Executive Functions Predict Academic Difficulties in Preterm with Protective Factors and Normal IQ

We investigated the impact of executive functions (EFs) on academic achievement in a quasi-experimental sample of 56 children born preterm (28-34 weeks' gestation; ages 7-9), without neurological impairment, in favorable educational and socioeconomic environments. Using standardized performance-based tests and daily-life proxy reports, we assessed EFs (inhibition, working memory, flexibility, planning) and academic achievement (reading, spelling, mathematics). Children with EF deficits faced a higher risk of academic difficulties (OR 7.87; 95% CI 2.2-35.2), with planning emerging as the most important predictor. A structured, multifaceted assessment of academic achievement and EFs should be systematically included in follow-up.