What do We Know about Neonatal Cognition?

How do human newborns come to understand the multimodal environment?

For a long time, newborns were considered as human beings devoid of perceptual abilities who had to learn with effort everything about their physical and social environment. Extensive empirical evidence gathered in the last decades has systematically invalidated this notion. Despite the relatively immature state of their sensory modalities, newborns have perceptions that are acquired, and are triggered by, their contact with the environment. More recently, the study of the fetal origins of the sensory modes has revealed that in utero all the senses prepare to operate, except for the vision mode, which is only functional starting from the first minutes after birth. This discrepancy between the maturation of the different senses leads to the question of how human newborns come to understand our multimodal and complex environment. More precisely, how the visual mode interacts with the tactile and auditory modes from birth. After having defined the tools that newborns use to interact with other sensory modalities, we review studies across different fields of research such as the intermodal transfer between touch and vision, auditory-visual speech perception, and the existence of links between the dimensions of space, time, and number. Overall, evidence from these studies supports the idea that human newborns are spontaneously driven, and cognitively equipped, to link information collected by the different sensory modes in order to create a representation of a stable world.

Abstract representations of small sets in newborns

From the very first days of life, newborns are not tied to represent narrow, modality- and object-specific aspects of their environment. Rather, they sometimes react to abstract properties shared by stimuli of very different nature, such as approximate numerosity or magnitude. As of now, however, there is no evidence that newborns possess abstract representations that apply to small sets: in particular, while newborns can match large approximate numerosities across senses, this ability does not extend to small numerosities. In two experiments, we presented newborn infants (N = 64, age 17 to 98 h) with patterned sets AB or ABB simultaneously in the auditory and visual modalities. Auditory patterns were presented as periodic sequences of sounds (AB: triangle-drum-triangle-drum-triangle-drum …; ABB: triangle-drum-drum-triangle-drum-drum-triangle-drum-drum …), and visual patterns as arrays of 2 or 3 shapes (AB: circle-diamond; ABB: circle-diamond-diamond). In both experiments, we found that participants reacted and looked longer when the patterns matched across the auditory and visual modalities – provided that the first stimulus they received was congruent. These findings uncover the existence of yet another type of abstract representations at birth, applying to small sets. As such, they bolster the hypothesis that newborns are endowed with the capacity to represent their environment in broad strokes, in terms of its most abstract properties. This capacity for abstraction could later serve as a scaffold for infants to learn about the particular entities surrounding them.

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Newborns were presented with auditory and visual patterns (AB vs. ABB).

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Participants reacted when the patterns presented were congruent across modalities.

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Newborns possess abstract representations applying to small sets.

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These representations may encode numerosity and/or repetitions.

Protocol of controlled odorant stimulation for reducing apnoeic episodes in premature newborns: a randomised open-label Latin-square study with independent evaluation of the main endpoint (PREMODEUR)

INTRODUCTION

Apnoea affects 85% of premature infants under 34 weeks of age and would be an important risk factor for subsequent neuropsychological disorders. Currently, premature children with life-threatening apnoeas receive stimulants such as methylxanthines (mainly, caffeine) or doxapram (an analeptic unlicensed in children under 15). However, these products have undesirable effects (hyperarousal, irritability, sleep disorders, tachycardia) and are not always effective because apnoea does persist in some premature newborns. Previous studies have indicated that odorant stimulation, a non-invasive intervention, may stimulate the respiratory rhythm. The objective of the present protocol is to reduce the occurrence of apnoeic episodes in premature newborns by controlled odorant stimulation added to current pharmacological treatments.

METHODS AND ANALYSIS

The project is a randomised open-label Latin-square trial with independent evaluation of the main endpoint. It will include 60 preterm neonates from two university hospital neonatal intensive care units over 2 years (2021-2023). Each newborn will receive no (S0), sham (S1) or real olfactory stimulation (S2) in random order. During S2, three distinct odorants (mint, grapefruit and vanilla) will be delivered successively, in puffs, over 24 hours. Mint and grapefruit odours stimulate the main and the trigeminal olfactory pathways, whereas vanilla odour stimulates only the main olfactory pathway. A statistical analysis will compare the incidence of apnoeic episodes during S1 versus S2 using a mixed effects Poisson model.

ETHICS AND DISSEMINATION

Ethical approval was obtained from the Comité de Protection des Personnes Île-de-France XI (# 2017-AO13-50-53). The results will be disseminated through various scientific meetings, specialised peer-reviewed journals and, whenever possible, posted on appropriate public websites.

TRIAL REGISTRATION NUMBER

NCT02851979; Pre-results.

Prenatal dietary choline supplementation modulates long-term memory development in rat offspring

Background: Previous studies on preclinical models have shown that giving supplemental choline during the embryonic period improves performance on memory tasks during adulthood. However, the effects of an early intervention on the development of cognitive functions in the immature brain have not been widely studied. In addition, it has been well established that short-term memory in rats emerges at an earlier stage than long-term memory.Objective: The aim of this work was to examine the effect of prenatal dietary choline supplementation on long-term memory development in rats.Methods: In order to assess long-term memory, we used an object-recognition task, which evaluates the ability to recall a previously presented stimulus. Pregnant rats were fed with the diets AIN 76-A standard (1.1 g choline/Kg food) or supplemented (5 g choline/Kg food) between embryonic days (E) 12 and E18. On the first post-natal day (PN 0), male offspring of the rats fed with the supplemented and standard diet were cross-fostered to rat dams fed a standard diet during pregnancy and tested at the age of PN21-22 or PN29-31 applying 24-hour retention tests.Results: The supplemented animals spent less time exploring the familiar object after a 24-hour retention interval, an effect that was observed in both the group tested at PN21-22 days of age and that tested at PN29-31 days. The non-supplemented rats only showed this effect in the group tested at PN29-31 days.Conclusions: These results suggest that prenatal supplementation with choline accelerates the development of long-term memory in rats.

What we talk about when we talk about pediatric suffering

In this paper I aim to show why pediatric suffering must be understood as a judgment or evaluation, rather than a mental state. To accomplish this task, first I analyze the various ways that the label of suffering is used in pediatric practice. Out of this analysis emerge what I call the twin poles of pediatric suffering. At one pole sits the belief that infants and children with severe cognitive impairment cannot suffer because they are nonverbal or lack subjective life experience. At the other pole exists the idea that once child suffering reaches some threshold it is ethical to eliminate the sufferer. Concerningly, at both poles, any particular child vanishes from view. Second, in an attempt to identify a theory of suffering inclusive of children, I examine two prominent so-called experiential accounts of suffering. I find them both wanting on account of their absurd entailments and their flawed assumptions regarding the subjective experiences of people who cannot communicate expressively. Finally, I extend arguments found in Alastair MacIntyre's Dependent Rational Animals to argue that child suffering can be understood only as a set of absences-absences of conditions such as love, warmth, and freedom from pain. An evaluation of these absences reveals the exquisite dependency of children. It also discloses why pediatric suffering is necessarily a social and political event. Unlike adults, children will never be either the authors or the mitigators of their own suffering. Rather, children must rely wholly on others in order to resist suffering, grow, and flourish.

Multiscale Structure-Function Gradients in the Neonatal Connectome

The adult functional connectome is well characterized by a macroscale spatial gradient of connectivity traversing from unimodal toward higher-order transmodal cortices that recapitulates known principles of hierarchical organization and myelination patterns. Despite an emerging literature assessing connectome properties in neonates, the presence of connectome gradients and particularly their correspondence to microstructure remains largely unknown. We derived connectome gradients using unsupervised techniques applied to functional connectivity data from 40 term-born neonates. A series of cortex-wide analysis examined associations to magnetic resonance imaging-derived morphological parameters (cortical thickness, sulcal depth, curvature), measures of tissue microstructure (intracortical T1w/T2w intensity, superficial white matter diffusion parameters), and subcortico-cortical functional connectivity. Our findings indicate that the primary neonatal connectome gradient runs between sensorimotor and visual anchors and captures specific associations to cortical and superficial white matter microstructure as well as thalamo-cortical connectivity. A second gradient indicated an anterior-to-posterior asymmetry in macroscale connectivity alongside an immature differentiation between unimodal and transmodal areas, indicating a connectome-level circuitry en route to an adult-like organization. Our findings reveal an important coordination of structural and functional interactions in the neonatal connectome across spatial scales. Observed associations were replicable across individual neonates, suggesting consistency and generalizability.

Dynamic effects of habituation and novelty detection on newborn event-related potentials

Newborns habituate to repeated auditory stimuli, and discriminate syllables, generating opportunities for early language learning. This study investigated trial-by-trial changes in newborn electrophysiological responses to auditory speech syllables as an index of habituation and novelty detection. Auditory event-related potentials (ERPs) were recorded from 16 term newborn infants, aged 1-3 days, in response to monosyllabic speech syllables presented during habituation and novelty detection tasks. Multilevel models demonstrated that newborns habituated to repeated auditory syllables, as ERP amplitude attenuated for a late-latency component over successive trials. Subsequently, during the novelty detection task, early- and late-latency component amplitudes decreased over successive trials for novel syllables only, indicating encoding of the novel speech syllable. We conclude that newborns dynamically encoded novel syllables over relatively short time periods, as indicated by a systematic change in response patterns with increased exposure. These results have important implications for understanding early precursors of learning and memory in newborns.

Assessment of memory functioning over two years following severe childhood traumatic brain injury: results of the TGE cohort

The aims of this study were (1) to prospectively measure memory functioning following severe childhood Traumatic Brain Injury (TBI), and its evolution over 2 years; (2) to assess demographic and medical factors associated with memory function and recovery; (3) to explore relations between memory and other TBI outcomes. Methods: Children (aged 0-15 years; n= 65) consecutively admitted in a single trauma center over a 3-year period, who survived severe non-inflicted TBI, were included in a prospective longitudinal study. Memory was assessed in 38 children aged 5-15 years at injury, using the Children's Memory Scale at 3, 12, and 24 months post-injury. Results: Mean general memory score was low at 3 months (M = 90.2, SD = 20.3) but within the normal range at 12 and 24 months (M = 100.6, SD = 23.1 and M = 108.6, SD = 24.1, respectively), with high variability. Improvement was stronger for immediate visual memory than for other memory indices. Lower general memory score was associated with higher injury severity, lower intellectual ability and functional status, higher overall disability, and ongoing education. Conclusion: Memory functioning is highly variable following severe childhood TBI, related to injury severity and functional, cognitive and educational outcomes; improvement is significant during the first-year post-injury, but varies according to the type of memory.

Fragility of haptic memory in human full-term newborns

BACKGROUND

Numerous studies have established that newborns can memorize tactile information about the specific features of an object with their hands and detect differences with another object. However, the robustness of haptic memory abilities has already been examined in preterm newborns and in full-term infants, but not yet in full-term newborns. This research is aimed to better understand the robustness of haptic memory abilities at birth by examining the effects of a change in the objects' temperature and haptic interference.

METHODS

Sixty-eight full-term newborns (mean postnatal age: 2.5 days) were included. The two experiments were conducted in three phases: habituation (repeated presentation of the same object, a prism or cylinder in the newborn's hand), discrimination (presentation of a novel object), and recognition (presentation of the familiar object). In Experiment 1, the change in the objects' temperature was controlled during the three phases.

RESULTS AND CONCLUSION

Results reveal that newborns can memorize specific features that differentiate prism and cylinder shapes by touch, and discriminate between them, but surprisingly they did not show evidence of recognizing them after interference. As no significant effect of the temperature condition was observed in habituation, discrimination and recognition abilities, these findings suggest that discrimination abilities in newborns may be determined by the detection of shape differences. Overall, it seems that the ontogenesis of haptic recognition memory is not linear. The developmental schedule is likely crucial for haptic development between 34 and 40 GW.

Eye-Hand-Mouth Coordination in the Human Newborn

BACKGROUND

There have been several studies concerning rudimentary coordination of the eyes, hands, and mouth in the human newborn. The author attempted to clarify the ontogenetic significance of the coordination during the earliest period of human life through a systematic review. The neural mechanism underlying the coordination was also discussed based on the current knowledge of cognitive neuroscience.

METHODS

Searches were conducted on PubMed and Google Scholar from their inception through March 2017.

RESULTS

Studies have demonstrated that the coordination is a visually guided goal-directed motor behavior with intension and emotion. Current cognitive research has proved that feeding requires a large-scale neural network extending over several cortices.

CONCLUSION

The eye-hand-mouth coordination in the newborn can be regarded as a precursor of subsequent self-feeding, and the coordination is very likely mediated through the underdeveloped but essentially the same network interconnecting cortices as in the adult.

The Soul, as an Uninhibited Mental Activity, is Reduced into Consciousness by Rules of Quantum Physics

This paper is an effort to describe, in neuroscientific terms, one of the most ambiguous concepts of the universe-the soul. Previous efforts to understand what the soul is and where it may exist have accepted the soul as a subjective and individual entity. We will make two additions to this view: (1) The soul is a result of uninhibited mental activity and lacks spatial and temporal information; (2) The soul is an undivided whole and, to become divided, the soul has to be reduced into unconscious and conscious mental events. This reduction process parallels the maturation of the frontal cortex and GABA becoming the main inhibitory neurotransmitter. As examples of uninhibited mental activity, we will discuss the perceptual differences of a newborn, individuals undergoing dissociation, and individuals induced by psychedelic drugs. Then, we will explain the similarities between the structure of the universe and the structure of the brain, and we propose that consideration of the rules of quantum physics is necessary to understand how the soul is reduced into consciousness.

Habituation as Parameter for Prediction of Mental Development in Healthy Preterm Infants: An Electrophysiological Pilot Study

The aim of this prospective pilot study was to evaluate the predictive value of discrimination and habituation, which was measured by mismatch negativity in 17 healthy very preterm (mean gestational age 27.4 weeks; range 25.0-31.3) and 16 term (mean gestational age 40.3 weeks; range 37.9-41.7) born infants at term equivalent age. Developmental outcome was measured by Bayley Scales of Infant Development-I in 13 preterm and 13 term-born children at a mean age of 21.7 months (±2.18) and 18.5 months (±1.9), respectively. No differences in amplitude and latency of the mismatch negativity were found between both groups at term equivalent age. Within the preterm group habituation capacity was positively correlated with the Mental Developmental Index (r = .654, P = .008) and Performance Developmental Index (r = .482, P = .048) at 21 months. Early learning capability, as measured by habituation, may be associated with a better prognosis for early mental development in healthy preterm infants.

Sound Interferes with the Early Tactile Manual Abilities of Preterm Infants

Premature birth is a sudden change of the sensory environment of a newborn, while their senses are still in development, especially in the stressful and noisy environment of the NICU. The study aimed to evaluate the effect of noise on the early tactile manual abilities of preterm infants (between 29 and 35 weeks PCA). Infants were randomly assigned to one of the two conditions: Silence and Noise. For each condition, two phases were introduced: a habituation phase (repeated presentation of the same object, prism or cylinder), followed by a test phase (presentation of the familiar or a novel object). In the Silence condition, they received the tactile habituation and test phases: In the Noise condition, they went through the same phases, while an alarm sounded. Sixty-three preterm infants were included. They displayed a strong and effective ability to memorize tactile manual information and to detect the difference between two shape features, but this ability seems to be impaired by the concomitant exposure to an alarm sound. This study is the first to highlight the effect of a negative stimulus on sensory functioning in premature infants. It reinforces the importance of developing environmental measures to lower the sound level in NICUs.

Robots Learn to Recognize Individuals from Imitative Encounters with People and Avatars

Prior to language, human infants are prolific imitators. Developmental science grounds infant imitation in the neural coding of actions, and highlights the use of imitation for learning from and about people. Here, we used computational modeling and a robot implementation to explore the functional value of action imitation. We report 3 experiments using a mutual imitation task between robots, adults, typically developing children, and children with Autism Spectrum Disorder. We show that a particular learning architecture - specifically one combining artificial neural nets for (i) extraction of visual features, (ii) the robot’s motor internal state, (iii) posture recognition, and (iv) novelty detection - is able to learn from an interactive experience involving mutual imitation. This mutual imitation experience allowed the robot to recognize the interactive agent in a subsequent encounter. These experiments using robots as tools for modeling human cognitive development, based on developmental theory, confirm the promise of developmental robotics. Additionally, findings illustrate how person recognition may emerge through imitative experience, intercorporeal mapping, and statistical learning.

Origins of Knowledge: Insights from Precocial Species

Behavioral responses are influenced by knowledge acquired during the lifetime of an individual and by predispositions transmitted across generations. Establishing the origin of knowledge and the role of the unlearned component is a challenging task, given that both learned and unlearned knowledge can orient perception, learning, and the encoding of environmental features since the first stages of life. Ethical and practical issues constrain the investigation of unlearned knowledge in altricial species, including human beings. On the contrary, precocial animals can be tested on a wide range of tasks and capabilities immediately after birth and in controlled rearing conditions. Insects and precocial avian species are very convenient models to dissect the knowledge systems that enable young individuals to cope with their environment in the absence of specific previous experience. We present the state of the art of research on the origins of knowledge that comes from different models and disciplines. Insects have been mainly used to investigate unlearned sensory preferences and prepared learning mechanisms. The relative simplicity of the neural system and fast life cycle of insects make them ideal models to investigate the neural circuitry and evolutionary dynamics of unlearned traits. Among avian species, chicks of the domestic fowl have been the focus of many studies, and showed to possess unlearned knowledge in the sensory, physical, spatial, numerical and social domains. Solid evidence shows the existence of unlearned knowledge in different domains in several species, from sensory and social preferences to the left-right representation of the mental number line. We show how non-mammalian models of cognition, and in particular precocial species, can shed light into the adaptive value and evolutionary history of unlearned knowledge.

Mind-Reading Ability and Structural Connectivity Changes in Aging

The Mind-Reading ability through the eyes is an important component of the affective Theory of Mind (ToM), which allows people to infer the other’s mental state from the eye gaze. The aim of the present study was to investigate to which extent age-associated structural brain changes impact this ability and to determine if this association is related to executive functions in elderly subjects. For this purpose, Magnetic Resonance Imaging was used to determine both gray matter and white matter (WM) areas associated with aging. The resulting areas have been included in a subsequent correlation analysis to detect the brain regions whose structure was associated with the Mind-Reading ability through the eyes, assessed with the Italian version of the “Reading the Mind in the Eyes” (RME) test, in a sample of 36 healthy subjects ranging from 24 to 79 years of age. The analysis resulted in three important findings: (1) the performance to the RME test is relatively stable across the decades 20–70 (despite a slight decrease of this ability with aging) and independent from executive functions; (2) structural brain imaging demonstrated the involvement of a great number of cortical ToM areas for the execution of the RME test: the bilateral precentral gyrus, the bilateral posterior insula, the left superior temporal gyrus and the left inferior frontal gyrus, which also showed a significant volume decrease with age; (3) an age and task-related decline in WM connectivity on left fronto-temporal portion of the brain. Our results confirm the age-related structural modifications of the brain and show that these changes have an influence on the Mind-Reading ability through the eyes.

Crossmodal discrimination of 2 vs. 4 objects across touch and vision in 5-month-old infants

Infants are known to possess two different cognitive systems to encode numerical information. The first system encodes approximate numerosities, has no known upper limit and is functional from birth on. The second system relies on infants’ ability to track up to 3 objects in parallel, and enables them to represent exact numerosity for such small sets. It is unclear, however, whether infants may be able to represent numerosities from all ranges in a common format. In various studies, infants failed to discriminate a small vs. a large numerosity (e.g., 2 vs. 4, 3 vs. 6), although more recent studies presented evidence that infants can succeed at these discriminations in some situations. Here, we used a transfer paradigm between the tactile and visual modalities in 5-month-olds, assuming that such cross-modal paradigm may promote access to abstract representations of numerosities, continuous across the small and large ranges. Infants were first familiarized with 2 to 4 objects in the tactile modality, and subsequently tested for their preference between 2 vs. 4, or 3 vs. 6 visual objects. Results were mixed, with only partial evidence that infants may have transferred numerical information across modalities. Implications on 5-month-old infants’ ability to represent small and large numerosities in a single or in separate formats are discussed.

Multisensory integration and child neurodevelopment

A considerable number of cognitive processes depend on the integration of multisensory information. The brain integrates this information, providing a complete representation of our surrounding world and giving us the ability to react optimally to the environment. Infancy is a period of great changes in brain structure and function that are reflected by the increase of processing capacities of the developing child. However, it is unclear if the optimal use of multisensory information is present early in childhood or develops only later, with experience. The first part of this review has focused on the typical development of multisensory integration (MSI). We have described the two hypotheses on the developmental process of MSI in neurotypical infants and children, and have introduced MSI and its neuroanatomic correlates. The second section has discussed the neurodevelopmental trajectory of MSI in cognitively-challenged infants and children. A few studies have brought to light various difficulties to integrate sensory information in children with a neurodevelopmental disorder. Consequently, we have exposed certain possible neurophysiological relationships between MSI deficits and neurodevelopmental disorders, especially dyslexia and attention deficit disorder with/without hyperactivity.

Bilateral gain control; an "innate predisposition" for all sorts of things

Empirical studies have revealed remarkable perceptual organization in neonates. Newborn behavioral distinctions have often been interpreted as implying functionally specific modular adaptations, and are widely cited as evidence supporting the nativist agenda. In this theoretical paper, we approach newborn perception and attention from an embodied, developmental perspective. At the mechanistic level, we argue that a generative mechanism based on mutual gain control between bilaterally corresponding points may underly a number of functionally defined “innate predispositions” related to spatial-configural perception. At the computational level, bilateral gain control implements beamforming, which enables spatial-configural tuning at the front end sampling stage. At the psychophysical level, we predict that selective attention in newborns will favor contrast energy which projects to bilaterally corresponding points on the neonate subject's sensor array. The current work extends and generalizes previous work to formalize the bilateral correlation model of newborn attention at a high level, and demonstrate in minimal agent-based simulations how bilateral gain control can enable a simple, robust and “social” attentional bias.