Original Article   

Minerva Pediatrics 2022 Apr 14

DOI: 10.23736/S2724-5276.22.06581-8

Copyright © 2022 EDIZIONI MINERVA MEDICA

language: English

Emotion recognition and theory of mind weakness at school age in children born preterm

Stefania M. BOVA ¹ ✉, Ivana OLIVIERI ², Arianna KRACHMALNICOFF ¹, Serena MICHELETTI ^{3, 4}, Andrea ROSSI ^{3, 4}, Elisa M. FAZZI ^{3, 4}, Laura SAVARÉ ^{5, 6, 7}, Simona ORCESI ^{8, 9}

¹ Child Neurology Unit, Vittore Buzzi Children’s Hospital, Milan, Italy; ² IRCCS Fondazione Don C. Gnocchi, Milan, Italy; ³ Unit of Child Neurology and Psychiatry, ASST Spedali Civili of Brescia, Brescia, Italy; ⁴ Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy; ⁵ MOX - Department of Mathematics, Politecnico di Milano, Milan, Italy; ⁶ CHDS, Center for Health Data Science, Human Technopole, Milan, Italy; ⁷ National Centre for Healthcare Research & Pharmacoepidemiology, at the University of Milano, Milan, Italy; ⁸ Child Neurology and Psychiatry Unit, IRCCS Mondino Foundation, Pavia, Italy; ⁹ Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy

BACKGROUND: Social immaturity and impaired social functioning are topical issues in recent research in the field of prematurity. Social-cognitive skills and emotional processing, the neuropsychological correlates underlying social behavior, are key aspects of these issues.
METHODS: We examined 48 Italian primary school children who had been born preterm with a very low birthweight (26 males; mean age 9 years; SD 1.2). All had shown a normal neonatal cerebral ultrasound at term age, and showed a normal neurological examination and average IQ at the time of the study. Social skills and executive functions (EFs) and their correlations with a set of neonatal, sociodemographic, cognitive and adaptive parameters were investigated using standardized scales and questionnaires.
RESULTS: Emotion recognition (ER) was impaired in 48% and Theory of Mind (ToM) in 8% of the children. These deficits showed no relationship with EFs or IQ, or with gestational age, birthweight, age or gender. Correlations between ER and socioeconomic status and between ToM and adaptive functioning were documented.
CONCLUSIONS: We suggest that adaptive and behavioral problems in preterm children may be linked to neurocognitive dysfunction characterized by deficits in social skills, which may be driven by socioeconomic, family and environmental factors, socioeconomic status in particular. Possible neural circuitry impairments underlying these deficits are discussed.

KEY WORDS: Preterm; Social skills; Emotion recognition