研究背景與目的：過去針對早期發展正常之極低出生體重(Very Low Birth Weight, VLBW)早產兒的研究發現，VLBW 早產兒學齡前認知與情緒執行功能(Executive Function)相較於足月兒童存在遲緩或缺損之現象(Ni et al., 2011; 江佳蓉，2019；簡禹萱，2020)。至學齡期時，雖 VLBW 早產兒認知與情緒執行功能的平均表現大致已與足月兒童無顯著差異，但在學齡前執行功能發展即遲緩或缺損的早產兒中，仍有較高比例於學齡期時仍顯示出遲緩或缺損（李詩雯，2022）。過去研究也嘗試探討學齡前與學齡期執行功能間的關係（毛婉琪，2022），但卻鮮少尋找可以早期預估之因子。從大腦神經科學的角度可發現注意力監控功能涉及許多腦區共同運作(Corbetta & Shulman, 2002; Fan et al., 2005; Friedman & Miyake, 2017; Luks et al., 2002)，各執行功能主要涉及前額葉皮質(Duncan & Owen, 2000)，所涉及之腦區也存在部分重疊。另注意力監控功能可用於區分執行功能表現(Espy & Bull, 2005; Sethi et al., 2000)。可見注意力監控功能可能為各執行功能之共同變異來源，之間可能存在預測力。然而，顯少研究將注意力監控功能視為一獨立部件納入探討，大多研究將注意力監控功能作為各執行功能之運作部件，如：Espy與Bull(2005)、Sethi等人(2000)的研究。故本研究欲檢驗早期發展正常之 VLBW 早產兒學齡前的注意力監控功能指標，是否能預測其學齡期時的認知與情緒執行功能發展。
研究方法：本研究之早產兒來自「財團法人台灣早產兒基金會」轉介的 VLBW 早產兒（懷孕週數小於 37 週，出生體重低於 1500 公克），以矯正年齡一歲或兩歲時的貝萊嬰幼兒量表第二版或第三版分數與五歲時魏氏幼兒智力量表修正版中文版或第四版全量表分數皆大於 70 分作為早期發展正常標準，納入早期發展正常且六歲與八歲皆有參與研究之 VLBW 早產兒，共 82 名早產兒。以廣泛性非語文注意力測驗(Comprehensive Nonverbal Attention Test Battery, CNAT)評估注意力監控功能。以記憶廣度(Digit span, DS)與Knox’s 方塊仿效測驗(Knox’s Cube imitation Test, KCT)評估工作記憶；以倫敦塔(Tower of London, ToL)評估計畫能力；以威斯康辛卡片分類測驗(Wisconsin Card Sorting Test, WCST)評估認知彈性；以心智理論(Theory of Mind, ToM)作業評估心智理論；並以失望/去失望禮物作業評估情緒調節能力。以 SPSS 29.0.1.0版本之獨立樣本 t 檢定、皮爾森積差相關與一般線性迴歸（逐步迴歸法）進行資料分析。
研究結果：早期發展正常之 VLBW 早產兒於六歲時的注意力監控功能與各執行功能存在顯著關聯性。早期發展正常之 VLBW 早產兒於六歲時的注意力監控功能能預測八歲時的三種執行功能：以 KCT 評估工作記憶，其中逆序敲擊表現能被注意力監控功能中的違反錯誤與反應速度指標所預測；以 ToL 評估計畫能力，其中所有指標能被注意力監控功能中的漏失錯誤、遲緩錯誤、違反錯誤、反應速度、總正確反應數指標所預測；以心智理論作業評估心智理論能力，其中心智理論總分能被注意力監控功能中的遲緩錯誤所預測。
結論與討論：研究結果顯示，早期發展正常之 VLBW 早產兒學齡前的注意力監控功能與認知、情緒執行功能果真息息相關，因此選用注意力監控功能的指標極有意義。至學齡期時，其學齡前的注意力監控功能表現仍可預測多種認知與情緒執行功能。即學齡前的注意力監控功能指標可作為早期發展正常之 VLBW 早產兒於學齡期認知與情緒執行功能遲緩或缺損之指標，以利及早介入。

This study explores the relationship between meta-attention and executive functions (EFs) in very low birth weight (VLBW) preterm children with normal early development. It has been previously noted that VLBW preterm children tend to have poorer EFs at preschool age. Although their EF performance at school age is generally comparable to that of full-term children, those with early deficits often continue to face challenges. Meta-attention, a component of EFs involving the coordinated operation of multiple brain regions, has been shown to predict EF performance. This study focuses on how meta-attention at preschool age can predict EFs at school age in VLBW preterm children. The study included 82 VLBW preterm children who were assessed for meta-attention and EF tasks at ages six and eight. Key findings include a significant correlation between meta-attention and various EFs at age six, with these functions having predictive power. Specifically, meta-attention at age six can predict three types of EFs at age eight: working memory (assessed by Knox’s Cube Test), planning ability (assessed by Tower of London), and theory of mind (assessed by theory of mind tasks). Indicators such as commission errors, reaction time, missing errors, delay errors, and the total number of correct responses in meta-attention were found to be significant predictors. The study concludes that meta-attention in preschool years can predict EFs in school-age VLBW preterm infants with normal early development, suggesting that early meta-attention indicators can serve as markers for potential EF deficits or delays, thereby facilitating early intervention.

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