B – 87 Defying the Odds: Executive Functioning in an Extremely Preterm Child

Objective Children born extremely preterm (< 28 weeks gestation) and with extremely low birth weight (ELBW; < 1000 g) are considered at high risk for intellectual disabilities and attention-deficit/hyperactivity disorders. In an extremely preterm ELBW case, we expected executive functioning impairments, including difficulties in planning, attention, inhibition, and self-regulation. Method This case study centers around “May,” an American, 13-year-old girl of Chinese descent born at 24 weeks gestation, who weighed 600 g at birth. Due to academic struggles in the 7th grade, a comprehensive evaluation was administered, including the Kaufman Assessment Battery for Children, Second Edition (KABC-II), the NEPSY-II, and the Behavior Assessment System for Children, Third Edition (BASC-3), with input from both her parent and teacher. Results Within the context of a KABC-II IQ of 84, her BASC-3 executive functioning T scores were 46 and 44 for her teachers’ reports and 51 for her mother’s. The Response Set and Auditory Attention scaled scores from the NEPSY-II were both 8, at the 25th percentile. Conclusion Unexpectedly, May's IQ is grossly within normal limits, and she has relative strengths in executive functioning. This case is a powerful example of resilience in a high-risk population, showing that executive functioning outcomes can differ significantly among children born with ELBW. Her profile challenges common assumptions and highlights the necessity for detailed, individualized assessments. This case supports a strengths-based clinical approach and enhances our understanding of the heterogeneous developmental trajectories of extremely preterm children.