Elsevier

The Journal of Pediatrics

Volume 181, February 2017, Pages 74-79.e3
The Journal of Pediatrics

Original Articles
Long-Term Stability of Language Performance in Very Preterm, Moderate-Late Preterm, and Term Children

https://doi.org/10.1016/j.jpeds.2016.09.006Get rights and content

Objective

To investigate whether children born very preterm, moderate-late preterm, and term differ in their average level and individual-difference stability in language performance over time.

Study design

Language was assessed at 5 and 20 months and 4, 6, and 8 years of age in 204 very preterm (<32 weeks' gestation), 276 moderate-late preterm (32-36 weeks' gestation), and 268 term (37-41 weeks' gestation) children from the Bavarian Longitudinal Study.

Results

Very preterm children consistently performed worse than term-born children, and moderate-late preterm children scored in between. Language performance was stable from 5 months through 8 years in all gestation groups combined, and stability increased between each succeeding wave. Stability was stronger between 5 months and 4 years in very preterm than moderate-late preterm and term groups, but this differential stability attenuated when covariates (child nonverbal intelligence and family socioeconomic status) were controlled.

Conclusions

Preterm children, even moderate-late preterm, are at risk for poorer language performance than term-born children. Because individual differences in language performance are increasingly stable from 20 months to 8 years in all gestation groups, pediatricians who attend to preterm children and observe language delays should refer them to language intervention at the earliest age seen.

Section snippets

Methods

Data were drawn from the prospective Bavarian Longitudinal Study.20 Participants were children born alive in a geographically defined area of Southern Bavaria (Germany) during a 14-month period who required admission to children's hospitals within the first 10 days after birth (N = 7505; 10.6% of all live births). Healthy infants who were born in the same obstetric hospitals (most born at term), cared for on normal postnatal wards, and discharged with their mothers were recruited as controls

Full Sample Language Stability Model

We used latent variables to model the shared variance among language measures. This procedure has the advantage of removing measurement error and specific variance for each scale from the latent factor, leaving a more precise and reliable estimate of language ability at each age.43 Furthermore, the use of latent variables allows for developmentally appropriate changes in the measurement of language as children age. Measurement models supported a single language factor at 4 years of age and

Discussion

At all time points across early development, very preterm children had lower language performance than term-born children. At 3 of the 5 ages, moderate-late preterm children also scored lower than term-born children (and better than very preterm children).4, 9, 10, 11 This study's novel contribution to the literature is its analysis of the stability of individual differences in the language of preterm children. From very early in development, very preterm, moderate-late preterm, and term

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  • Cited by (0)

    D.P. and M.B. were supported by the intramural program of the National Institutes of Health, Eunice Kennedy Shriver National Institute of Child Health and Human Development. Data acquisition was supported by the German Federal Ministry of Education and Science (PKE24, JUG14, 01EP9504, and 01ER0801 [to D.W. and S.E.-M.]). The authors declare no conflicts of interest.

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