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Original article
Language in 2-year-old children born preterm and term: a cohort study
  1. Katherine Sanchez1,2,3,
  2. Alicia J Spittle1,4,5,
  3. Jeanie LY Cheong1,5,6,
  4. Deanne K Thompson1,6,7,
  5. Lex W Doyle1,5,8,
  6. Peter J Anderson1,8,9,
  7. Angela T Morgan2,3,10
  1. 1 Victorian Infant Brain Study, Murdoch Children’s Research Institute, Parkville, Victoria, Australia
  2. 2 Speech and Language, Murdoch Children’s Research Institute, Parkville, Victoria, Australia
  3. 3 Department of Audiology and Speech Pathology, University of Melbourne, Parkville, Victoria, Australia
  4. 4 Department of Physiotherapy, University of Melbourne, Parkville, Victoria, Australia
  5. 5 Newborn Research, The Royal Women’s Hospital, Parkville, Victoria, Australia
  6. 6 Department of Obstetrics and Gynecology, University of Melbourne, Parkville, Victoria, Australia
  7. 7 Neuroimaging and Neuroinformatics, Florey Institute of Neuroscience and Mental Health, Parkville, Victoria, Australia
  8. 8 Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
  9. 9 Monash Institute of Cognitive and Clinical Neuroscience, Monash University, Clayton, Victoria, Australia
  10. 10 Department of Speech Pathology, the Royal Children’s Hospital, Parkville, Victoria, Australia
  1. Correspondence to Professor Angela T Morgan, Speech and Language Research Group, Murdoch Children’s Research Institute, Parkville, VIC 3052, Australia; angela.morgan{at}mcri.edu.au

Abstract

Purpose Language skills are critical. Children born very preterm are vulnerable to language problems, but further work is needed to determine characteristics and specific predictors of language problems in this population. We aimed to compare language outcomes between 2-year-old children born <30 weeks and their term-born peers; and to explore risk factors for language difficulties in this cohort.

Design Language at 2 years was examined in 134 children born <30 weeks and 133 children born at term using the Bayley Scales of Infant and Toddler Development – 3rd Edition (Bayley-3) and the Communication and Symbolic Behaviour Scale: Developmental Profile (Infant Toddler Checklist) (CSBS:DP). Outcomes were compared between groups. Factors hypothesised to predict language outcome were examined in the preterm group: gestational age at birth, birth weight z-score, sex, hearing loss, multilingualism, maternal education, brain abnormality on MRI, medical risk and oromotor concerns at 12 months.

Results Children born <30 weeks performed more poorly on the CSBS:DP (particularly the social and symbolic composites) and the language scale of the Bayley-3 at 2 years than term-born peers. Lower gestational age at birth, male sex, hearing loss and multilingualism predicted poorer language scores.

Conclusions Despite improvements in medical management, children born very preterm exhibit language delays at 2 years of age, with specific deficits in social communication and symbolic skills. Significant predictors of poorer language outcomes were similar to those in the general population (male sex, hearing loss, multilingualism), suggesting that further work is needed to establish which specific factors place preterm-born children at heightened risk.

  • preterm
  • premature

https://doi.org/10.1136/archdischild-2018-315843

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    Footnotes

    • Contributors KS made substantial contributions to the design of the work, the acquisition, analysis and interpretation of data, and drafting the work. KS made substantial contributions to the design of the work, the acquisition, analysis and interpretation of data, and drafting the work. All authors approved the final version to be published and agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

    • Funding This research was supported by the National Health and Medical Research Council (AM Career Development Award 607315 and Practitioner Fellow 1105008; AS Career Development Fellowship 11098714, DT Career Development Fellowship 1085754, JC Career Development Fellowship 1141354, PA Senior Research Fellowship 1081288, KS AS JC DT LD and PA Centre for Research Excellence in Newborn Medicine grant 1060733), an Australian Government Research Training Program Scholarship (KS), and from Speech Pathology Australia’s Nadia Verrall Memorial Research Grant (KS). Murdoch Children’s Research Institute research is supported by the Victorian government’s Operational Infrastructure Support Program.

    • Competing interests None declared.

    • Patient consent Not required.

    • Ethics approval Human Research Ethics Committee (HREC 10/07) approved this study.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement Additional unpublished data for this study is currently unavailable.