Early Speech Therapy Is Associated with Decreased Length of Stay in Preterm Infants <28 Weeks Gestational Age

The aim of this study was to assess the timing of speech therapy (ST) on the length of stay (LOS) and developmental outcomes at 6 and 12 months in preterm infants.

Infants delivered at 24 to 28 weeks gestational age (GA) who received ST from 2022 to 2025 were enrolled. Analysis comparing postmenstrual age (PMA) at ST initiation determined two cohorts. Demographic, imaging studies, and clinical outcomes were compared between cohorts using R software. Multivariable regression adjusting for comorbidities was analyzed using SAS. p-Value < 0.05 was considered significant.

Eighty-four infants initiated ST < 40 weeks PMA (group A) compared with thirty infants ≥ 40 weeks PMA (group B). Comorbidities including bronchopulmonary dysplasia (BPD) and intraventricular hemorrhage (IVH) were more prevalent in group B (BPD: n = 32, 42.9% group A vs. n = 18, 60.6% group B, p < 0.01; IVH: n = 11, 13.1% group A vs. n = 7, 22.3%, p < 0.01). Group B had more occupational therapy (OT) and ST visits during their hospital stay (OT: 13.2 vs. 20.7, ST: 11.6 vs. 18.2, p < 0.01). Barium swallow studies showed there was less aspiration described in group A (p < 0.01), but no difference in laryngeal penetration (p = 0.14). Group B was tube-fed more often at the 6-month follow-up (n = 8, 10.3% vs. n = 12, 41.4%, p < 0.01) and at the 12-month follow-up (n = 13, 21% vs. n = 8, 66.7%, p < 0.01). Group A had higher developmental scores on their Ages and Stages Questionnaire (ASQ) at their 12-month follow-up. Group A had a shorter LOS using multivariable linear regression (standard error of the mean: 32.8 [ ± 12.2], 95% CI [8.4, 57.7], p = 0.02).

Infants who initiated ST before 40 weeks PMA (group A) had a shorter LOS, decreased risk of aspiration and lower rates of comorbidities during their neonatal intensive care unit stay, and higher ASQ scores at 12 months compared with group B.

· LOS was decreased in infants who initiated ST before 40 weeks PMA.. · Early ST is associated with higher rates of oral feeds at 6- and 12-month follow-up.. · Infants with later ST implementation had higher risk of aspiration on barium swallow studies.. · Delayed oral skills maturation is common in preterm infants and should be evaluated by ST..