Neurophysiologic evaluation of early cognitive development in high-risk infants and toddlers.

New knowledge of the perceptual, discriminative, and memory capabilities of very young infants has opened the door to further evaluation of these abilities in infants who have risk factors for cognitive impairments. A neurophysiologic technique that has been very useful in this regard is the recording of event-related potentials (ERPs). The event-related potential (ERP) technique is widely used by cognitive neuroscientists to study cognitive abilities such as discrimination, attention, and memory. This method has many attractive attributes for use in infants and children as it is relatively inexpensive, does not require sedation, has excellent temporal resolution, and can be used to evaluate early cognitive development in preverbal infants with limited behavioral repertories. In healthy infants and children, ERPs have been used to gain a further understanding of early cognitive development and the effect of experience on brain function. Recently, ERPs have been used to elucidate atypical memory development in infants of diabetic mothers, difficulties with perception and discrimination of speech sounds in infants at risk for dyslexia, and multiple areas of cognitive differences in extremely premature infants. Atypical findings seen in high-risk infants have correlated with later cognitive outcomes, but the sensitivity and specificity of the technique has not been studied, and thus evaluation of individual infants is not possible at this time. With further research, this technique may be very useful in identifying children with cognitive deficits during infancy. Because even young infants can be examined with ERPs, this technique is likely to be helpful in the development of focused early intervention programs used to improve cognitive function in high-risk infants and toddlers.