Language in 3-year-olds born preterm and term (Sanchez et al., 2019)

posted on 19.12.2019 by Katherine Sanchez, Alicia J. Spittle, Jessica O. Boyce, Linda Leembruggen, Anastasia Mantelos, Stephanie Mills, Naomi Mitchell, Emily Neil, Miya St John, Jasmin Treloar, Angela T. Morgan
Purpose: Language difficulties are prevalent among children born preterm. Existing studies have largely used standardized language tests, providing limited scope for detailed descriptive examination of preterm language. This study aimed to examine differences in conversational language between children born < 30 weeks and at term as well as correlations between language sample analysis (LSA) and a standardized language tool.
Method: Two hundred four 3-year-olds (103 born < 30 weeks, 101 born at term) recruited at birth provided a 10-min language sample and completed the Preschool Language Scales–Fifth Edition (I. Zimmerman, Steiner, & Pond, 2011). LSA was conducted using the Systematic Analysis of Language Transcripts and Index of Productive Syntax. Group differences were analyzed using linear regression, and Pearson correlation coefficient (coef) was used to determine correlations between measures.
Results: Children born < 30 weeks scored lower than term-born peers on multiple metrics when controlled for confounding factors (sex, high social risk, multilingualism, and diagnosed neurodevelopmental disorders), including mean length of utterance in morphemes (coef = –0.28, 95% confidence interval [CI] [–0.56, 0.01]) and words (coef = –0.29, 95% CI [–0.53, –0.05]), number of different word roots (coef = –10.04, 95% CI [–17.93, –2.14]), and Index of Productive Syntax sentence structures (coef = –1.81, 95% CI [–3.10, –0.52]). Other variables (e.g., number of utterances, number of nouns and adjectives) were not significantly different between groups. LSA and the Preschool Language Scales–Fifth Edition were at most moderately correlated (≤ .45).
Conclusions: Three-year-old children born preterm demonstrated poorer conversational language than children born at term, with some specific areas of deficit emerging. Furthermore, formal assessment and LSA appear to provide relatively distinct and yet complementary data to guide diagnostic and intervention decisions.

Supplemental Material S1. Comparison between participants with < 50 versus ≥ 50 utterances.

Supplemental Material S2. Interrater reliability.

Sanchez, K., Spittle, A. J., Boyce, J. O., Leembruggen, L., Mantelos, A., Mills, S., Mitchell, N., Neil, E., St John, M., Treloar, J., & Morgan, A. T. (2019). Conversational language in 3-year-old children born very preterm and at term. Journal of Speech, Language, and Hearing Research. Advance online publication. https://doi.org/10.1044/2019_JSLHR-19-00153


Funding for this study was received from the National Health and Medical Research Council (Career Development Award 607315 and Practitioner Fellowship 1105008 [awarded to A. M.]; Career Development Fellowship 11098714, Centre for Research Excellence in Newborn Medicine Grant 1060733 [awarded to A. S.]; Centre for Research Excellence in Newborn Medicine Grant 1060733 [awarded to K. S.]) and an Australian Government Research Training Program Scholarship (awarded to K. S.). Murdoch Children’s Research Institute research was supported by the Victorian government’s Operational Infrastructure Support Program.