Expressive Language in Preschoolers Born Preterm: Results of Language Sample Analysis and Standardized Assessment

Abstract

Purpose Preschoolers born preterm are at an increased risk for the development of language impairments. The primary objective of this study was to document the expressive language skills of preschoolers born preterm through 2 assessment procedures, language sample analysis, and standardized assessment. A secondary objective was to investigate the role of nonlinguistic factors in standardized assessment scores. Method The language skills of 29 children born preterm (mean gestational age of 31 weeks) were compared to a group of 29 preschoolers born full term. Language samples were collected during free play and objective measures of semantic and grammatical skills were calculated. Likewise, grammatical and semantic measures of language were obtained from a standardized assessment. Information on nonlinguistic factors, including attention, hyperactivity, and nonverbal intelligence quotient, was also collected. Results The results of analyses of variance indicated that the children in the PT group had significantly poorer performance than the children born full term on all of the measures of language skill obtained from the language sample analysis. Group differences were found for only 1 measure of language skill obtained from the standardized assessments. Nonverbal factors were not found to account for group differences in assessment scores. Conclusions Generally, the children born preterm performed more poorly when language skill was measured via language sample analysis than standardized assessment. These findings underscore the importance of using language sample analysis in conjunction with standardized assessment in the evaluation of children's developing language skills.

Conversational Language in 3-Year-Old Children Born Very Preterm and at Term

“…The incidence of low language performance (scoring ≥ 1.5 SDs below the term mean PLS-5 total score, MLUm, or TNW) in children who produced > 50 utterances over 10 min in the term group (13%) was comparable to previous incidence studies using direct assessment methods (Raghavan et al, 2018;Reilly et al, 2010), whereas the incidence of low language in the preterm group (18%) was somewhat lower than expected (Foster-Cohen, Friesen, Champion, & Woodward, 2010), perhaps reflecting relatively low medical acuity in this study group. Our findings are consistent with some of the literature in this area suggesting that children born preterm demonstrate reductions in conversational MLU (Félix et al, 2017;Imgrund et al, 2019;Le Normand et al, 1995;Rice et al, 1999), sentence complexity (Grunau et al, 1990;Imgrund et al, 2019), and lexical diversity, particularly when it comes to verbs (Imgrund et al, 2019;Le Normand & Cohen, 1999), although these findings are by no means universal (Crosbie et al, 2011;Feldman et al, 1994;Grunau et al, 1990;Mahurin-Smith et al, 2014). Demographic differences between study participants may account for some of this variation-for example, two of the studies with significantly different results to ours examined an older group of children, which may reflect differences in the clinical validity of LSA in different age groups (Crosbie et al, 2011;Mahurin-Smith et al, 2014).…”

“…While some studies have found similarly weak correlations-including insignificant correlations-between LSA and standardized assessment tools (Ebert & Scott, 2014), others have found stronger relationships (Owens & Pavelko, 2017), at least for some measures. However, our results were more congruent than those of previous studies that contrasted standardized assessment with LSA in the preterm population (Crosbie et al, 2011;Imgrund et al, 2019;Mahurin-Smith et al, 2014). This may be a result of the relatively young age of our participants or may be related to our use of the PLS-5, as opposed to different standardized assessments (e.g., the Clinical Evaluation of Language Fundamentals-Fifth Edition) used in other studies.…”

“…In nonpreterm populations, studies have observed congruence between LSA metrics such as MLU and the outcomes of standardized tools (Owens & Pavelko, 2017). However, those that have examined this in children born preterm have found a less consistent picture, with children born preterm typically performing worse on standardized assessment than LSA (Crosbie et al, 2011;Imgrund, Loeb, & Barlow, 2019;Mahurin-Smith et al, 2014). It is important to establish the congruence between measures to better understand the potential impact of using different assessment methods and to gain a true, uninflated picture of language deficits in this population.…”

Language, Motor, and Cognitive Outcomes of Toddlers Who Were Born Preterm

“…This methodology needs to evolve. Recently, Imgrund et al (2019) report that preschoolers born preterm did not differ significantly from full-term peers on a standardized assessment tool but did display language delay when language sampling was utilized. In the current study, we may have under identified children in our study due to not using language sampling.…”

Desenvolvimento de linguagem e das habilidades auditivas em prematuros adequados e pequenos para a idade gestacional: idade cronológica entre 18 e 36 meses

“…The literature shows that preterm infants have worse performance in language tests and skills such as gross motor, fine-adaptive motor and personal-social compared to term children (1)(2)(3) . On the other hand, some studies report that the language impairment not as a condition related to prematurity but related to factors such as gestational age (4)(5)(6)(7) and birth weight (4)(5)(6)(7)(8) .…”