Language barriers and mental health problems of preschool children born very preterm in Germany

We assessed whether behavioural and emotional problems of 5- to 6-year-old preschool children born very preterm (<32 weeks' gestation) are associated with an immigrant background and linguistic distance of their first language to the host country's official language, German.

This is an observational longitudinal cohort study. Data are from the national multicentre German Neonatal Network cohort, including all very preterm births from 2009 onwards. A total of 3220 (n = 1570 female) children were followed up at preschool age; 629 (n = 324 female) of these had an immigrant background. Behavioural and emotional problems were assessed using the parent-reported Strengths and Difficulties Questionnaire (SDQ).

Mixed-effects models showed that immigrant status alone was not associated with children's behavioural and emotional problems. However, a higher linguistic distance of the children's first language to German was associated with higher SDQ total problem scores (coefficient = 0.008, 95% confidence interval 0.002, 0.015), after adjusting for known confounders.

Language barriers in the form of linguistic distance between the first language of children born very preterm and countries' official languages are associated with increased risk for behavioural and emotional problems. More research is needed on how language barriers affect long-term developmental outcomes of immigrant children born very preterm.