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The effects of intraventricular hemorrhage on functional communication skills in preterm toddlers
S H Landry1, M Schmidt, M A Richardson
1Department of Pediatrics, University of Texas Medical Branch, Galveston 77550.
Insights
Preterm toddlers with severe brain bleeds (IVH Grades III and IV) showed delayed language development. Maternal communication support was less effective for these high-risk infants, impacting their functional communication skills.
Area of Science:
- Neonatal Medicine
- Developmental Psychology
- Speech-Language Pathology
Background:
- Preterm birth is associated with various medical complications, including intraventricular hemorrhage (IVH).
- Early medical complications may impact neurodevelopmental outcomes, particularly language acquisition.
- Understanding the interplay between medical factors, maternal interaction, and child communication is crucial for early intervention.
Purpose of the Study:
- To investigate the effects of intraventricular hemorrhage (IVH) severity on functional language use in preterm toddlers.
- To examine the relationship between maternal verbal stimulation and child communication behaviors in preterm and full-term toddlers.
- To identify how different levels of IVH influence mother-child communication dynamics.
Main Methods:
- A cohort of 24-month-old preterm toddlers (n=27) was categorized by IVH severity (none, Grades I-II, Grades III-IV).
- Participants were matched to a full-term toddler group (n=10) on socioeconomic status and developmental age.
- Functional language use and mother-child interaction patterns were assessed.
Main Results:
- Preterm toddlers, especially those with higher IVH grades, exhibited less frequent use of verbalizations and gestures for various communicative functions.
- Child communication behaviors did not significantly differ based on specific medical complications, but maternal behavior patterns did.
- Maternal verbal support was linked to child language use in full-term and lower-risk preterm groups, but not in the high-risk IVH (Grades III-IV) group.
Conclusions:
- Severe intraventricular hemorrhage (IVH Grades III-IV) is associated with functional communication delays in preterm toddlers.
- Maternal responsiveness patterns differ in high-risk preterm infants, potentially affecting the efficacy of verbal stimulation.
- Targeted interventions addressing both child communication needs and adapted maternal interaction strategies are warranted for preterm infants with severe IVH.
Abstract:
A group of 24-month-old preterm toddlers (n = 27) were subdivided into three groups according to their early specific medical complications [i.e., respiratory distress syndrome (RDS), without intraventricular hemorrhage (IVH), IVH (Grades I and II), and IVH (Grades III and IV]) and were matched to a group of full-term toddlers (n = 10) on socioeconomic status and mental and receptive language age. We evaluated (1) the effects of IVH on functional use of language (e.g., speech acts), and (2) the relationship of mothers' verbal attempts to stimulate children's interest in topics and toys with the communication behaviors used by the children. The preterm groups used verbalizations and gestures less frequently to express a range of functions, but were comparable to the full-term children in their use of communicative acts that served to continue interactions. Although child behaviors did not differ in relation to specific medical complications, these differences were apparent in the mothers' behavior patterns and in the relationships between mother and child behavior. Mothers' verbal maintaining behavior was strongly associated with children's use of language for the full-term and two lower risk preterm groups, but not the higher risk IVH (Grades III and IV) group. The mothers of the IVH (Grades III and IV) group showed high responsiveness to lower level child behaviors, a pattern that was not apparent in the other preterm groups for lower risk children who showed comparable delays in their functional communication development.