Speech and language development in very preterm children

In the Netherlands about 2 to 3 percent of children are born VPT (i.e. GA <32
weeks or BW <1500 grams). Meta-analyses highlighted substantial impairment in
multiple developmental domains in preterm children throughout childhood, such
as cognitive and motor development, language development, behavior, and
academic achievement (Van Noort-van der Spek et al, 2012; Wolke et al, 1999;
Bhutta et al, 2002; Kieviet de et ak, 2009; Aarnoudse-Moens et al, 2009). Even
with no major neurosensory impairment (i.e. cerebral palsy, mental
developmental index <70, or severe visus and hearing impairment) approximately
20-40% of VPT children develop speech and languages problems (wolke et al,
1999). 24% of VPT children has no normal speech by age 6 (Wolke et al, 1999).
In spite of the large amount of research conducted on speech and language
function in very preterm children, little is known about the risk factors which
are associated with speech and language impairment in VPT children entering
primary school. An adequate speech and language development is extremely
important in the light of a child*s learning and social-emotional development.
Hille et al found that at the age of 9 years, 19% of VPT children were in
special education compared to 4.7% in the general population. Of the VPT
children in mainstream education, 32% were in a grade below appropriate level
for age and 38% had special assistance (Hille et al. 2007). Since language
function is essential in all kinds of social and academic life, insight in the
developmental course of speech and language function and the possible risk
factors for speech and language impairment is of great value. Timely and
appropriate intervention of speech and language problems in this vulnerable
population may prevent emotional, social, and learning deficits, and may
improve long-term outcomes, reducing the need for special education (Beitchman
et al, 1996; Agt van der et al, 2007).

Primary objectives: (1) To longitudinally describe the speech and language
development in VPT children at 2 and 4 years of age, and (2) to identify
possible neonatal and personal risk factors associated with speech and language
impairment in 4-year-old VPT children entering primary school.
Secondary objective: To examine the association between speech and language
problems and cognitive development, behavior and hearing function in VPT
children at 2 and 4 years of age.

A single-center, prospective, cohort study in which VPT infants will be
assessed with well-known and standardized speech, language, and hearing tests
at 4 years of age.

Burden:
Determination of speech, language, and hearing function requires an hospital
visit at the age of 4 years. This visit will last at the most 1 hour and 20
minutes in total.
Benefit and risks:
The 100 VPT children will be assessed with well-known and standardized speech,
language and hearing tests, of which in literature and clinical practice no
risks are known.
Group relatedness:
VPT children are at risk for substantial impairment in multiple developmental
domains throughout childhood, such as cognitive and motor development, language
development, behavior, and academic achievement.