Language and cognition in very low birth weight preterm infants with PELCDO application

A Comparison of the Clinical Presentation of Preterm Birth and Autism Spectrum Disorder: Commonalities and Distinctions in Children Under 3

Premature infants and infants later diagnosed with autism spectrum disorder (ASD) share many commonalities in clinical presentations. However, prematurity and ASD also have differences in clinical presentation. These overlapping phenotypes can lead to misdiagnoses of ASD or missing a diagnosis of ASD in preterm infants. We document these commonalities and differences in various developmental domains with the hope of aiding in the accurate early detection of ASD and timely intervention implementation in children born premature. Given the degree of similarities in presentation, evidence-based interventions designed specifically for preterm toddlers or toddlers with ASD may ultimately aid both populations.

Motor and cognitive outcomes of neonates with low birth weight in Brazil: a systematic review and meta-analysis

BACKGROUND

 Data on the outcomes of preterm newborns in South American countries are scarce. Given the great effect of low birth weight (LBW) and/or prematurity on children's neurodevelopment, it is extremely necessary to conduct studies on these phenomena in greater depth in more heterogeneous populations such as those ones from countries with limited resources.

METHODS

 We conducted a comprehensive literature search on databases including PubMed, the Cochrane Library, and Web of Science for articles published in Portuguese and English up to March 2021 involving children born and evaluated in Brazil. The analysis of the risk of bias was adapted from the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement and used to evaluate the methodology of the included studies.

RESULTS

 From the eligible trials, 25 articles were selected for qualitative synthesis, and 5 of those, for quantitative synthesis (meta-analysis). The meta-analyses showed that children born with LBW presented lower scores on motor development when compared with controls (standardized mean difference: -1.15; 95% confidence interval [95%CI]: -1.56--0.73]; I²: 80%) and also scored lower in terms of cognitive development (standardized mean difference: -0.71; 95% CI: -0.99--0.44; I²: 67%).

CONCLUSION

 The results of the present study reinforce that impaired motor and cognitive functions can be a significant long-term outcome of LBW. The lower the gestational age at delivery, the higher the risk of impairment in those domains. The study protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO) database under number CRD42019112403.

Screening for language development of preterm infants: relationship between two assessment instruments

ABSTRACT Purpose: to associate two screening instruments used to assess global and language development of preterm infants. Methods: a study including 69 children aged 0-24 months of corrected age, premature at birth, who were admitted to the Neonatal Intensive Care Unit (NICU). Researchers used an anamnesis and two protocols: Early Language Milestone Scale (ELM) and Observation and Monitoring Guide for Children from 0-48 months of age. According to the categorical and numerical variables, the protocols were associated with each other through descriptive percentages and non-parametric statistical tests, such as the Chi-square, Spearman's rank correlation coefficient and Mann-Whitney U, Kruskal-Wallis test and multiple correspondences (p<0.05). Results: a significant relationship was found between the Guide and the ELM, since the “not expected for the age” classification was associated with delayed/pathological classification in the Guide, while “expected” results were related to “adequate”. There was also a relationship between the percentile of both instruments, as the higher the Guide value, the higher the ELM values (ELM-R=0.564; p=0.000), suggesting that both protocols complement each other in the evaluation results. Conclusion: the protocols for the assessment of language acquisition in children showed to be complementary, providing a complete assessment and relevant data on the development of preterm infants.

Supporting caregivers of children born prematurely in the development of language: A scoping review

Background

Infants born prematurely can display impairments that negatively impact the early years of their development. Compared to their peers born at term, preterm children have higher risks of cerebral palsy, sensory deficits, learning disabilities, cognitive and language deficits, as well as difficulties related to attention and behaviour. Following discharge, parents of preterm children are often supported through neonatal follow-up programs or by community health care practitioners. Through assessment and consultation, professionals foster parental resilience by teaching them about their child's development. Research shows a large volume of literature on improving outcomes for preterm infants, but less attention has been given to the impact and potential importance of education of parents regarding the care they provide from the home.

Objective

A scoping review was completed to determine the best practices for early intervention in premature children regarding the development of language skills during the preschool years.

Methods

The review followed the guidelines for the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA).

Results

Four general themes emerged from the review and included the importance of providing (1) parental training in the care of an infant born prematurely during neonatal intensive care unit stay; (2) education on the development of language and the importance of parental responsiveness; (3) provision of activities to support child language learning; and (4) overall and ongoing monitoring and support by qualified health professionals.

Conclusions

The conclusions drawn will provide guidance to health care professionals regarding the education of parents on best practices for stimulating language development in their child.

Spontaneous language of preterm children aged 4 and 5 years

ABSTRACT Purposes: to evaluate spontaneous language development through the Mean Length of Utterance in words (MLU-w) of children with gestational age between 28 and 36 weeks. This research also aims to study if the gestational age, birth weight, gender, and parents’ level of formal education can influence that measurement. Methods: nineteen premature children (9 males, 10 females), in the age range 4-5 years old, enrolled on Lisbon area kindergartens, and considered as having typical development, participated in this research. Spontaneous speech of each child was recorded for 30 minutes and transcribed afterwards. Results: mean values of MLU-w of Portuguese premature children were significantly lower than those with typical development. A positive and significant correlation between the gestational age and the birth weight with the MLU-w was also found. The gender of the children and the parents’ level of formal education showed no influence on the results. Conclusion: these results reinforce the need to identify, on these children, possible deficits, in order to prevent negative impacts in school education, and stimulate their psychosocial development.

Desempenho linguístico de prematuros de 2 anos, considerando idade cronológica e idade corrigida

RESUMO Introdução O nascimento prematuro acarreta problemas que não se restringem à mortalidade perinatal. Alguns prematuros, mesmo na ausência de lesões cerebrais, apresentam consequências negativas em diversos aspectos do desenvolvimento, como dificuldades em adquirir linguagem. Objetivo O objetivo deste estudo foi verificar o desempenho linguístico de prematuros, na faixa etária de 2 anos, considerando a idade cronológica e a idade corrigida. Métodos Participaram do estudo 23 sujeitos prematuros e para verificar as habilidades linguísticas foi aplicado o Test of Early Language Development – TELD-3. Resultados Os sujeitos prematuros apresentaram desempenho total alterado no TELD-3 em 39,13% dos casos. Os prematuros também foram analisados considerando o atraso para a idade cronológica e a corrigida e não houve diferença no desempenho para os subtestes receptivo (p = 0,250) e expressivo (p = 1,000). Conclusão O grupo de prematuros aos 2 anos de idade constitui população de risco para alterações de linguagem que não podem ser compensadas com a correção da idade.

Association between gestational age and birth weight on the language development of Brazilian children: a systematic review

OBJECTIVE

To review the literature that addresses the relationship between prematurity, birth weight, and development of language in Brazilian children.

SOURCES

A systematic review of studies published between 2003 and 2012 in English and Portuguese and indexed in PubMed, LILACS, and SciELO. The following key words were used in the searches: Prematuro, Prematuridade, Linguagem, Prematurity, Language, Speech-Language Pathology. Fifty-seven articles were retrieved, 13 of which were included in the systematic review.

SUMMARY OF THE FINDINGS

The results showed an association between prematurity, low birth weight, and language development. In studies that made comparisons between preterm and term infants, there was evidence that preterm infants had poorer performance on indicators of language. It was also observed that children born with lower birth weight had a poorer performance on measures of language when compared to children with higher weight and closer to 37 weeks of gestational age. Regarding the type of language assessed, expression proved to be more impaired than reception. Higher parental education and family income were indicated as protective factors for the development of language. Conversely, lower birth weight and higher degree of prematurity emerged as risk factors.

CONCLUSIONS

Preterm birth and low birth weight poses risks for the language development of children, especially in the first years of life. Therefore, it is essential that pediatricians are aware of the language development of these children to ensure proper treatment.

School children with low birth weight inserted in system of Embu's education: construction of sentences

PURPOSE

To characterize the construction of sentences in schoolchildren born with low weight.

METHODS

We selected 413 students from Embu das Artes (SP), Brazil. Application of Recreating Speech Acts of Test of Language Competence sub-test. We analyzed the number of words and the holistic score. Age group of 6-10 years old, female/male, with low birth weight (<2,500 g) in Study Group (SG; n=238), and birth weight above or equal to 2,500 g composing the Control Group (CG; n=175). Children with anomalies were excluded. The both groups' responses were considered as well as the association of the responses with variables birth weight, gender, age of child and maternal age and education, through Student's t-test, χ2test and linear regression.

RESULTS

The SG scored less on the total number of words and had worst performance in items that involved prepositions with a sense of temporality and place, with adverb functions. There was no difference between groups regarding the holistic score. It was found positive impact of the variables birth weight (p=0.002), age of child, age of mother and maternal education on standard test scores in both groups.

CONCLUSION

The SG had fewer words compared to CG. The higher the birth weight, the higher the score test pattern. It was evident the age-related changes in morpho-syntactic skills addressed in the study, and protection factors mother's schooling and age had a positive impact on language performance.

Habilidades comunicativas de crianças prematuras e prematuras extremas

Objetivo comparar o desempenho das habilidades comunicativas, de crianças nascidas prematuras, prematuras extremas e típicas de idade cronológica entre dois e três anos. Métodos participaram do estudo 72 crianças distribuídas em quatro grupos: 20 prematuros (GE-I), 16 prematuros extremos (GE-II) e 36 crianças com desenvolvimento típico (GC-I e GC-II), de idade cronológica entre dois a três anos. Houve pareamento quanto à idade cronológica e sexo. A avaliação constou da aplicação do Protocolo de Anamnese e Observação do Comportamento Comunicativo. O tratamento estatístico constou do Teste “t” Student e do Teste de Mann-Whitney (p ≤ 0,05). Resultados na comparação entre os grupos de prematuros e típicos (GE-I e GC-I e GEII e GC-II), quanto às habilidades comunicativas verificou-se diferenças significantes, apesar da heterogeneidade no desempenho dos prematuros e prematuros extremos. Na comparação entre os prematuros (GE-I e GE-II) não foram observadas diferenças significantes, entretanto, GE-I obteve desempenho superior em todas as categorias, exceto para a categoria uso de gestos. As categorias de menor ocorrência para GE-I foram: respeitar troca de turno, participar e manter atividade dialógica. Para o GE-II foram: participar e manter atividade dialógica, realizar ordens complexas, iniciar e respeitar troca de turno, funções de informar, oferecer e produzir frases. Conclusão houve diferenças significantes no desempenho comunicativo das crianças prematuras e prematuras extremas, quanto comparadas às crianças típicas, mas não houve diferenças significantes na comparação entre os prematuros. Apesar dos resultados indicarem que os grupos de prematuros tendem ao atraso no desenvolvimento das habilidades comunicativas, os grupos não demonstraram ser homogêneos.

Early relations between language development and the quality of mother-child interaction in very-low-birth-weight children

BACKGROUND

It is not clearly understood how the quality of early mother-child interaction influences language development in very-low-birth-weight children (VLBW).

AIMS

We aim to analyze associations between early language and the quality of mother-child interaction, and, the predictive value of the features of early mother-child interaction on language development at 24 months of corrected age in VLBW children.

STUDY DESIGN

A longitudinal prospective follow-up study design was used.

METHODS

The participants were 28 VLBW children and 34 full-term controls. Language development was measured using different methods at 6, 12 and at 24 months of age. The quality of mother-child interaction was assessed using PC-ERA method at 6 and at 12 months of age.

RESULTS

Associations between the features of early interaction and language development were different in the groups of VLBW and full-term children. There were no significant correlations between the features of mother-child interaction and language skills when measured at the same age in the VLBW group. Significant longitudinal correlations were detected in the VLBW group especially if the quality of early interactions was measured at six months and language skills at 2 years of age. However, when the predictive value of the features of early interactions for later poor language performance was analyzed separately, the features of early interaction predicted language skills in the VLBW group only weakly.

CONCLUSIONS

The biological factors may influence on the language development more in the VLBW children than in the full-term children. The results also underline the role of maternal and dyadic factors in early interactions.

Expressive language and cognitive development: diversity and complexity of children's productions

BACKGROUND

Objective and systematized analysis of cognitive and expressive language development.

AIM

To characterize expressive language and cognitive development considering the diversity and complexity of children's productions.

METHOD

This study involved 20 subjects (10 male and 10 female), who were adequate for gestational age and birth weight and had no pre, peri or post natal intercurrences. Participants were submitted to 30-minute sessions, once a month, for the observation of expressive language and cognitive development. The observations were made during the period that went from eight to 18 months of age, using the material and application procedures suggested by the PELCDO-r.

RESULTS

The amount of different schemes, gestures and verbalizations that children were capable of producing (diversity and complexity) are presented and analyzed considering each one of the 30-minute sessions as well as the overall total during the period of observation (from eight to 18 months).

CONCLUSION

The PELCDO-r allowed the characterization of expressive language and cognitive development by means of the objective observation of this process concerning the diversity and complexity of subjects' productions, considering the period between the fourth phase of sensorimotor stage and the beginning of preoperational stage.

Emergência dos esquemas simbólicos em crianças com síndrome de Down, prematuros muito baixo peso e crianças com desenvolvimento típico

OBJETIVO: verificar a emergência dos esquemas simbólicos simples e combinados e seus respectivos subtipos em 20 crianças prematuras muito baixo peso, 20 crianças com síndrome de Down e 20 crianças com desenvolvimento típico. MÉTODOS: todos os sujeitos foram acompanhados mensalmente durante seis meses, a partir da avaliação inicial em que estavam localizados no final da quinta fase do período sensório-motor. Para tanto, foi utilizado o Protocolo para Observação do Desenvolvimento Cognitivo e da Linguagem Expressiva - versão revisada (PODCLE-r). Os dados foram analisados de forma quantitativa e qualitativa. RESULTADOS: os resultados revelaram que os esquemas simbólicos simples e combinados emergiram de forma semelhante para todos os grupos, embora se tenha observado ritmo de desenvolvimento mais lento para as crianças prematuras muito baixo peso e crianças com síndrome de Down, quando comparadas às crianças com desenvolvimento típico. A análise qualitativa, referente à diversidade e complexidade dos esquemas simbólicos produzidos, mostrou que as crianças prematuras muito baixo peso apresentaram pior desempenho quando comparadas às crianças com síndrome de Down e às com desenvolvimento típico, apresentando também dificuldades específicas quanto ao uso de esquemas simbólicos aplicados a objetos não-figurativos, ou seja, quanto à construção da representação por meio de significantes arbitrários. CONCLUSÃO: estes dados reforçam a importância de se acompanhar a emergência e o desenvolvimento dos esquemas simbólicos simples e combinados nessas crianças, com o objetivo de monitorar e estimular esse desenvolvimento, com vistas a minimizar os efeitos da defasagem cognitiva e a favorecer o desenvolvimento da linguagem.