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

Abstract

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.

Keywords: gestation; language development; preterm; term.

Figure 1

Participant flow.

Figure 2

Model of language stability from age 5 months to 8 years in the full sample. Standardized coefficients are presented. All coefficients were significant at p<.001. Indicators of first-order latent variables are listed next to their factors along with the standardized loadings. Model fit: χ²(312)=747.88, p<.001, CFI=.96, TLI=.96, RMSEA=.043 (90%CI=.039-.047), SRMR=.043. AWST = Active Vocabulary Test. LSVT-A = Language Comprehension Test - Part A. LVST-C = Language Comprehension Test – Part C. HSET = Heidelberger Sprachenwicklungstest. DSL = Diagnosis of Speech and Language.

Figure 3

Model of language stability from age 5 months to 8 years by gestation group. Bolded coefficients were significantly different from other gestation groups. All coefficients were significant at p<.001 unless otherwise noted. * p < .05.