Elsevier

The Journal of Pediatrics

Volume 202, November 2018, Pages 86-91.e1
The Journal of Pediatrics

Original Articles
Language Trajectories of Children Born Very Preterm and Full Term from Early to Late Childhood

https://doi.org/10.1016/j.jpeds.2018.06.036Get rights and content

Objective

To identify distinct language trajectories of children born very preterm and full term from 2 to 13 years of age and examine predictors for the identified trajectories.

Study design

A cohort of 224 children born very preterm and 77 full term controls recruited at birth were followed up at ages 2, 5, 7, and 13 years. The number of distinct language trajectories was examined using latent growth mixture modeling allowing for linear and quadratic time trends. Potential predictors in the neonatal period (eg, birth group, sex, and medical risk) and at 2 years (ie, social risk and use of allied health services) for the language trajectories were tested using multinomial logistic regression.

Results

Five distinct language trajectories were identified across childhood: stable normal (32% of study cohort), resilient development showing catch-up (36%), precocious language skills (7%), stable low (17%), and high-risk (5%) development. The very preterm group was 8 times more likely to have a language trajectory that represented poorer language development compared with full term controls (very preterm, 40%; full term, 6%). Greater social risk and use of allied health services were associated with poorer language development.

Conclusions

Variable language trajectories were observed, with a substantial proportion of children born very preterm exhibiting adverse language development. These findings highlight the need for monitoring language skills in children born very preterm before school entry and across middle childhood.

Section snippets

Methods

Children were part of a prospective longitudinal cohort study of 224 infants born very preterm (<30 weeks of gestation) or with a birthweight of <1250 g at the Royal Women's Hospital, Melbourne, Australia. Children were recruited at birth between July 2001 and December 2003. Children with genetic or congenital abnormalities associated with adverse development and children of non–English-speaking parents were ineligible. A group of 77 infants born full term (>37 weeks' gestation) were recruited

Determining Distinct Language Trajectories

In LGMM and subsequent analyses, 291 children were included as 10 children (very preterm, n = 8; full term, n = 2) were excluded owing to missing language scores at all 4 follow-up waves. Although the 4-class (intercept covariance) model had the best model fit indices (Table II), the smallest latent class included just 3 children (1% of the cohort). There are no criteria for the smallest number of people in a latent class, but model selection should be based on fit statistics as well as

Discussion

This study identified 5 developmental trajectories of language in very preterm and full term children. Most of the full term group (94%) exhibited favorable language development across childhood. The majority of children born very preterm demonstrated catch-up in their language functioning, and by 7 years of age most of the very preterm group (60%) had stable language trajectories that were similar to their full term peers. Of concern, however, are the remaining children born very preterm (40%)

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    Supported by the Australian National Health and Medical Council (Centre for Research Excellence 1060733; Project grants 237117, 491209 & 1066555; Senior Research Fellowship [1081288 to P.A.]); US National Institutes of Health (HD058056); the Murdoch Children's Research Institute and the Royal Children's Hospital Foundation; and the Victorian Government's Operational Infrastructure Support Program. The authors declare no conflicts of interest.

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