Language outcomes at 4 years of linguistically diverse children born very preterm: an Australian retrospective single-centre study

Giannina Tinoco Mendoza; Jacqueline Stack; Mohamed E Abdel-Latif; Shanti Raman; Pankaj Garg

doi:10.1136/bmjpo-2022-001814

Language outcomes at 4 years of linguistically diverse children born very preterm: an Australian retrospective single-centre study

BMJ Paediatr Open. 2023 Jul;7(1):e001814. doi: 10.1136/bmjpo-2022-001814.

Authors

Giannina Tinoco Mendoza^{1

2}, Jacqueline Stack^{2

3}, Mohamed E Abdel-Latif^{4

5

6}, Shanti Raman^{2

7}, Pankaj Garg^{2

7}

Affiliations

¹ Newborn Care Centre, Royal Hospital for Women, Sydney, New South Wales, Australia Giannina.TinocoMendoza@health.nsw.gov.au.
² School of Women's and Children's Health, University of New South Wales, Sydney, New South Wales, Australia.
³ Newborn Care Centre, Liverpool Hospital, Sydney, New South Wales, Australia.
⁴ Department of Neonatology, Centenary Hospital for Women and Children, Canberra Hospital, Canberra, Australian Capital Territory, Australia.
⁵ Discipline of Neonatology, School of Medicine and Psychology, Australian National University, Canberra, Australian Capital Territory, Australia.
⁶ Department of Public Health, La Trobe University, Melbourne, Victoria, Australia.
⁷ Department of Community Paediatrics, South Western Sydney Local Health District, Liverpool, New South Wales, Australia.

Abstract

Background: Very preterm children are at increased risk of language delays. Concerns have been raised about the utility of standardised English language tools to diagnose language delay in linguistically diverse children. Our study investigated the incidence of language delay at 4 years in linguistically diverse very preterm children.

Methods: Very preterm children born in South Western Sydney, Australia, between 2012 and 2016, were assessed with the Clinical Evaluation of Language Fundamentals Preschool-2 (CELF-P2) tool at 4 years of age. We sought to determine the incidence of language delay in this cohort using language scores from the CELF-P2 assessment tool, and explore potential predictors associated with language delay.

Results: One hundred and sixty very preterm children attended the 4-year assessment out of the included 270 long-term survivors. At 4 years, 76 (52%) very preterm children had language delay diagnosed using the CELF-P2 assessment tool. Children who preferred a language other than English had lower average core language scores on the CELF-P2 assessment tool (75.1±14.4) compared with children that preferred English (86.5±17.9); p=0.002. Very preterm children growing up in households that preferenced a language other than English and those who were born from multiple births had higher odds of language delay at 4 years (AOR 10.30 (95% CI 2.82 to 38.28); p<0.001 and AOR 2.93 (95% CI 1.20 to 7.14); p=0.018, respectively). Assessing these children using an English language tool may have affected language scores at 4 years.

Conclusions: In this metropolitan setting, very preterm children from linguistically diverse backgrounds were found to be vulnerable to language delays at 4 years. Further large-scale studies evaluating the language outcomes of linguistically diverse preterm children with more culturally appropriate tools are warranted. We question the utility of standardised English language tools to assess language outcomes of linguistically diverse populations.

Keywords: Neonatology.

MeSH terms

Australia / epidemiology
Child
Child, Preschool
Female
Humans
Infant, Extremely Premature*
Infant, Newborn
Language
Language Development Disorders* / diagnosis
Language Development Disorders* / epidemiology
Retrospective Studies