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Neonatology
Original research
Language outcomes at 4 years of linguistically diverse children born very preterm: an Australian retrospective single-centre study
  1. Giannina Tinoco Mendoza1,2,
  2. Jacqueline Stack2,3,
  3. Mohamed E Abdel-Latif4,5,6,
  4. Shanti Raman2,7,
  5. Pankaj Garg2,7
  1. 1Newborn Care Centre, Royal Hospital for Women, Sydney, New South Wales, Australia
  2. 2School of Women’s and Children’s Health, University of New South Wales, Sydney, New South Wales, Australia
  3. 3Newborn Care Centre, Liverpool Hospital, Sydney, New South Wales, Australia
  4. 4Department of Neonatology, Centenary Hospital for Women and Children, Canberra Hospital, Canberra, Australian Capital Territory, Australia
  5. 5Discipline of Neonatology, School of Medicine and Psychology, Australian National University, Canberra, Australian Capital Territory, Australia
  6. 6Department of Public Health, La Trobe University, Melbourne, Victoria, Australia
  7. 7Department of Community Paediatrics, South Western Sydney Local Health District, Liverpool, New South Wales, Australia
  1. Correspondence to Dr Giannina Tinoco Mendoza; Giannina.TinocoMendoza{at}health.nsw.gov.au

Abstract

Background Very preterm children are at increased risk of language delays. Concerns have been raised about the utility of standardised English language tools to diagnose language delay in linguistically diverse children. Our study investigated the incidence of language delay at 4 years in linguistically diverse very preterm children.

Methods Very preterm children born in South Western Sydney, Australia, between 2012 and 2016, were assessed with the Clinical Evaluation of Language Fundamentals Preschool-2 (CELF-P2) tool at 4 years of age. We sought to determine the incidence of language delay in this cohort using language scores from the CELF-P2 assessment tool, and explore potential predictors associated with language delay.

Results One hundred and sixty very preterm children attended the 4-year assessment out of the included 270 long-term survivors. At 4 years, 76 (52%) very preterm children had language delay diagnosed using the CELF-P2 assessment tool. Children who preferred a language other than English had lower average core language scores on the CELF-P2 assessment tool (75.1±14.4) compared with children that preferred English (86.5±17.9); p=0.002. Very preterm children growing up in households that preferenced a language other than English and those who were born from multiple births had higher odds of language delay at 4 years (AOR 10.30 (95% CI 2.82 to 38.28); p<0.001 and AOR 2.93 (95% CI 1.20 to 7.14); p=0.018, respectively). Assessing these children using an English language tool may have affected language scores at 4 years.

Conclusions In this metropolitan setting, very preterm children from linguistically diverse backgrounds were found to be vulnerable to language delays at 4 years. Further large-scale studies evaluating the language outcomes of linguistically diverse preterm children with more culturally appropriate tools are warranted. We question the utility of standardised English language tools to assess language outcomes of linguistically diverse populations.

  • Neonatology

Data availability statement

Data are available on reasonable request. All data relevant to the study are included in the article or uploaded as online supplemental information.

http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bmjpo-2022-001814

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    Data availability statement

    Data are available on reasonable request. All data relevant to the study are included in the article or uploaded as online supplemental information.

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    Footnotes

    • Contributors This research project was conceived by PG and GTM, and further developed with input from JS and MEA-F. Data extraction and initial analyses was performed by GTM, and complimentary analyses were conducted by PG and MEA-F. GTM conducted the literature search and drafted the initial manuscript. PG, JS and SR supervised the study and reviewed the manuscript. All authors agreed to the published version of the manuscript. GTM is the guarantor for this study.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None Declared.

    • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

    • Provenance and peer review Not commissioned; externally peer reviewed.