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Published on: November 20, 2015
Communication in children born very preterm: a prospective cohort study
Katherine Sanchez1,2, Jessica O Boyce1,2, Cristina Mei1
1Murdoch Children's Research Institute, Parkville, Victoria, Australia.
Insights
Children born preterm, especially before 30 weeks gestation, show poorer language development. Male sex, social risk, and neurodevelopmental diagnosis impact language outcomes in preterm infants.
Area of Science:
- Developmental Pediatrics
- Speech-Language Pathology
- Neonatology
Background:
- Premature birth (<30 weeks gestation) can impact child development.
- Language, speech, and voice are crucial developmental domains.
- Identifying predictors of developmental outcomes is essential for early intervention.
Purpose of the Study:
- To compare language, speech, and voice in children born preterm versus at term.
- To identify predictors of language, speech, and voice outcomes in preterm infants.
Main Methods:
- Prospective study of 300 infants (149 preterm, 151 term-born).
- Assessment at 3 years using standardized language, speech, and voice evaluations.
- Analysis of predictors including gestational age, birthweight, sex, chronic lung disease, social risk, and neurodevelopmental diagnosis.
Main Results:
- Children born preterm exhibited poorer language skills compared to term-born children.
- Speech and voice outcomes were comparable between preterm and term-born groups.
- Chronic lung disease predicted voice quality; male sex, high social risk, and neurodevelopmental diagnosis predicted poorer language outcomes.
Conclusions:
- Preterm infants, particularly those born before 30 weeks gestation, face challenges in language development.
- Neurodevelopmental disabilities and high social risk are significant predictors of poorer language outcomes in preterm children.
- Targeted language enrichment strategies are recommended for preterm infants with identified risk factors.
Aim:
To compare language, speech, and voice of children born preterm and at term, and determine relevant predictors of outcome.
Method:
Three hundred infants (150 males, 150 females; 149 born at <30wks' gestation, 151 term-born) were prospectively recruited at birth from the Royal Women's Hospital. We administered the Preschool Language Scales, Fifth Edition, Diagnostic Evaluation of Articulation and Phonology, Grade Roughness Breathiness Asthenia Strain Scale, and Pediatric Voice Handicap Index at 3 years, and compared groups. We examined hypothesized predictors in children born preterm: gestational age at birth, birthweight, sex, chronic lung disease, high social risk, multilingualism, neurodevelopmental diagnosis, and oromotor feeding.
Results:
Children born preterm had poorer language than children born at term (coefficient -5.43). Speech and voice were similar between groups (coefficients -0.70 to 1.63). Chronic lung disease predicted voice (coefficient 6.05); male sex (coefficients 4.54-6.18), high social risk (coefficient -6.02 to -9.30), and neurodevelopmental diagnosis (coefficients -16.42 to -20.61) predicted language.
Interpretation:
Children born before 30 weeks' gestation had poorer language than children born at term. Children born preterm with neurodevelopmental disabilities or high social risk experience poorer language outcomes, and would benefit from enrichment of their language environment.
What This Paper Adds:
Speech and voice outcomes were similar between children born preterm and at term. Male sex, high social risk, and neurodevelopmental diagnosis predicted language outcomes.
