Performance of 5-Year-Old Children on Seven Visual Perceptual Tasks in Relation to Neonatal Ultrasound Abnormalities

We investigated whether neonatal brain damage can give rise to visual perceptual deficits, in addition to the well-documented impairments in visual acuity. To this end, forty-one children (age 5.02 to 5.89 years) were given four visual object identification tasks and three visuo-constructive tasks. These subjects were neonatal at risk owing to prematurity or birth asphyxia. From neonatal ultrasound scans, the occurrence of intracranial hemorrhage (ICH, N = 17), periventricular leukomalacia (PVL, N = 15), and/or white matter damage due to either of these conditions (WMD, N = 9) was determined for each subject. Scans were normal in fourteen of them. The number of subjects performing at or below Pc10 of same-age normal children was significantly above 10% for each task (range 27% – 49%). This was still true when mental instead of chronological age was used for comparison, as shown by the results of nine subjects for which intelligence data were available. This high incidence of impairment is not attributable to loss of visual acuity, since grating acuity was reduced in only four subjects (14 – 19 cycles deg⁻¹). The frequency of scores < Pc10 correlated significantly with WMD in six tasks, with PVL in 4 tasks, but not with ICH. We conclude that neonatal at risk children are more likely to develop impaired visual perceptual skills, independent of mental disability and visual acuity loss. On ultrasound permanent white matter abnormalities are most strongly associated with visual perceptual deficit, whereas intracranial hemorrhage is unrelated.