Association of Language Skills with Other Developmental Domains in Extremely, Very, and Moderately Preterm Children: EPIPAGE 2 Cohort Study

Charkaluk, Marie‐Laure; Rousseau, Jessica; Benhammou, Valérie; Datin-Dorrière, Valérie; Flamant, Cyrille; Gire, Catherine; Kern, Sophie; Pierrat, Véronique; Kaminski, Monique; Marret, Stéphane

doi:10.1016/j.jpeds.2018.12.007

Cited by 22 publications

(27 citation statements)

References 26 publications

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“…The social environment of the child in his or her early years has been shown to be crucial for language acquisition and vocabulary development at 2–3 years of age,25 with an increasing effect in early adolescence,14 but our understanding of the causal pathways remains limited. As in our study, many studies have used maternal educational level as an indicator of socioeconomic disadvantage 10 12 13 34. This indicator has been found to have a stronger impact on language outcomes at 20 months’ CA in preterm infants than other sociodemographic characteristics 5.…”

Section: Discussionmentioning

confidence: 53%

“…About one quarter of children were not combining words around 2 years CA and almost 40% had a low expressive vocabulary, which is consistent with previous findings. According to the lexicon size criteria, 24.1% of Italian children born ≤33 weeks28 and 29.4% of French children born ≤34 weeks (Etude épidémiologique sur les petits âges gestationnels (EPIPAGE) 2 study)12 were classified under the 10th percentile of the adapted MCDI-SF based on national normative values, while an absence of word combination was 21.6% 12. Consistent with previous studies,10 12 29 we also found an increasing risk for early language delay among children with higher perinatal risk, defined in our study as lower GA and/or severe neonatal morbidity.…”

Section: Discussionmentioning

confidence: 99%

“…According to the lexicon size criteria, 24.1% of Italian children born ≤33 weeks28 and 29.4% of French children born ≤34 weeks (Etude épidémiologique sur les petits âges gestationnels (EPIPAGE) 2 study)12 were classified under the 10th percentile of the adapted MCDI-SF based on national normative values, while an absence of word combination was 21.6% 12. Consistent with previous studies,10 12 29 we also found an increasing risk for early language delay among children with higher perinatal risk, defined in our study as lower GA and/or severe neonatal morbidity. Compared with children born at term, children born VPT are at higher risk for atypical brain development, and developmental impairments in various domains 2 3 30.…”

Section: Discussionmentioning

confidence: 99%

“…There is evidence that language functioning is reduced in school-aged children born VPT compared with term controls 9–11. Children born VPT experience more delays in language development in early childhood than children born at term, assessed through their lexicon size and word combination around 2 years of age 12 13. While there is a solid evidence in the general population linking language development to the social environment, including maternal educational levels, these relationships remain poorly documented in the VPT population as studies have been conducted on small and selective samples (ie, monolingual singletons without severe conditions recruited from a single-centre study) 13–15…”

Section: Introductionmentioning

confidence: 99%

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Maternal education and language development at 2 years corrected age in children born very preterm: results from a European population-based cohort study

Sentenac

Johnson

Charkaluk

et al. 2020

J Epidemiol Community Health

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BackgroundSocioeconomic factors influence language development in the general population, but the association remains poorly documented in children born very preterm (VPT). We assessed the impact of maternal education on language development in children born VPT and effect modification by perinatal risk.MethodsData were from the Effective Perinatal Intensive Care in Europe (EPICE) population-based cohort of children born <32 weeks’ gestational age (GA) in 2011/2012. Regions from six countries (Estonia, France, Germany, Italy, Sweden and UK) used a validated short form MacArthur Developmental Communicative Inventories Checklist to assess language at 2 years corrected age. Perinatal variables were collected from clinical records. We assessed expressive language delay (ELD), defined as (a) not combining words; and (b) expressive vocabulary <10th percentile of norms for age and sex. Perinatal risk (low, moderate and high) was determined using GA, small for GA and neonatal morbidities. We estimated adjusted risk ratios (aRR) of ELD by maternal education with inverse weighting to account for non-response bias.ResultsOf 2741 children, 24.6% were not combining words and 39.7% had a low expressive vocabulary. Low maternal education (lower secondary or less compared with a bachelor’s degree or more) increased risks of ELD: not combining words: aRR=1.52 (95% CI 1.36 to 1.69); low expressive vocabulary: aRR=1.25 (1.04 to 1.51). For children with low perinatal risk, the aRR were 1.88 (1.26 to 2.80) and 1.44 (1.06 to 1.95), respectively, compared with those with high perinatal risks: 1.36 (1.10 to 1.67) and 1.11 (0.97 to 1.27), respectively.ConclusionLow maternal education affects ELD for children born VPT, although the association appears attenuated among those with highest perinatal risk.

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Section: Discussionmentioning

confidence: 53%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Maternal education and language development at 2 years corrected age in children born very preterm: results from a European population-based cohort study

Sentenac

Johnson

Charkaluk

et al. 2020

J Epidemiol Community Health

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“…Our result contradicts previous research where those characteristics are usually strongly associated with language development. 42,43 Studies addressing language impairments for preterm infants showed that language difficulties were more evident around the age of 2 42 and later in childhood when more sophisticated language skills are required. 43 In the present study, infants were younger than 20 months old, which could be too soon for more complex language screening, and maybe only the factors that are stronger at this early age were significant in the model.…”

Section: Language Developmentmentioning

confidence: 99%

Neonatal Adverse Outcomes, Neonatal Birth Risks, and Socioeconomic Status: Combined Influence on Preterm Infants’ Cognitive, Language, and Motor Development in Brazil

et al. 2020

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Background: This study extended previous research by investigating the combined effects of neonatal birth risks, neonatal adverse outcomes, and socioeconomic status on preterm neurodevelopment. Method: A total of 184 preterm infants were assessed using the Bayley Scales of Infant Development III in a follow-up clinic in southern Brazil. Structural equation modeling was conducted with 3 latent variables (neonatal birth risks, neonatal adverse outcomes, and socioeconomic status) and 3 outcomes (cognitive, language, and motor development). Results: The analyses showed that neonatal adverse outcomes were associated with infants’ cognitive (b = –0.45, P < .001), language (b = –0.23, P = .001), and motor (b = –0.51, P < .001) development. Socioeconomic status also explained the variances (cognitive: b = 0.20, P = .006; language: b = 0.28, P = .001; and motor: b = 0.21, P = .004), whereas neonatal birth risks remained significant only in the motor development (b = 0.15, P = .040). Conclusion: This study suggests that the most evident contributors to poor neurodevelopment were adverse outcomes and socioeconomic risk factors.

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Cognitive Training for Visuospatial Processing in Children Aged 5½ to 6 Years Born Very Preterm With Working Memory Dysfunction

Gire,

Beltran Anzola,

Marret

et al. 2023

JAMA Netw Open

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ImportanceCompared with term-born peers, children born very preterm generally perform poorly in executive functions, particularly in working memory and inhibition. By taking advantage of neuroplasticity, computerized cognitive training of working memory in those children could improve visuospatial processing by boosting visual inhibition via working memory.ObjectiveTo evaluate the long-term effect of cognitive working memory training on visuospatial processing in children aged 5½ to 6 years born very preterm who have working memory impairment.Design, Setting, and ParticipantsThis multicenter (18 French university hospitals), open-label randomized clinical trial with 2 parallel groups (EPIREMED) was conducted from November 2016 to April 2018, with the last follow-up during August 2019. Eligible children from the EPIPAGE 2 cohort were aged 5½ to 6 years, were born between 24 and 34 weeks’ gestation, and had a global intelligence quotient greater than 70 and a working memory index less than 85. Data were analyzed from February to December 2020.InterventionChildren were randomized 1:1 to standard care management and a working memory cognitive training program (Cogmed software) for 8 weeks (25 sessions) (intervention) or to standard management (control).Main Outcomes and MeasuresThe primary outcome was the visuospatial index score from the Wechsler Preschool and Primary Scale of Intelligence, 4th Edition. Secondary outcomes were working memory, intellectual functioning, executive and attention processes, language skills, behavior, quality of life, and schooling. Neurobehavioral assessments were performed at inclusion and after finishing training at 6 months (intermeditate assessment; secondary outcomes) and at 16 months (final assessment; primary outcome).ResultsThere were 169 children randomized, with a mean (SD) age of 5 years 11 months (2 months); 91 (54%) were female. Of the participants, 84 were in the intervention group (57 of whom [68%] completed at least 15 cognitive training sessions) and 85 were in the control group. The posttraining visuospatial index score was not different between groups at a mean (SD) of 3.0 (1.8) months (difference, −0.6 points; 95% CI, −4.7 to 3.5 points) or 12.9 (2.6) months (difference, 0.1 points; 95% CI, −5.4 to 5.1 points). The working memory index score in the intervention group significantly improved from baseline at the intermediate time point (difference, 4.7 points; 95% CI, 1.2-8.1 points), but this improvement was not maintained at the final assessment.Conclusions and RelevanceThis randomized clinical trial found no lasting effect of a cognitive training program on visuospatial processing in children aged 5½ to 6 years with working memory disorders who were born very preterm. The findings suggest that this training has limited long-term benefits for improving executive function. Transient benefits seemed to be associated with the developmental state of executive functions.Trial RegistrationClinicalTrials.gov Identifier: NCT02757794

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Association of Language Skills with Other Developmental Domains in Extremely, Very, and Moderately Preterm Children: EPIPAGE 2 Cohort Study

Cited by 22 publications

References 26 publications

Maternal education and language development at 2 years corrected age in children born very preterm: results from a European population-based cohort study

Maternal education and language development at 2 years corrected age in children born very preterm: results from a European population-based cohort study

Neonatal Adverse Outcomes, Neonatal Birth Risks, and Socioeconomic Status: Combined Influence on Preterm Infants’ Cognitive, Language, and Motor Development in Brazil

Cognitive Training for Visuospatial Processing in Children Aged 5½ to 6 Years Born Very Preterm With Working Memory Dysfunction

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