Newborn Care Centre, Royal Hospital for Women, Sydney, New South Wales, Australia
School of Women's and Children's Health, University of New South Wales, Sydney, New South Wales, Australia.
BMJ Paediatr Open. 2023 Jul;7(1). doi: 10.1136/bmjpo-2022-001814.
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.
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.
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.
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.
极早产儿罹患语言发育迟缓的风险增加。人们对使用标准化英语语言工具来诊断语言多样化的儿童语言发育迟缓的效用提出了担忧。本研究旨在调查语言多样化的极早产儿在 4 岁时语言发育迟缓的发生率。
2012 年至 2016 年期间，在澳大利亚西南悉尼出生的极早产儿在 4 岁时使用临床评估语言基本技能学前 2 级（CELF-P2）工具进行评估。我们试图使用 CELF-P2 评估工具的语言分数来确定该队列中语言发育迟缓的发生率，并探讨与语言发育迟缓相关的潜在预测因素。
270 名长期幸存者中有 160 名极早产儿参加了 4 岁的评估。在 4 岁时，76 名（52%）极早产儿使用 CELF-P2 评估工具诊断为语言发育迟缓。与偏好英语的儿童相比，偏好其他语言的儿童在 CELF-P2 评估工具上的核心语言平均分数较低（75.1±14.4），而偏好英语的儿童为 86.5±17.9；p=0.002。在偏好其他语言的家庭中长大的极早产儿和多胞胎出生的极早产儿在 4 岁时语言发育迟缓的可能性更高（OR 10.30（95%CI 2.82 至 38.28）；p<0.001 和 OR 2.93（95%CI 1.20 至 7.14）；p=0.018，分别）。使用英语语言工具评估这些儿童可能会影响他们在 4 岁时的语言分数。
在这个大都市环境中，语言多样化的极早产儿在 4 岁时容易出现语言发育迟缓。需要进一步开展大规模研究，使用更具文化适应性的工具评估语言多样化的早产儿的语言结局。我们对使用标准化英语语言工具评估语言多样化人群的语言结局的效用提出质疑。
