Language functions deserve more attention in follow-up of children born very preterm

Abstract

Background: Language is a complex neurodevelopmental phenomenon. Approximately 45% of children born very preterm (VP) show mild-to-severe language problems throughout childhood. Nevertheless, in most hospitals in Europe language functions are not routinely assessed at follow-up. Objective: To give clear indications for extensive language assessment in school-aged children born VP, based on routinely assessed intelligence and behavioral problems. Method: Language functions of 63 10-year-old children born VP (<32 weeks’ gestation) without major handicaps were compared to their intellectual and executive functions and behavioral problems. Using multiple linear regression analyses, the predictive value of perinatal factors and the association with neurodevelopmental factors of low language were measured. Results: The mean language score was significantly lower than the verbal intelligent quotient (VIQ; mean difference = 6.4, p <.001, d=.48) and the mean vocabulary knowledge (mean difference = 9.3, p <.001, d=.70). Besides, VIQ (β =.649, p =.001) and performance IQ (PIQ; β =.260, p =.035) were significantly associated with language scores. Significant predictors of language scores were number of days of assisted ventilation (β = -.592, p =.015) and mother's vocabulary knowledge (β =.473, p =.014), rather than mother's educational level (β =.139, p =.956). Conclusions: Children born VP had language problems that were not expected from their significantly higher VIQ and vocabulary knowledge. Clinicians assessing these children should be aware of possible language problems, which cannot be detected with a simple vocabulary task. Our findings provide evidence of the need for adequate language assessments by a speech-language pathologist in children born VP, especially in those with VIQ scores in the low average range.