Correcting for prematurity affects developmental test scores in infants born late and moderately preterm.

BACKGROUND: Corrected age is typically applied when assessing the development of children born <32 weeks of gestation. There is no consensus as to whether corrected age should be applied when assessing children born late/moderately preterm (LMPT; 32-36 weeks of gestation). AIMS: This study explored the impact of corrected age on developmental test scores in infants born LMPT. STUDY DESIGN: 221 LMPT infants were assessed at two years corrected age using the Bayley-III cognitive and language scales, from which cognitive and language composite scores were derived (Normative Mean 100; SD 15). Assessments were then re-scored using chronological age. Bayley-III composite scores <80 were used to define developmental delay. Paired sample t-tests were used to assess the difference in mean test scores derived using corrected versus chronological age, and McNemar's tests to assess the difference in the proportion of infants with developmental delay using corrected versus chronological age. RESULTS: Mean corrected age scores were significantly higher than chronological age scores (cognitive: 2.1 points; 95% CI 1.6, 2.5; language 2.5; 95% CI 2.1, 2.8). Overall, significantly more LMPT infants were classified with developmental delay when chronological (18.3%) versus corrected (15.0%) age was used (p=0.016). CONCLUSIONS: Correcting for prematurity results in significantly higher developmental test scores and a significantly lower prevalence of developmental delay in LMPT infants and may affect eligibility for intervention services. Researchers and clinicians should be aware that the use of corrected age may impact on developmental test scores at both an individual and population level among infants born LMPT.

A parent questionnaire for developmental screening in infants born late and moderately preterm.

BACKGROUND: The Parent Report of Children's Abilities-Revised (PARCA-R) is a questionnaire for assessing cognitive and language development in very preterm infants. Given the increased risk of developmental delay in infants born late and moderately preterm (LMPT; 32-36 weeks), this study aimed to validate this questionnaire as a screening tool in this population. METHODS: Parents of 219 children born LMPT completed the PARCA-R questionnaire and the Brief Infant Toddler Social and Emotional Assessment when children were 24 months corrected age (range, 24 months-27 months). The children were subsequently assessed by using the cognitive and language scales of the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III). RESULTS: An average Bayley-III, cognitive and language (CB-III) score and a total PARCA-R Parent Report Composite (PRC) score were computed. There was a large association between PRC and CB-III scores (r = 0.66, P < .001) indicating good concurrent validity. Using Youden index, the optimum PARCA-R cutoff for identifying children with moderate/severe developmental delay (CB-III scores < 80) was PRC scores < 73. This gave sensitivity 0.90 (95% confidence interval: 0.75-1.00) and specificity 0.76 (95% confidence interval: 0.70-0.82), indicating good diagnostic utility. Approximately two-thirds of the children who had a PRC score < 73 had false-positive screens. However, these children had significantly poorer cognitive and behavioral outcomes than children with true negative screens. CONCLUSIONS: The PARCA-R has good concurrent validity with a gold standard developmental test and can be used to identify LMPT infants who may benefit from a clinical assessment. The PARCA-R has potential for clinical use as a first-line cognitive screening tool for this sizeable population of infants in whom follow-up may be beneficial.

Delay or deficit? Spelling processes in children with specific language impairment.

UNLABELLED: Few studies have explored the phonological, morphological and orthographic spellings skills of children with specific language impairment (SLI) simultaneously. Fifteen children with SLI (mean age=113.07 months, SD=8.61) completed language and spelling tasks alongside chronological-age controls and spelling-age controls. While the children with SLI showed a deficit in phonological spelling, they performed comparably to spelling-age controls on morphological spelling skills, and there were no differences between the three groups in producing orthographically legal spellings. The results also highlighted the potential importance of adequate non-word repetition skills in relation to effective spelling skills, and demonstrated that not all children with spoken language impairments show marked spelling difficulties. Findings are discussed in relation to theory, educational assessment and practice. LEARNING OUTCOMES: As a result of this activity, readers will describe components of spoken language that predict children's morphological and phonological spelling performance. As a result of this activity, readers will describe how the spelling skills of children with SLI compare to age-matched and spelling age-matched control children. Readers will be able to interpret the variability in spelling performance seen in children with SLI.

Written language skills in children with specific language impairment.

BACKGROUND: Young children are often required to carry out writing tasks in an educational context. However, little is known about the patterns of writing skills that children with specific language impairment (CwSLI) have relative to their typically developing peers. AIMS: To assess the written language skills of CwSLI and compare these with typically developing peers. It also aimed to assess the relative contributions of reading and spelling skills to written language skills. METHODS & PROCEDURES: Forty-five children took part in the study: 15 were CwSLI, 15 were a chronological age match and 15 were a spelling age match. The children took part in a range of tasks that assessed writing, reading and spelling abilities. OUTCOMES & RESULTS: In their written language and compared with typical age-matched peers, CwSLI used a significantly less diverse range of words, had lower quality written compositions overall, and lower levels of organization, unity and coherence. They also had a higher proportion of spelling errors. Overall, writing skills were strongly associated with reading skills. CONCLUSIONS & IMPLICATIONS: The findings demonstrate the challenges CwSLI have in producing good-quality written text and that these challenges are likely to be related to the linguistic skills profile shown by these children.