Trajectories of receptive language development from 3 to 12 years of age for very preterm children

Abstract

Objectives: The goal was to examine whether indomethacin use, gender, neonatal, and sociodemographic factors predict patterns of receptive language development from 3 to 12 years of age in preterm children.

Methods: A total of 355 children born in 1989-1992 with birth weights of 600 to 1250 g were evaluated at 3, 4.5, 6, 8, and 12 years with the Peabody Picture Vocabulary Test-Revised. Hierarchical growth modeling was used to explore differences in language trajectories.

Results: From 3 to 12 years, preterm children displayed catch-up gains on the Peabody Picture Vocabulary Test-Revised. Preterm children started with an average standardized score of 84.1 at 3 years and gained 1.2 points per year across the age period studied. Growth-curve analyses of Peabody Picture Vocabulary Test-Revised raw scores revealed an indomethacin-gender effect on initial scores at 3 years, with preterm boys assigned randomly to receive indomethacin scoring, on average, 4.2 points higher than placebo-treated boys. However, the velocity of receptive vocabulary development from 3 to 12 years did not differ for the treatment groups. Children with severe brain injury demonstrated slower gains in skills over time, compared with those who did not suffer severe brain injury. Significant differences in language trajectories were predicted by maternal education and minority status.

Conclusion: Although indomethacin yielded an initial benefit for preterm boys, this intervention did not alter the developmental trajectory of receptive language scores. Severe brain injury leads to long-term sequelae in language development, whereas a socioeconomically advantaged environment supports better language development among preterm children.

Figures

FIGURE 1

Predicted trajectory of PPVT-R standard scores among preterm children from 3 to 12 years corrected age in comparison to the reference population standard norms. Preterm children (dotted line) exhibited catch-up in PPVT-R standard scores when compared to the reference population (mean = 100). Average initial score at 3 years for the preterm cohort was 84.1 increased by 1.2 point per year over the studied period.

FIGURE 2

Comparison of increase in PPVT-R raw scores from 3 to 12 years corrected age between children randomized to indomethacin or placebo stratified by gender Preterm males randomized to indomethacin (solid line) started at a slightly higher level than preterm saline males (dashed line), whereas preterm females, regardless of treatment, started at similar levels (p = 0.025 for interaction term indomethacin × male). Over time, growth in PPVT-R raw scores was similar across groups (p = 0.445).

FIGURE 3

Effect of severe brain injury, maternal education, and minority status on development in PPVT-R raw scores from 3 to 12 years corrected age among preterm children