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Speed of Language Comprehension at 18 Months Old Predicts School-Relevant Outcomes at 54 Months Old in Children Born Preterm

Marchman, Virginia, A., PhD*; Loi, Elizabeth, C., BA; Adams, Katherine, A., BA; Ashland, Melanie, BA*; Fernald, Anne, PhD*; Feldman, Heidi, M., MD, PhD

Journal of Developmental & Behavioral Pediatrics: April 2018 - Volume 39 - Issue 3 - p 246–253
doi: 10.1097/DBP.0000000000000541
Original Articles

Objective: Identifying which preterm (PT) children are at increased risk of language and learning differences increases opportunities for participation in interventions that improve outcomes. Speed in spoken language comprehension at early stages of language development requires information processing skills that may form the foundation for later language and school-relevant skills. In children born full-term, speed of comprehending words in an eye-tracking task at 2 years old predicted language and nonverbal cognition at 8 years old. Here, we explore the extent to which speed of language comprehension at 1.5 years old predicts both verbal and nonverbal outcomes at 4.5 years old in children born PT.

Method: Participants were children born PT (n = 47; ≤32 weeks gestation). Children were tested in the “looking-while-listening” task at 18 months old, adjusted for prematurity, to generate a measure of speed of language comprehension. Parent report and direct assessments of language were also administered. Children were later retested on a test battery of school-relevant skills at 4.5 years old.

Results: Speed of language comprehension at 18 months old predicted significant unique variance (12%–31%) in receptive vocabulary, global language abilities, and nonverbal intelligence quotient (IQ) at 4.5 years, controlling for socioeconomic status, gestational age, and medical complications of PT birth. Speed of language comprehension remained uniquely predictive (5%–12%) when also controlling for children's language skills at 18 months old.

Conclusion: Individual differences in speed of spoken language comprehension may serve as a marker for neuropsychological processes that are critical for the development of school-relevant linguistic skills and nonverbal IQ in children born PT.

*Department of Psychology, Stanford University, Stanford, CA;

Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University, Stanford, CA;

Department of Applied Psychology, Steinhardt School of Culture, Education, and Human Development, New York University, New York, NY.

Address for reprints: Heidi M. Feldman, MD, PhD, Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University, Stanford, CA 94305; e-mail:

This work was supported by grants from the National Institutes of Health to A. Fernald and H. M. Feldman (R01 HD069150).

Disclosure: The authors declare no conflict of interest.

Received September , 2017

Accepted November , 2018

Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.