Does preterm birth increase a child's risk for language impairment?

Abstract

Background: Although premature birth is associated with lags in language acquisition, it is unclear whether preterms exhibit an elevated risk for language impairment (LI). This study determined whether preterms, without frank cerebral damage, at 2;6 and 3;6 exhibited a higher rate of risk for LI as compared to full-terms, and also sought to identify predictors of risk.

Method: Sixty-four Italian very immature preterms were assessed longitudinally at 2;6 and 3;6; age-matched full-terms served as controls at 2;6 (n=22) and 3;6 (n=40). Each completed individualized assessments of cognition and language ability. At each time point, using cut-offs specific to each of the language measures, children were differentiated into two groups (at risk for LI, not at risk).

Results: The percentage of full-terms at risk for LI at 2;6 (9.1% to 13.6%) and 3;6 (7.5%) was consistent with prior estimates of LI at these ages. The percentage of preterms at risk for LI at 2;6 (16.1% to 24.1%) and 3;6 (34.4%) was higher at both ages and statistically significant at 3;6 (difference=26.8%, 95% CI=12.3% to 41.4%). The best model predicting risk status at 3;6 was preterms' mean length of utterance (MLU) at 2;6, (sensitivity 72.73%, specificity 85%) when adjusting for maternal education.

Conclusion: Preterms exhibit a heightened risk for LI in the preschool years, since about one in four preterms at 2;6 and one in three preterms at 3;6 experiences significant lags in language acquisition. Findings argue the importance of early identification of language difficulties among preterms coupled with implementation of systematic language-focused interventions for these youngsters.