Speech and Language Performance of 3 Year Old Children Born Preterm: A Preliminary Report

INTRODUCTION: The association between preterm birth and an increased risk for cognitive impairment and academic struggles later in life is well established. In particular, the tendency for preterm infants to show delayed language acquisition even without evidence of brain damage has been the subject of much recent research. We hypothesized there would be a positive association between birth weight/gestational age of preterm infants and their speech and language performance at 3 years of age. METHODS: We recruited 43 children from the Low Birth Weight Clinic at Children's Medical Center Dallas and the Pediatrix Tots Clinic at Baylor University Medical Center with a mean age of 37.8 months (range 36-45 months). Their mean gestational age was 28.6 weeks (range 23-35 weeks) and mean birth weight was 1219.8 grams (range 550-2525 grams). Children had no history of hearing loss, structural abnormalities such as cleft lip or palate, or prolonged mechanical ventilation after NICU discharge. Each child underwent a hearing screening, the Battelle Developmental Inventory Screening Test, and 40 of the 43 children underwent the Goldman-Fristoe 2 Test of Articulation (GFTA). Each child's spontaneous speech was recorded during a 30-minute interactive play session with their primary caregiver. Their speech was then transcribed and analyzed using the Systematic Analysis of Language Transcripts (SALT) program, matching each participant to a group of control children based on age and gender. SALT measures included percent intelligibility, total number of words, number of different words, and words per minute. Finally, the primary caregiver completed the MacArthur-Bates Communicative Development Inventory-III for each child. RESULTS: Performance on the MacArthur-Bates and SALT measures did not correlate with birth weight or gestational age. SALT analysis showed that our participants produced significantly shorter utterances, did not use as many different words, and were significantly less intelligible than controls. The mean age equivalent on the Battelle was 36.3 months (range 14-51 months). DISCUSSION: Preliminary analysis does not support a correlation between birth weight/gestational age of preterm infants and speech and language performance at age 3 years. Therefore, a higher birth weight or later gestational age does not imply a lesser risk for preterm infants. Thus, it is critically important that parents and pediatricians alike remain vigilant when assessing the speech and language of all children who were born preterm, regardless of birth weight or gestational age.