Adult Talk in the NICU With Preterm Infants and Developmental Outcomes Language assessment of non-handicapped twins at 5 years of age. Neurological and developmental outcome in extremely preterm children born in England in 1995 and 2006: the EPICure studies High Prevalence/Low Severity Language Delay in Preschool Children Born Very Preterm Trajectories of Receptive Language Development From 3 to 12 Years of Age for Very Preterm Children Long-term cognition, achievement, socioemotional, and behavioral development of healthy late-preterm infants. Neurodevelopmental pathways to preterm children's specific and general mathematic abilities. Events at early development: are they associated with early word production and neurodevelopmental abilities at the preschool age? Cognitive development in low risk preterm infants at 3–4 years of life Importance of Parent Talk on the Development of Preterm Infant Vocalizations Randomised trial of parental support for families with very preterm children: outcome at 5 years Influence of perinatal, developmental and environmental factors on cognitive abilities of preterm children without major impairments at 5 years. Prediction of participation and sensory modulation of late preterm infants at 12 months: a prospective study. Neurophysiologic correlates of deficient phonological representations and object naming in prematurely born children Patterns of visual impairment associated with lesions of the preterm infant brain. Language outcomes of 7-year-old children with or without a history of late language emergence at 24 months. Early exposure to maternal voice: effects on preterm infants development.
OBJECTIVE : The goal of this study was to test the association of mean adult word counts at 32 and 36 weeks ’ postmenstrual age in the NICU  with Bayley Scales of Infant and Toddler Development , 3rd Edition ( Bayley-III ) , cognitive and language scores . It was hypothesized that preterm infants exposed to higher word counts would have higher cognitive and language scores at 7 and 18 months ’ corrected age . METHODS : This prospect i ve cohort study included 36 preterm infants with a birth weight ≤1250 g.  Sixteen-hour recordings were made in the NICU by using a digital language processor at 32 and 36 weeks ’ postmenstrual age . Regression analyses were performed on adult word count per hour , with Bayley-III measures correcting for birth weight . RESULTS : Adult word counts in the NICU were positively correlated with 7- and 18-month Bayley-III scores . For the 32-week recording , in regression analyses adjusting for birth weight , adult word count per hour independently accounted for 12 % of the variance in language composite scores ( P = .04 ) and 20 % of the variance in expressive communication scores at 18 months ( P = .008 ) . For the 36-week recording , adult word count per hour independently accounted for 26 % of the variance in cognitive composite scores at 7 months ( P = .0049 ) . CONCLUSIONS : Increased amount of parent talk with preterm infants in the NICU was associated with higher 7- and 18-month corrected age Bayley-III language and cognitive scores . These findings offer an opportunity for language intervention starting in the NICU BACKGROUND The aim of the present study was to determine language levels in twins and singletons born after at least 34 weeks gestation and without identifiable neurological abnormality and to evaluate whether in vitro fertilization ( IVF ) affects language development in twin pregnancies . METHODS A prospect i ve study of a large cohort of all children born between 1 January 2001 and 31 December 2003 was carried out at Gazi University Hospital . All live-born twin pairs in which both twins survived were identified , and a comparable sample of families with pairs of singletons were chosen . The  Stanford-Binet Intelligence Scale Form and the translated Turkish form of the Peabody Picture Vocabulary Test  were completed at 60 months . RESULTS Even after excluding the most premature twins and those with diagnosable neurological damage , twins performed worse than singletons on language development tests . Twin girls had better scores than twin boys . A statistically significant difference was found between the scores of term and preterm twins . No significant difference was noted when compared according to birth order . Appropriate for gestational age ( AGA ) twins did better than small for gestational age ( SGA ) twins in the test scores . All twin girls did not differ from singleton girls , but all twin boys performed worse than singleton boys . Term twins had similar results with term singletons , but preterm twins had lower scores than preterm singletons . SGA singletons had better scores than SGA twins , while AGA twins and singletons did not differ . When the children were compared with regard to method of conception , IVF children had significantly lower scores on the tests than those in the spontaneous conception group . CONCLUSION It is hoped that the present findings could lead to a more precise assessment of children for speech impairment and , above all , to more efficient preventive intervention . Whatever mechanisms are involved , the present results indicate that twins born as a result of IVF , are at a disadvantage in terms of language development in comparison with spontaneously conceived twins Objective To determine outcomes at age 3 years in babies born before 27 completed weeks ’ gestation in 2006 , and to evaluate changes in outcome since 1995 for babies born between 22 and 25 weeks ’ gestation . Design Prospect i ve national cohort studies , EPICure and EPICure 2 . Setting Hospital and home based evaluations , Engl and . Participants 1031 surviving babies born in 2006 before 27 completed weeks ’ gestation . Outcomes for 584 babies born at 22 - 25 weeks ’ gestation were compared with those of 260 surviving babies of the same gestational age born in 1995 . Main outcome measures Survival to age 3 years , impairment ( 2008 consensus definitions ) , and developmental scores . Multiple imputation was used to account for the high proportion of missing data in the 2006 cohort . Results Of the 576 babies evaluated after birth in 2006 , 13.4 % ( n=77 ) were categorised as having severe impairment and 11.8 % ( n=68 ) moderate impairment . The prevalence of neurodevelopmental impairment was significantly associated with length of gestation , with greater impairment as gestational age decreased : 45 % at 22 - 23 weeks , 30 % at 24 weeks , 25 % at 25 weeks , and 20 % at 26 weeks ( P<0.001 ) . Cerebral palsy was present in 83 ( 14 % ) survivors . Mean developmental quotients were lower than those of the general population ( normal values 100 ( SD 15 ) ) and showed a direct relation with gestational age : 80 ( SD 21 ) at 22 - 23 weeks , 87 ( 19 ) at 24 weeks , 88 ( 19 ) at 25 weeks , and 91 ( 18 ) at 26 weeks . These results did not differ significantly after imputation . Comparing imputed outcomes between the 2006 and 1995 cohorts , the proportion of survivors born between 22 and 25 weeks ’ gestation with severe disability , using 1995 definitions , was 18 % ( 95 % confidence interval 14 % to 24 % ) in 1995 and 19 % ( 14 % to 23 % ) in 2006 . Fewer survivors had shunted hydrocephalus or seizures . Survival of babies admitted for neonatal care increased from 39 % ( 35 % to 43 % ) in 1995 to 52 % ( 49 % to 55 % ) in 2006 , an increase of 13 % ( 8 % to 18 % ) , and survival without disability increased from 23 % ( 20 % to 26 % ) in 1995 to 34 % ( 31 % to 37 % ) in 2006 , an increase of 11 % ( 6 % to 16 % ) . Conclusion Survival and impairment in early childhood are both closely related to gestational age for babies born at less than 27 weeks ’ gestation . Using multiple imputation to account for the high proportion of missing values , a higher proportion of babies admitted for neonatal care now survive without disability , particularly those born at gestational ages 24 and 25 weeks Objective : To examine the language development at corrected age 4 years of a regionally representative cohort of children born very preterm ( VPT ) . Of particular interest was the identification of biological and socioenvironmental risk and protective factors that influence  VPT children 's early language development . Method : Data were collected as part of a prospect i ve longitudinal study of 110 VPT ( VPT : ≤33 weeks gestation ) and 113 full-term children ( full term : 37–41 weeks gestation ) born in Canterbury , New Zeal and from 1998 to 2000 . At corrected age 4 years , all children were assessed with the preschool version of the Clinical Evaluation of Language Fundamentals . Extensive information was also collected about children 's family social background , perinatal health , childrearing environment , education/intervention exposures , and neurodevelopmental progress from birth to age 4 . Results : At the age of 4 years , VPT children were characterized by poorer receptive and expressive language development than full-term children . These differences persisted after exclusion of children with neurosensory impairment as well as statistical adjustment for the effects of social risk . Within the VPT group , the key predictors of children 's overall language development were family social risk at birth ( p = .05 ) , severity of white matter abnormalities on neonatal magnetic resonance imaging ( p = .49 ) , observed parent-child synchrony ( p = .001 ) , and concurrent child cognitive ability ( p = .001 ) . Together , these factors accounted for 45 % of the variance in children 's total Clinical Evaluation of Language Fundamentals — Preschool scores . Conclusion : By preschool age , children born VPT  show early emerging mild to moderate language delays that are likely to affect their school success and longer-term developmental progress . Findings highlight the importance of potentially modifiable factors such as early brain injury and parenting quality in predicting the language outcomes of children born VPT OBJECTIVES : The goal was to examine whether indomethacin use , gender , neonatal , and sociodemographic factors predict patterns of receptive language development from 3 to 12 years of age in preterm children . METHODS : A total of 355 children born in 1989–1992 with birth weights of 600 to 1250 g were evaluated at 3 , 4.5 , 6 , 8 , and 12 years with the Peabody Picture Vocabulary Test-Revised  . Hierarchical growth modeling was used to explore differences in language trajectories . RESULTS : From 3 to 12 years , preterm children displayed catch-up gains on the Peabody Picture Vocabulary Test-Revised . Preterm children started with an average st and ardized score of 84.1 at 3 years and gained 1.2 points per year across the age period studied . Growth-curve analyses of Peabody Picture Vocabulary Test-Revised raw scores revealed an indomethacin-gender effect on initial scores at 3 years , with preterm boys assigned r and omly to receive indomethacin scoring , on average , 4.2 points higher than placebo-treated boys . However , the velocity of receptive vocabulary development from 3 to 12 years did not differ for the treatment groups . Children with severe brain injury demonstrated slower gains in skills over time , compared with those who did not suffer severe brain injury . Significant differences in language trajectories were predicted by maternal education and minority status . CONCLUSION : Although indomethacin yielded an initial benefit for preterm boys , this intervention did not alter the developmental trajectory of receptive language scores . Severe brain injury leads to long-term sequelae in language development , whereas a socioeconomically advantaged environment supports better language development among preterm children OBJECTIVE To compare healthy late-preterm infants with their full-term counterparts from age 4 through 15 years for numerous st and ard cognitive , achievement , socioemotional , and behavioral outcomes . DESIGN Prospect i ve cohort study . SETTING National Institute of Child Health and Development Study of Early Child Care and Youth Development , 1991 - 2007 . PARTICIPANTS A total of 1298 children ( 53 born at 34 - 36 weeks ' gestational age ) , and their families , observed from birth through age 15 years . None of the infants had major health problems before or immediately following birth , and all the infants were discharged from the hospital within 7 days . MAIN EXPOSURE Preterm status : children born late preterm ( 34 - 36 weeks ) vs those born full term ( 37 - 41 weeks ) . MAIN OUTCOME MEASURES Eleven st and ard outcomes measuring cognition , achievement , social skills , and behavioral/emotional problems using the Woodcock-Johnson Psycho-Educational Battery-Revised and the Child Behavior Checklist , administered repeatedly through age 15 years . RESULTS No consistent significant differences were found between late-preterm and full-term children for these st and ard measures from ages 4 to 15 years . Through age 15 years , the mean difference of most of these outcomes hovered around 0 , indicating , along with small confidence intervals around these differences , that it is unlikely that healthy late-preterm infants are at any meaningful disadvantage regarding these measures . CONCLUSION Late-preterm infants born otherwise healthy seem to have no real burdens regarding cognition , achievement , behavior , and socioemotional development throughout childhood BACKGROUND Preterm children have problems with mathematics but knowledge about the predictors of specific mathematic abilities in preterm population s is scarce . AIMS This study investigated neurodevelopmental pathways to children 's general and specific mathematic abilities across the full gestational age range . STUDY DESIGN Prospect i ve geographically defined longitudinal investigation in Germany . SUBJECTS 947 children across the full gestational age range ( 23 - 41 weeks ) . Outcome measures . At 8 years , children 's cognitive and mathematic abilities were measured and residuals of a regression predicting mathematic scores by IQ were used to identify specific mathematic abilities . RESULTS Neurodevelopmental cascade models revealed that adverse effects of preterm birth on mathematic abilities were mediated by neonatal risk . Specific mathematic abilities were uniquely predicted by the duration of hospitalization and ventilation . CONCLUSIONS Prolonged neonatal medical treatment and , in particular , mechanical ventilation may lead to specific impairments in mathematic tasks . These findings have implication s for the mode of respiratory support in neonates , routine follow-up and intervention planning as well as research about brain reorganization after preterm birth BACKGROUND Obstetrical and neonatal complications and /or an adverse parenting environment are risk factors for language impairment , but little is known about their effects on early word production ( late talking ) . AIMS To determine obstetrical and neonatal risk factors in children with delayed word production ;  to assess the influence of the parenting environment on word production ; to determine whether the toddler 's vocabulary competence is related to his/her social competence ; to document the neurodevelopmental outcome at the late preschool age . STUDY DESIGN Prospect i ve follow-up study . Based on word production at 18 months , children were retrospectively classified into consistent or transient late talkers and controls . SUBJECTS Full-term infants , N=30 ( mean GA 40.3+/-1.1 weeks , mean birth weight 3577+/-267 g ) were assessed at 18 and 24 months ; and 5 years and 7 months . METHODS Austrian Communicative Development Inventories ; Bayley Scales of Infant Development ; Griffiths Developmental Scales . OUTCOME MEASURES Peabody Picture Vocabulary Test ; Kaufman Assessment Battery for Children ; Touwen 's neurological examination . RESULTS AND CONCLUSIONS Lower Apgar scores and the need for neonatal intensive care were associated with delayed word production . The parents ' educational and vocational levels were lower in late talkers . Early vocabulary competence correlated with social competence . With regard to the prediction of lexical and cognitive outcomes , late talkers did not differ from controls . Minor neurological dysfunctions ( MND ) were seen in nearly half of the late talkers and indicate the necessity to follow these children into school age , when MND might become more obvious and literacy can be assessed Background : Major neurological h and icaps and neuropsychological disturbances are more common in ex-preterm children than their counterparts born at term . Objective : To establish in a prospect i ve study whether a characteristic neuropsychological profile exists in ex-preterm children who do not exhibit neurodevelopmental deficits on routine clinical examination . Methods : Thirty intellectually normal children born preterm ( 30–34 weeks gestation ) without major neurological disabilities and a control group of term children matched for age , sex , and parental educational and occupational status were assessed at 3–4 years of age to obtain a complete neuropsychological profile . Intellectual ability , language comprehension and expression , perceptual and visual motor function , working memory , and attention and behavioural problems were investigated . Results : Even in the absence of major neurological signs , children born preterm achieved lower mean scores than controls on the Stanford-Binet intelligence scale ( 110.8 v 121 , p<0.001 ) , visual perception test ( 33.8 v 42.7 , p<0.001 ) , visual motor integration test ( 42.6 v 47.4 , p = 0.049 ) , memory for location test ( 8.4 v 9.5 , p = 0.007 ) , sustained attention test ( 41.6 v 51.5 , p = 0.009 ) , and the picture vocabulary test ( 33.3 v 44.7 , p = 0.021 ) . Conclusions : Neuropsychological abnormalities can be detected early in childhood in apparently normal ex-preterm children and are consistent with a growing body of evidence that prematurity may be associated with long term neuropsychological morbidity in childhood and adolescence OBJECTIVE : To determine the sound environment of preterm infants cared for in the NICU and to test the hypothesis that infants exposed to more adult language will make more vocalizations . METHODS : This was a prospect i ve cohort study of 36 infants who had a birth weight of ≤1250 g. Sixteen-hour recordings of the infant sound environment were made in the NICU from a digital language processor at 32 and 36 weeks ' postmenstrual age . Adult word counts , infant vocalizations , and conversational turns were analyzed . RESULTS : Infant vocalizations are present as early as 32 weeks . Both adult word counts per hour and infant vocalizations per hour increase significantly between 32 and 36 weeks . Infant exposure to language as a percentage of time was small but increased significantly . When a parent was present , infants had significantly more conversational turns per hour than when a parent was not present at both 32 and 36 weeks ( P < .0001 ) . CONCLUSIONS : Preterm infants begin to make vocalizations at least 8 weeks before their projected due date and significantly increase their number of vocalizations over time . Although infant exposure to language increased over time , adult language accounted for only a small percentage of the sounds to which an infant is exposed in the NICU . Exposure to parental talk was a significantly stronger predictor of infant vocalizations at 32 weeks and conversational turns at 32 and 36 weeks than language from other adults . These findings highlight the powerful impact that parent talk has on the appearance and increment of vocalizations in preterm infants in the NICU Aims : To test the effectiveness of a home based developmental education intervention in improving outcome at 5 years for very preterm infants . Methods : The Avon Premature Infant Project ( APIP ) is a r and omised controlled trial in which the parents of 284 babies born <33 weeks gestational age received a developmental education programme , a social support intervention , or st and ard care .  A term reference population was also recruited . This study reports outcomes at 5 years ( mean age 58 months 15 days ) for 187 ( 66 % ) of these children without disability . Outcomes were assessed using the British Ability Scales II for cognitive development , the Movement ABC for motor impairment , and the Child Behavior Checklist for behavioural problems . Results : Preterm infants showed poorer cognitive performance than their term peers . Mean ( SD ) general conceptual ability ( GCA ) scores were : Portage 99.2 ( 15.7 ) ; parent adviser 100.3 ( 14.8 ) ; preterm control 101.1 ( 15.0 ) ; term reference 107.2 ( 13.4 ) . There were no significant differences between preterm groups in GCA scores indicating no effect of either intervention . Similarly , there was no significant effect of intervention on behavioural or motor outcomes . Further analyses , in which outcome data were adjusted for social factors , did not reveal any differences between the three preterm groups or by subgroups classified by a range of perinatal variables . Conclusion : The small advantage shown at 2 years of age is no longer detectable at 5 years . These results question the effectiveness of early intervention in enhancing cognitive , behavioural , and motor function at 5 years The relative role of perinatal factors ( birthweight , gestational age , gender , asphyxia , mechanical ventilation and cerebral lesions ) , developmental factors ( neuromotor development during the first 18 months of life ) and environmental factors ( socio-economic status and bilingualism ) on cognitive abilities was evaluated in a cohort of preterm children who had been prospect ively examined for haemorrhage ( PVH ) and periventricular leucomalacia ( PVL ) and followed-up to 5 years of age . St and ardized neurological examinations and development assessment including tests of cognitive function were carried out . Major impairments could be ascribed to the presence of large PVL changes . Among the 226 children without major impairment , the overall incidence of neuropsychological anomalies ( neuromotor , language , visual , auditory and behaviour anomalies ) was 46.5 % and did not differ within ultrasound groups ( normal scans , PVH and small PVL ) . However , children with small changes of PVL presented more abnormal neuromotor development within the first 18 months of life and had more complex neuropsychological anomalies at 5 years . The multiple regression analysis ( General Intellectual Index ( GII ) predicted = 113.7 - coefficient x social class - 8.5 x bilingualism - 5.5 x dystonia + 1.4 x gestational age + 8 x mechanical ventilation ) showed that socioeconomic status was the most important factor affecting the General Intellectual Index ( GII ) . The contribution of sex and cerebral lesions was not significant . As children grew-up , environmental factors seemed to overcome perinatal factors The aim of the study was to prospect ively assess the differences in participation and sensory modulation between late preterm infants ( LPI ) and term babies , and to predict it by LPI characteristics . The study population includes 124 late preterm infants at gestational age between 34 and 35 6/7 weeks who were born at the same medical center . The control group comprised of 33 term babies ( 18 boys , 15 girls ) , born during the same period and location ( mean age 12.47 , SD = 0.73 ) .  Sensory modulation  was assessed by the test of sensory functions in infants and the infant/toddler sensory profile and for assessment of participation and parents ' satisfaction we used question naires . Term infants had better sensory modulation than LPI . Approximately 10 % of the sensory modulation of participants in the study was explained by gestational age and head circumference .  LPI participation and parental satisfaction decreased in the LPI group . Among all the explanatory variables only multiple gestations and head circumference contributed to the explained variance of participation ( 16 % ) , and parents ' satisfaction ( 13 % ) . At age of 1 year , children born as late preterm are at increased risk of developing sensory modulation disorder , showing less participation , and result ing in less parental satisfaction OBJECTIVE The aim of this follow-up study was to evaluate the development of object naming ability and auditory processing in prematurely born children . Furthermore , we investigated whether the mismatch negativity ( MMN ) parameters at the age of 4 years correlate with the MMN parameters and naming ability at the age of 6 years . METHODS Twelve very low birth weight ( VLBW ) preterm children ( mean age 5 years 7 months ) and matched controls were studied . Object naming was measured by the Boston naming test  . Auditory event-related potentials ( ERPs ) , especially the MMN  , were recorded for Finnish syllables ( st and ard /taa/ ; deviants /ta/ and /kaa/ ) in an oddball paradigm . RESULTS VLBW preterm children scored significantly lower in the object naming test than their controls . The MMN amplitude for consonant change was significantly smaller in the preterm group compared to the controls . The MMN amplitude at the age of 4 years correlated with the MMN amplitude at the age of 6 years . Furthermore , absence of the MMN at the age of 4 years predicted naming difficulties at the age of 6 years . CONCLUSIONS VLBW preterm children with a difficulty to preattentively discriminate changes in syllables , as indexed by the diminished change detection response , MMN , seem to have sustained naming difficulty . Therefore , it is reasonable to record the MMN along with the language development from infancy , in order to identify the children at risk for language deficiencies and to provide appropriate rehabilitation The visual function of 42 children with haemorrhagic and /or ischaemic cerebral lesions acquired before a gestational age of 35 weeks was examined and related to cranial ultrasound in the neonatal period and to MRI and neurodevelopmental status at follow-up . All 37 children with abnormal ultrasound scans and one of the five with normal ultrasound scans showed impairment of one or more aspects of visual function . While impaired acuity was more frequent among infants with MRI evidence of visual pathway damage , this was not an invariable finding . Normal or near-normal visual acuity did not preclude the presence of other functional visual deficits . The authors conclude that preterm cerebral insults may produce a variety of visual difficulties , the pattern and severity of which can not be predicted on imaging . Each child therefore requires individual assessment of multiple aspects of visual function PURPOSE The aim of this study was to investigate the language outcomes of 7-year-old children with and without a history of late language emergence at 24 months . METHOD One hundred twenty-eight children with a history of late language emergence ( LLE ) at 24 months and 109 children with a history of normal language emergence ( NLE ) at 24 months participated in direct behavioral assessment of multiple dimensions of language at 7 years . The children were recruited from a prospect i ve cohort study of 1,766 epidemiologically ascertained 24-month-old singleton children . RESULTS The group mean for the LLE children was within the typical range on an omnibus measure of general language ability and measures of specific dimensions of language . However , a greater percentage of LLE children , relative to NLE children , performed below normative expectations on a measure of general language ability ( 20 % versus 11 % ) , speech ( 7 % versus 2 % ) , syntax ( 18 % versus 8 % ) , and morphosyntax ( 9%-23 % versus 2%-14 % ) , but not vocabulary or semantics . CONCLUSION The results provide support for growth models of language impairment that predict that late onset of language foretells a protracted growth difference for some LLE children relative to NLE children , particularly for syntax and morphosyntax BACKGROUND Preterm infants complete their development in Neonatal Intensive Care Unit being exposed to environmental stimuli that lead to the early maturation of the sensory systems . It is known that the fetus perceives sounds and reacts to them with movements since the 26th-28th week of gestational age . Maternal voice represents a source of sensory stimulation for the fetus . AIMS To investigate the effect of the exposure to maternal voice , administered by bone conduction , on preterm infants autonomic and neurobehavioral development . STUDY DESIGN Longitudinal , explorative , case control study . SUBJECTS 71 preterm infants with birth weight < 1500 g , born adequate for gestational age OUTCOME MEASURES vital and neurobehavioral parameters at term , neurofunctional assessment at 3 and 6months of corrected age . RESULTS Infants in the treatment group had lower heart rate values and a higher proportion of stable skin color at each study point as compared to the control group . The scores in the visual attention performance and in the quality of the general movements at term were better in the treatment group than in the control one . Neurofunctional assessment score at 3months of corrected age was higher in the treatment group whereas no difference between the two groups was detected at 6months of corrected age . CONCLUSIONS Early exposure to maternal voice exerts a beneficial effect on preterm infants autonomic and neurobehavioral development
RESULTS : Preterm-born children scored significantly lower compared with term-born children on simple ( d = –0.45 [ 95 % CI : –0.59 to –0.30 ] ; P < .001 ) and on complex ( d = –0.62 [ 95 % CI : –0.82 to –0.43 ] ; P < .001 ) language function tests , even in the absence of major disabilities and independent of social economic status .
: While growing up , preterm-born children have increasing difficulties with complex language function
BACKGROUND AND OBJECTIVE : Preterm-born children ( < 37 weeks ’ gestation ) have higher rates of language function problems compared with term-born children .
It is unknown whether these problems decrease , deteriorate , or remain stable over time .
The goal of this research was to determine the developmental course of language functions in preterm-born children from 3 to 12 years of age .