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Speech and language development after infant tracheostomy
1Medical-Behavioral Center, Rainbow Babies & Children's Hospital, Cleveland, OH.
Insights
Children intubated before 13 months showed normal overall language skills. However, older children in the study exhibited significant expressive language deficits, challenging prior assumptions.
Area of Science:
- Pediatric Medicine
- Speech-Language Pathology
- Developmental Pediatrics
Background:
- Endotracheal intubation is a medical intervention used in infants and children.
- Prolonged intubation may potentially impact speech and language development.
- Previous assumptions suggested normal language acquisition in children with a history of intubation.
Purpose of the Study:
- To investigate the long-term speech and language development in children who underwent prolonged endotracheal intubation.
- To identify potential age-related patterns of language deficits following early-life intubation.
Main Methods:
- A cohort of 31 children with endotracheal tubes (intubation before 13 months, duration >3 months) was assessed.
- Children with pre-existing neurological disorders or developmental delays were excluded.
- Standardized speech, language, and cognitive assessments were administered.
Main Results:
- Overall language functioning was within normal limits for the entire group.
- A specific pattern of expressive language impairment was observed in the oldest children tested.
- Cognitive abilities were commensurate with overall language functioning.
Conclusions:
- While overall language skills may appear normal, early and prolonged endotracheal intubation can be associated with specific expressive language difficulties.
- The findings challenge the assumption of universally normal speech and language development in this pediatric population.
- Further research is warranted to understand the mechanisms and long-term implications of intubation on pediatric language acquisition.
Abstract:
This study describes the speech/language development of 31 children who had been fitted with an endotracheal tube. Intubation in all cases occurred prior to 13 months of age and remained in situ for more than 3 months. These children were chosen from a pool of 130 potential subjects. Individuals diagnosed as having a primary neurological disorder, developmental delays, or mental retardation were excluded from the study. Demographic, birth, and medical factors that might also affect language outcome were documented. Standardized outcome measures were used to assess speech, language, and cognitive development of the children seen for testing. For the entire group of children, the overall measures of language functioning at follow-up were within normal limits and commensurate with cognitive ability. However, when a breakdown of results based on the children's ages was done, a clear pattern of language disability was noted in the expressive language of the oldest group of children tested. These findings raise questions about this group of children who were previously thought to develop speech and language skills normally.