Impact of the <scp>NICU</scp> environment on language deprivation in preterm infants

Rand, Katherine; Lahav, Amir

doi:10.1111/apa.12481

Cited by 52 publications

(49 citation statements)

References 62 publications

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“…These include intrinsic factors such as perinatal insults [6][7][8]; gestational age at birth [9][10][11] and altered neurological pathways [3,5]; low birthweight [12][13][14][15][16][17]; disease processes and severity [18][19][20]; genetic and epigenetic factors including sociocultural influences [17,21], language exposure [22][23][24] and developmental interaction [25][26][27][28]; and nosocomially derived factors such as adverse environmental exposures [29,30], sepsis and neurotoxicity from drugs [31,32]. Long-term studies on language outcomes in preterm infants reveal delays in various aspects of receptive and expressive language [13,14], articulation, comprehension [25], oromotor skills and spontaneous speech [33].…”

Section: Introductionmentioning

confidence: 99%

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Language Exposure of Preterm Infants in the Neonatal Unit: A Systematic Review

Best¹,

Bogossian²,

New³

2018

Neonatology

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Background: Elevated sound levels and low language exposures of preterm infants (< 37 weeks) cared for in the neonatal unit contribute to poorer growth, cognition, language and motor outcomes. These delays can have lasting effects on childhood development and continue throughout adult life. Whilst recommendations have been established for appropriate sound exposure levels in neonatal units, very little is known about the optimal level of language exposure. Objectives: To examine the evidence regarding language exposure, both measured (observational) and prescribed (interventional), in preterm infants (< 37 weeks) cared for in neonatal units and to identify optimal exposure levels to promote neurodevelopment. Search Methods: An electronic search of English-language articles with an open date range was conducted in the PubMed, MEDLINE, Joanna Briggs, CINAHL and Cochrane databases and in Google Scholar. The criteria were limited to original research studies of preterm infants (< 37 weeks) in which language was either measured as it naturally occurred in the neonatal unit environment or through a language intervention. Results: The search produced a total of 2,367 articles, 49 of which were related to language. A full-text review of these articles identified 10 eligible studies and 6 studies from reference searches. Conclusions: Preterm infants experience low levels of language exposure and high sound exposures in neonatal units. There is a lack of conclusive evidence to recommend an optimal level of language exposure to support improved neurodevelopmental outcomes in preterm infants. Further research from large, good-quality clinical trials is required before clear direction can be provided to inform clinical practice.

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Section: Introductionmentioning

confidence: 99%

“…Two primary concerns associated with abnormal auditory exposures in neonatal units are related to excessive noxious noise and a paucity of useful language [30]. The hyperstimulatory environment induced by an open-bed space can be loud and block meaningful language exposure.…”

Section: Introductionmentioning

confidence: 99%

Language Exposure of Preterm Infants in the Neonatal Unit: A Systematic Review

Best¹,

Bogossian²,

New³

2018

Neonatology

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“…Numerous studies have suggested that the auditory environment available for preterm infants in the NICU may not be conducive for their neurodevelopment (44)(45)(46)(47). These concerns are Significance Newborns can hear their mother's voice and heartbeat sounds before birth.…”

mentioning

confidence: 99%

“…derived from the frequent reality that hospitalized preterm newborns are overexposed to loud, toxic, and unpredictable environmental noise generated by ventilators, infusion pumps, fans, telephones, pagers, monitors, and alarms (48)(49)(50)(51), whereas at the same time they are also deprived of the low-frequency, patterned, and biologically familiar sounds of their mother's voice and heartbeat, which they would otherwise be hearing in utero (33,45). In addition, the hospital environment contains a significant amount of high-frequency electronic sounds (52,53) that are less likely to be heard in the womb because of the sound attenuation provided by maternal tissues and fluid within the intrauterine cavity (54)(55)(56).…”

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confidence: 99%

Mother’s voice and heartbeat sounds elicit auditory plasticity in the human brain before full gestation

Webb¹,

Heller

Benson

et al. 2015

Proc. Natl. Acad. Sci. U.S.A.

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174

106

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Brain development is largely shaped by early sensory experience. However, it is currently unknown whether, how early, and to what extent the newborn's brain is shaped by exposure to maternal sounds when the brain is most sensitive to early life programming. The present study examined this question in 40 infants born extremely prematurely (between 25-and 32-wk gestation) in the first month of life. Newborns were randomized to receive auditory enrichment in the form of audio recordings of maternal sounds (including their mother's voice and heartbeat) or routine exposure to hospital environmental noise. The groups were otherwise medically and demographically comparable. Cranial ultrasonography measurements were obtained at 30 ± 3 d of life. Results show that newborns exposed to maternal sounds had a significantly larger auditory cortex (AC) bilaterally compared with control newborns receiving standard care. The magnitude of the right and left AC thickness was significantly correlated with gestational age but not with the duration of sound exposure. Measurements of head circumference and the widths of the frontal horn (FH) and the corpus callosum (CC) were not significantly different between the two groups. This study provides evidence for experience-dependent plasticity in the primary AC before the brain has reached full-term maturation. Our results demonstrate that despite the immaturity of the auditory pathways, the AC is more adaptive to maternal sounds than environmental noise. Further studies are needed to better understand the neural processes underlying this early brain plasticity and its functional implications for future hearing and language development. auditory | brain | mother's voice | heartbeat | preterm newborns

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“…This means that more than 10% of infants that are born in the United States will likely spend time in the NICU. Researchers have questioned how the altered sensory environment of the NICU could effect the neural and behavioral organization of the preterm infant and their subsequent perceptual, cognitive, and behavioral development in the months and years beyond the NICU (e.g., Als, 2013;Rand & Lahav, 2014;Wachman & Lahav, 2010;VandenBerg, 2007). While it is important to investigate these questions, we are severely limited in carrying out manipulations of sensory experience with human fetuses or newborns.…”

Section: Introductionmentioning

confidence: 99%

Effects of Altered Prenatal Sensory Stimulation on Postnatal Contingency Learning in Bobwhite Quail Neonates (Colinus Virginianus)

Raju¹

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Impact of the NICU environment on language deprivation in preterm infants

Abstract: Further research is needed to identify evidence-based design solutions for providing preterm infants with a healthier linguistic hospital environment that aids growth and development.

Cited by 52 publications

References 62 publications

Language Exposure of Preterm Infants in the Neonatal Unit: A Systematic Review

Language Exposure of Preterm Infants in the Neonatal Unit: A Systematic Review

Mother’s voice and heartbeat sounds elicit auditory plasticity in the human brain before full gestation

Effects of Altered Prenatal Sensory Stimulation on Postnatal Contingency Learning in Bobwhite Quail Neonates (Colinus Virginianus)

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