Language and cognition in very low birth weight preterm infants with PELCDO application

Abstract

The performance of very low birth weight preterm infants, in terms of cognition and expressive language, was analyzed and compared with that of term infants with the Protocol for Expressive Language and Cognition Development Observation (PELCDO). The study involved 12 very low birth weight preterm infants and 20 term infants, all of whom were evaluated monthly. Sessions were videotaped, and data were analyzed according to this specific protocol. Our results suggest that cognition and expressive language develop significantly later in very low birth weight preterm infants than in the term. We found positive correlations for cognitive and expressive language development, the delay becoming more evident after 6 months of age, persisting through the sensorimotor period, and continuing into the beginning of preoperational period, indicating the importance of follow-up evaluation, defining the true needs of such infants and identifying the ideal moment for speech-language intervention.

Variáveis de risco para o desenvolvimento da linguagem associadas à prematuridade

“…A number of studies in the field of child development have investigated the association between preterm birth and handicap in this development, comprising sensory, growth, language and / or learning gaps (2,3,4,5,6,7,8,9,10,11) . However, such risk is not due to prematurity per se, but can be attributed to the adverse conditions associated with preterm birth, which may evolve to nervous system damage (5,8,19,21,22) .…”

“…According to the literature, language disorders in preterm infants are more evident by 6 months of age (6) , since at this stage, the critical period of brain development takes place, when the neurogenesis, gliogenesis, neuronal migration and myelination processes occur at high speed (23) . Regarding the linguistic question, the transition from the preverbal to the verbal period is observed in this age group and, thus, delays are more easily identified by relatives and / or other health professionals of other areas than speech, language and hearing sciences.…”

“…Damage to any of these aspects may specifically affect language skills, which develops in parallel and integrally / intrinsically with cognitive skills (1) . This development may be affected by several complications during gestational, perinatal and / or postnatal periods, among which prematurity is one of the known risk factors for linguistic impairment (1,2,3,4,5,6,7,8,9,10,11) . According to the World Health Organization (12) , newborns are babies with a gestational age of less than 37 completed weeks (borderline preterm infants: 35-36 gestational weeks; moderate preterm infants: 31-34 gestational weeks; extremely preterm infants: <30 gestational weeks) given that, the lower the gestational age, the greater the probability of mortality, abandonment and health problems.…”

“…Regarding the linguistic development of this risk group, there are evidences that preterm infants have changes in several linguistic subdomains (5,6,8) and those changes are variable, i.e., a child may have impairments in phonological development, but not in lexical development (18) . There are reports in the literature involving the population of preterm infants pointing out that impairments in expressive language are more frequent when compared to those of receptive language (10,11) and that, between 2 and 3 years of age, pragmatic disorders, characterized by a difficulty in the heuristic function and in respecting communicative turns, participating and maintaining dialogic activities, are observed (9) .…”

Habilidades comunicativas de crianças prematuras e prematuras extremas

“…Studies have reported that premature children may show delay in receptive language and in expressive language 2,19 . Regarding the communicative abilities, literature also shows the affected areas in premature refer to linguistic abilities, to vocabulary, to grammar and phonological awareness, which are usually less developed when compared to the development of children who were born at term 3,[14][15][16][19][20][21][22][23][24][25][26][27][28][29][30][31] . Given the above, this study purpose was to compare the development of communicative abilities in children who were born premature, extreme premature and typical children with chronological age between two and three.…”