investigate the predictive effect of birthweight and home environment on the cognitive EFs of VLBW / ELBW preterm children.

The preterm children were recruited from the Premature Baby Foundation of Taiwan. Inclusion criteria were their scores of Bayley Scales of Infant and Toddler Development, second or third edition at 12 and 24 months, and Wechsler Preschool and Primary Scale of Intelligence, Revised Edition at 5 years old were higher than 70. Exclusion criteria were visual impairment, hearing impairment, and cerebral palsy. There was a total of 287 preterm children with age 6 recruited in the present study. Preterm children were then divided into VLBW group (n=202, birthweight between 1001-1500g) and ELBW group (n=85, birthweight less than 1000g). The typical children included 89 term-born healthy and typically developing children with age 6, who were recruited from comparable social status families in the community. Four types of cognitive EFs including 22 indicators were assessed. Inhibition ability including 8 indicators was assessed through Comprehensive Nonverbal Attention Test Battery (CNAT), cognitive flexibility including 6 indicators was assessed through Wisconsin Card Sorting Test (WCST), working memory including 2 indicators was assessed through Digit Span Subtest of Wechsler Intelligence Scale for Children-IV (WISC-IV) and Knox's Cube Test (KCT), planning ability including 6 indicators was assessed through Tower of London (ToL). The home environment was assessed through Home Observation for Measurement of the Environment (HOME), Revised edition. Data were analyzed with Stepwise Regression.

Results showed that the regression model with birthweight significantly predicted 83.3% of planning ability indicators, 83.3% of cognitive flexibility indicators, and 50% of working memory indicators. Among indicators mentioned above, birthweight has been found the greatest predictive effect on summation-of score of ToL (R2=.04, p<.001). The regression model with HOME significantly predicted 66.7% of planning ability indicators, 16.7% of cognitive flexibility indicators, and 12.5% of inhibition ability indicators. Among the indicators mentioned above, HOME has been found the greatest predictive effect on rule-1 of ToL (R2=.027, p=.001). The regression model with birthweight and HOME significantly predicted 50% of planning ability indicators. Among indicators mentioned above, the regression model has been found the greatest predictive effect on summation-of-score of ToL (R2=.061, p<.001).

Both birthweight and home environment have been found significantly predicted different types of cognitive EFs at preschool-age of VLBW / ELBW preterm children with normal early development. Though the home environment doesn't have such a great predictive effect as birthweight is, both birthweight and home environment are significant predictors of planning ability.

Expertise in social perception, defined as the ability to decode another person's mental states based on basic behavioral signals (Allison et al., 2000; Beauchamp et al., 2008). The Reading the Mind in the Eyes Test (RMET) is a social-perception task of theory of mind (ToM, Meinhardt-Injac et al., 2020) and used to test different clinical disorders, like autism spectrum disorders (ASD, Peñuelas-Calvo et al., 2019). RMET has been used to demonstrate gender, cultural, genetic, and personality trait influences on ToM and elucidate its neurobiological mechanisms (Adams et al., 2010). In Taiwan, there has few sensitive tools to evaluate children's social perception, thus the purpose of this study is to examine psychometric properties of child's version of RMET in Taiwan (RMET-C-TW) and cross-cultural comparisons.

RMET-C (Baron-Cohen et al., 2001) was used to assess mental state/emotion recognition (Vellante et al., 2013). It consists of photographs of the eye regions of 28 faces. Participants were asked to make a choice between four words presented, choose the one that best described for feel or think. One point was given to each correctly response. RMET-C-TW was double-translation of words to ensure cultural applicability in Taiwan. This study included both a normative sample and criteria sample. The normative sample consisted of 769 (385 male, 384 female) 3 to 9 grades students from northern Taiwan. The normative sample completed both the RMET-C-TW and Chinese Vocabulary Test (CVT) in groups at their own schools, the CVT was to ensure that participants had sufficient vocabulary skills to understand the options provided in REMT-C-TW. The criteria sample were collected from 46 matched, school-aged children with ASD (age mean = 10.52, SD = 1.62; IQ = 108.39, SD = 11.75), and normally developing controls (age mean = 10.66, SD=1.68; IQ = 109.70, SD = 12.12). These two groups were administered the (1) WISC-III (2) CVT (3) RMET-C-TW and (4) ToM Test.

The results showed that RMET-C-TW had acceptable test-retest reliability and internal consistency (test-retest reliability = .71, Cronbach α= .40). There were significant gender and age difference in the performance of RMET-C-TW, example female, older participants performed better. Item analysis showed 93% of items in the RMET-C-TW had cross- cultural consistency in the distribution of respondents' choices. In criteria sample, the control group's RMET-C-TW scores significantly better than ASD group. Physician diagnosis (r = .49, p < .01) and high-order ToM's scores (r = .33, p < .01) were significantly associated with RMET-C-TW scores.

RMET-C-TW has acceptable reliability and good developmental validity (age-related growth) in three to nine grades, and future can be extended to different age and clinicians to understand the development of social perception. Therefore, RMET-C-TW can be used as an initial screening and cross-cultural tool for ASD. In addition, EF is divided into cold and hot, and hot EF makes a unique contribution to ToM in ASD (Kouklari et al., 2017), thus this tool may also be used in the future to understand the association of hot EF with social perception.

The preschool children born very low birth weight(VLBW) still have executive functions(EFs) deficits even with normal early development(Ni, Huang, & Guo, 2011). Consequently, early intervention might be more important than expected. This study aims to investigate the follow-up outcome of the therapeutic effects of integrative neuropsychological training model(INTM) focused on EFs for school-age VLBW children with EFs deficits.

The VLBW children, recruited from the Regional Cohort Network for premature infants who were admitted to neonatal intensive care units, had normal scores in Bayley and Wechsler Intelligence systems before 6 years old. They also received follow-up neuropsychological assessment for EFs at 6 or 8-year-old. The deficits of EFs were defined from the result of Digit Span Subtest of WISC-IV, Knox's Cube Test(KCT), Tower of London(ToL), Wisconsin Card Sorting Test(WCST), and Comprehensive Nonverbal Attention Test Battery(CNAT). A total of 8 VLBW children with EFs deficits were recruited and received EFs training at 6 or 8-year-old. The INTM combined with Comprehensive Memory Training System(CMTS), Executive FUNction Training(EFT), and multi-ecological materials focused on enhancing the four aspects of EFs, including working memory, planning, cognitive flexibility, and inhibition ability. Then, they received follow-up neuropsychological assessment for EFs at 8 or 10-year-old.

The results showed that all children got benefits from 20 hours of INTM and most of the EF aspects remained improved at follow-up. A total of 8 VLBW children with an average of 3.4 aspects EFs deficits had an average of 1.4 aspects of EFs deficits left at the follow-up. More precisely, 5 of them had 1 aspects of EFs deficits and 3 of them had 2 aspects of EFs deficits.

This study revealed that such a short-term INTM had long-term effects in enhancing the EFs of those VLBW children who had normal early development but later grew into EFs deficits at school-age. Besides, their EFs are still improving even after two years of intervention. Further study on more subjects with longer follow-up might help VLBW children to achieve better neuropsychological function.

During the COVID-19 pandemic, wearing face masks is an important strategy to prevent people from infection, allowing people to find a balance between maintaining social interaction and keeping social distancing. Since face mask might disrupt information processing of social cognition, it could lead to less functional connectivity of occipital face area, fusiform face area, and superior temporal sulcus which interrupted the development of medial prefrontal cortex (MPFC) for mentalizing. However with better executive function (EF) people could process facial stimuli more efficiently. The objective of this study is to examine the effect of wearing face masks on preschoolers' facial emotion recognition, and the factors which might affect the development of facial emotion recognition.

In this study, preschoolers (N=44, 24 boys and 20 girls, aged 3 to 5 years-old) recruited from the community were asked to identify the emotions expressed in the 36 stimulus photos, each randomly presented with six emotion (happy, sad, angry, surprised, fearful, and disgusted). The total face stimulus photos were 2 (face sex) × 6 emotions × 3 facial features (full face, presenting upper counterparts of face with face mask covering the mouth, and presenting lower counterparts of face with hat covering the eyes). The EF of preschoolers and their parent were also evaluated to examine whether EF could predict the correct score of facial emotion recognition.

It was found that the correct score of emotion recognition increased with age. The recognition with full face feature were better than with upper feature and lower feature. When recognizing happy and disgust, participant tended to use lower features. When recognizing sad and angry, participant tended to use upper features. The EF of preschoolers could predict the correct score of emotion recognition. The EF of parents could predict the preschoolers' correct score of positive emotion recognition.

The ability of facial emotion recognition evolved rapidly in preschool age with the accumulation of social interaction experience and improved the development of auditory and visual subcortical cortex and the connectivity of MPFC. This study examined the emotion recognition ability of preschoolers and found that the face features preschoolers used to recognized emotion were consist with previous study. However, when the presenting stimulus were covered by face mask or hat, it was more difficult for preschoolers to recognizing emotion which would result in difficulty of understanding the social context and development of MPFC for mentalizing. In this study, it was found that preschooler's with better EF could be more efficiently recognizing facial emotion. Also, parents with better EF showed more positive emotion in daily life which lead to their children more sensitive to positive facial emotion.

Previous studies had shown that even with normal early development, preterm children at age six still have executive function deficits, including planning, cognitive flexibility, and nonverbal working memory. The present study aims to discuss further the correlation between IQ and EF of preterm children with different birthweight in order to clarify the potential influence of birthweight.

The preterm children were recruited from the Regional Cohort Network for premature infants who were admitted to neonatal intensive care units. Inclusion criteria were their scores of Bayley Scales of Infant and Toddler Development, second or third edition at 12 and 24 months, and Wechsler Preschool and Primary Scale of Intelligence, Revised Edition at 5 years old were higher than 70. Meanwhile, their FSIQ of Wechsler Intelligence Scale for Children, Fourth Edition were higher than 85 at age 6. Exclusion criteria were visual impairment, hearing impairment, and cerebral palsy. There was a total of 251 preterm children recruited in the present study. Preterm children were then divided into very low birthweight (VLBW) and extremely low birth weight (ELBW) groups. The VLBW group included 183 preterm children, whose birthweight is between 1000-1500g, and gestational age is less than 37 weeks. The ELBW group included 68 preterm children, whose birthweight is less than 1000g and gestational age is less than 37 weeks. Four types of executive function were assessed. Inhibition was assessed through Comprehensive Nonverbal Attention Test Battery (CNAT), cognitive flexibility was assessed through Wisconsin Card Sorting Test (WCST), verbal working memory was assessed through the Longest Digit Span Forward (LDSB) index of Digit Span Subtest of Wechsler Intelligence Scale for Children-IV (WISC-IV), and nonverbal working memory was assessed through Knox's Cube Test (KCT), and planning ability was assessed through Tower of London (ToL). Data were analyzed with independent T-test and Pearson Correlation.

In VLBW preterm group, results showed that there were significant correlations (p<.05) between FSIQ and EF indexes in five out of six indexes of WCST, LDSB of Digit Span of WISC-IV, Backward score of Knox's Cube Test, and three out of six indexes of ToL. As to the CNAT, there was no index of CNAT that was significantly correlated with FSIQ in the VLBW preterm group. In ELBW preterm group, results showed that there were significant correlations (p<.05) between FSIQ and EF indexes in one out of five indexes of CNAT, one out of six indexes of WCST, Backward score of Knox's Cube Test, and two out of six indexes of ToL. And the LDSB of Digit Span of WISC-IV was not significantly correlated with FSIQ in ELBW preterm group.

There were fewer EF indexes significantly correlated with FSIQ in ELBW preterm children with normal early development than VLBW preterm children with normal early development, suggesting that even with an IQ higher than 85, lower the birthweight, especially lower than 1000g, higher the EF performance should be concerned. Therefore, in the clinical setting, it is very important to assess the EF independently. And birthweight may be a crucial factor in preterm children's prefrontal cortex maturity.

Previous studies had shown that very low birth weight(VLBW) preterm children with normal early development had poorer cognitive executive functions(CEFs) and emotional executive functions(EEFs) at preschool-aged. There were still about 73% of children with deficits of CEFs and 74% of them with deficits of EEFs at school-aged. (Ni et al., 2011; Chiang et al., 2019; Lee et al., 2022). Besides, former studies less discuss the core neuropsychological ability related to the EFs development. In this study, meta-attention was chosen as the core ability. This study applied longitudinal design aimed to discuss the predictive power of meta-attention at preschool-aged on the CEFs and EEFs at school-aged for VLBW preterm and typically developing children.

The VLBW group was referred by Premature Baby Foundation of Taiwan. These children have been followed up with Bayley Scales of Infant Development(BSID) II or III administered at the age of 12 months and 24 months and Wechsler Preschool and Primary Scale of Intelligence-Revised(WPPSI-R) at the age of 5-year-old. Children with visual impairment, auditory impairment, cerebral palsy developmental indices of BSID-II or III less than 70, or full-scale IQ of WPPSI-R less than 70 were excluded.

The typical group was recruited from the community and included 30 children whose development was typical. Both preterm and typically developing children completed the CEFs and EEFs test at 6 and 8. Four types of CEFs including 33 indicators were assessed: Meta-attention including 18 indicators through Comprehensive Nonverbal Attention Test Battery(CNAT), working memory including 2 indicators through Digit Span Subtest of Wechsler Intelligence Scale for Children-IV(WISC-IV) and Knox’s Cube Test(KCT), planning ability including 6 indicators through Tower of London(ToL), and cognitive flexibility including 7 indicators through Wisconsin Card Sorting Test(WCST).

Two types of EEFs including 5 indicators were assessed. We designed Emotional EF Ecological Assessment Battery for Children in Taiwan to assess EEFs, including 3 indicators of theory of mind and 2 indicators of emotion regulation. Data were analyzed with correlation analysis and independent sample t-test.

Meta-attention at 6 among the VLBW group significantly correlated with 73.3% of CEFs and 80% of EEFs indicators at 8 and had significant predictive power on working memory, planning ability, cognitive flexibility, emotion regulation, and theory of mind. (p<.05) When the significance level was 0.01, meta-attention still correlated with 33% of CEFs and 80% of EEFs indicators and can predict those CEFs and EEFs among the VLBW group. Meta-attention at 6 among the typical group significantly correlated with 26.7% of CEFs and 80% of EEFs indicators at 8 and had significant predictive power on working memory, planning ability, emotion regulation, and theory of mind. (p<.05)

When the significance level was 0.01, meta-attention only correlated with 80% of EEFs indicators and can’t predict any CEFs and EEFs among the typical group.

Meta-attention at 6 can predict CEFs and EEFs among VLBW preterm children at 8, while the effect didn’t be found among typically developing children. Thus, meta-attention can be served as a clinical cut-point for VLBW preterm children to find the deficits and intervene early.

The relationships between childhood weight self-misperception and obesity-related factors particularly health markers have not been extensively discussed. This study aims to examine the associations between weight self-misperception and obesity-related knowledge, attitudes, lifestyles and cardio-metabolic markers among Chinese paediatric population.

Cross-sectional study.

Data sourced from a national survey in Chinese seven provinces in 2013.

Children and adolescents aged 5–19 years.

Of the total 14 079 participants, there were 14·5 % and 2·2 % participants over-estimated and under-perceived their weight, respectively. Multi-variable logistic regression was applied to calculate OR and 95 % CI (95 % Cl) of obesity-related behaviours and cardio-metabolic markers by actual and perceived weight status. Individuals who perceived themselves as overweight/obese were more likely to have prolonged screen time, insufficient dairy intake and over sugar-sweetened beverages consumption (all P < 0·05), regardless of their weight. Furthermore, actual overweight/obese individuals had higher odds of abnormal cardio-metabolic markers, but a smaller magnitude of association was found among weight under-estimators. Among non-overweight/obese individuals, weight over-estimation was positively associated with abdominal obesity (OR: 10·49, 95 % CI: 7·45, 14·76), elevated blood pressure (OR: 1·30, 95 % CI: 1·12, 1·51) and dyslipidemia (OR: 1·43, 95 % CI: 1·29, 1·58).

Weight over-perception was more prevalent than under-estimation, particularly in girls. Weight over-estimators tended to master better knowledge but behave more unhealthily; both weight over-perception and actual overweight/obesity status were associated with poorer cardio-metabolic markers. Future obesity intervention programmes should additionally pay attention to the population with inaccurate estimation of weight who were easily overlooked.