Impact of Differing Language Background Exposures on Bayley-III Language Assessment in a National Cohort of Children Born Less than 29 Weeks’ Gestation

Abstract

Preterm infants are at risk for adverse neurodevelopmental outcomes, especially language delay. Preterm infants < 29 weeks’ gestational age, cared for in Canadian Neonatal Follow-Up Network affiliated hospitals, were assessed between 18 to 21 months corrected age using the Bayley-III. Bayley-III Language Composite Scores were compared using univariate and multivariate analyses for children in three primary language groups: English, French and other. 6146 children were included. The primary language at home was English, French or another language for 3708 children (60%), 1312 children (21%) and 1126 children (18%), respectively, and overall, 44% were exposed to two or more languages at home. Univariate analysis showed that primary language was associated with lower Bayley-III Language scores; however, multivariate analyses demonstrated that neither primary language nor language of administration were significantly associated with lower language scores when adjusted for gestational age, other developmental delays and sociodemographic factors, but multiple language exposure was. Sociodemographic and other factors are more important in determining language development than primary language at home. Further studies are needed to examine the association between exposure to multiple languages and lower Bayley-III language scores in preterm infants.

Language outcomes at 18–24 months of preterm infants from US Spanish‐ and English‐speaking homes

“…reported that children with multilingual exposure outperformed their monolingual preterm peers. Contrastingly, BSID‐III scores were lower among bilingual French–English speakers in a cohort of preterm according to Chan et al 2 . Nevertheless, there is data that suggests bilingualism among young children can lead to slower rates of language development in both languages 27 .…”

“…Studies have shown that this delay is secondary to a combination of biological and environmental factors including a critical period of brain development and prolonged hospitalisation in neonatal intensive care unit (NICU) 1 . This topic of language development has previously been explored in extremely PT infants from Spanish‐speaking homes and PT infants from bilingual French–Canadian English cohorts 1,2 . In a cohort of EPT children at age 2 years, Lowe et al 1 .…”

“…They suggest that the testing tools may be biased against non‐English speaking children. The second multicentre study by Chen et al 2 . of preterms <29 weeks identified in adjusted analyses that exposure to multiple languages and sociodemographic factors rather than primary language were associated with lower BSID‐III scores.…”

“…1 This topic of language development has previously been explored in extremely PT infants from Spanish-speaking homes and PT infants from bilingual French-Canadian English cohorts. 1,2 In a cohort of EPT children at age 2 years, Lowe et al 1 identified a delay in Bayley Scales of Infant and Toddler Development, Third Edition (BSID-III) language scores but no difference in BSID-III cognitive scores. They suggest that the testing tools may be biased against non-English…”

“…8 The primary aim of this study was to assess the association between mild to moderate expressive and receptive language delay and primary language (Spanish and English) spoken in the home of PT infants using the BSID-III 9 and to examine the association with socio-economic factors. It was hypothesised that PT infants from Spanish-speaking households would demonstrate a higher prevalence of mild-moderate language delay than PT infants from English-speaking homes related to the following factors: (1) Spanish speakers in the United States are more likely to have public insurance, a proxy for poverty and low educational attainment and (2) The United States has limited availability of Spanish-speaking providers who can offer or refer families to EI support. 7,10 The secondary aim was to test the effects of a Spanish-speaking household on cognitive and motor scores.…”