Original Article Relations Among Upper-Limb Movement Organization and Cognitive Function at School Age in Children Born Preterm Erik Domellöf, PhD,*† Anna-Maria Johansson, PhD,* Aijaz Farooqi, MD, PhD,‡ Magnus Domellöf, MD, PhD,‡ Louise Rönnqvist, PhD* ABSTRACT: Objective: To explore relations between aspects of upper-body spatiotemporal movement organization and intelligence in children born preterm at school age. Methods: Three-dimensional (3D) kinematic recordings of arm and head movements during a unimanual precision task were related to per- formance on the Wechsler Intelligence Scale for Children, 4th edition, in a sample of 32 children born preterm (gestational age, mean: 31.5 weeks [range: 22–35 weeks]; birth weight, mean: 1699 g [range: 404–2962 g]) at 6 years to 8 years with no diagnosed cognitive, sensory, or motor impairments compared with 40 age- matched control children born fullterm. Results: In the children born preterm, upper-limb movement duration and segmentation of movement trajectories were significantly associated with full-scale intelligence quotient independent of gestational age (GA) and sex. These effects pertained to the preferred side, characterized by more effective movement organization being linked with increased intelligence scores. The same relations were not seen in the controls. Within the children born preterm, a significant effect of GA was also found for some aspects of upper-limb movement organization. Full-scale intelligence quotient was within normal limits for both groups but significantly lower in the preterm (mean: 94.5 [range: 72–120]) compared with the fullterm (mean: 101.7 [range: 76–119]) born children. Conclusions: The findings demonstrate that, independent of GA, the spatiotemporal organization of upper-limb movements is partly associated with cognitive performance in children born preterm. (J Dev Behav Pediatr 34:344–352, 2013) Index terms: children, preterm, WISC-IV, kinematics, IQ, sensorimotor. It is well established that a preterm birth (,37 weeks’ gestation) increases the risk for injury to and disruption of the developing brain. 1 Frequently reported sequelae of preterm birth are neurodevelopmental impairments including cognitive function 2,3 and motor performance. 4 Although severe behavioral deviances are most promi- nently associated with birth at extremely low gestational age (ELGA # 27 weeks’ gestation) or with extremely low birth weight (ELBW , 1000 g), significant cognitive and neuromotor difficulties are also reported in apparently healthy children born preterm without disability, 5 including children born late-preterm (i.e., born at 34–36 weeks’ gestation). 6 Converging evidence from studies involving children born preterm suggests that deficits in cognitive and motor performance may be related. For example, compared with preterm children without motor coordination problems, evidently lower intelligence quotient (IQ) scores have been reported in preterm very low birth weight (VLBW , 1500 g) and ELBW children with developmental coordination disorder at 5 years 7 and at 8 to 9 years. 8,9 Furthermore, associations between motor scores on standardized test batteries of motor function and IQ scores have been found in ELBW children at 5 years, 10 ELGA children at 6 years, 11 and children born at a very low gestational age (VLGA , 32 weeks’ gestation) at 7 to 8 years. 12 Seitz et al 13 associated timed motor per- formance and movement quality (rated by means of video observation) with cognitive functions in VLBW children at 6 years. They found an evident correlation between impaired motor performance and cognitive delay (IQ , 85) and a pattern of reliable associations between impaired performances on adaptive fine and gross motor tasks (pegboard and dynamic balance) and a visual per- ceptual subtest, suggesting a deficit in visuomotor trans- formation. Longitudinal studies have further reported significant associations between early motor proficiency and cognitive abilities in preterm children at school age, suggesting an interrelated development of motor and cognitive functions. 14,15 It has been suggested that the cognitive and behav- ioral deficits observed in preterm children without disability are caused by the same disruptive mecha- nisms that are activated in severer forms of neonatal From the *Department of Psychology, Umeå University, Umeå, Sweden; †Research and Development Unit, Kolbäcken Child Rehabilitation Centre, Umeå, Sweden; ‡Division of Pediatrics, Department of Clinical Sciences, Umeå University, Umeå, Sweden. Received September 2012; accepted January 2013. This study was supported by grants from the Swedish Research Council (Grant No. 2007-2438; 2011-179) and the Norrbacka-Eugenia Foundation. Disclosure: The authors have no financial relationships relevant to this article to disclose. The authors have no conflicts of interest to disclose. Address for reprints: Erik Domellöf, PhD, Department of Psychology, Umeå University, SE-901 87 Umeå, Sweden; e-mail: erik.domellof@psy.umu.se. Copyright Ó 2013 Lippincott Williams & Wilkins 344 | www.jdbp.org Journal of Developmental & Behavioral Pediatrics