Language and Fine Motor Outcomes of Children Born Prematurely: Hidden Deficits.

The goal of this study was to provide preliminary data on fine motor and language outcomes of children born prematurely in a Northern Ontario, Canada, hospital. Participants (n=91) had a mean gestational age of 31.0 wks (SD 2.8) and a mean birth weight of 1.65 kg (SD 0.53). A retrospective chart review was conducted on all children monitored by an interdisciplinary Follow-Up Program, assessed by the same clinician from 0-2 years. Overall, the results demonstrated that the majority of children assessed fell within the average range in their fine motor development; a greater incidence of delays were noted in language development. The largest proportion of children referred to speech-language therapy were born very preterm and/or with low birthweight; those referred to occupational therapy were most often born late preterm and/or with low birthweight. At the time of the last appointment, approximately 30% of participants had delays in both fine motor and language development, the largest proportion born late preterm, those historically perceived to be at lower risk. Of these, 100% had been previously identified as delayed in language and 40% in fine motor development. These results demonstrate the high prevalence, low morbidity deficits in all categories of premature children. Given the significant relationship between motor development, social cognition, language and social interactions, the early identification and referral of these children is imperative.

Supporting caregivers of children born prematurely in the development of language: A scoping review.

BACKGROUND: Infants born prematurely can display impairments that negatively impact the early years of their development. Compared to their peers born at term, preterm children have higher risks of cerebral palsy, sensory deficits, learning disabilities, cognitive and language deficits, as well as difficulties related to attention and behaviour. Following discharge, parents of preterm children are often supported through neonatal follow-up programs or by community health care practitioners. Through assessment and consultation, professionals foster parental resilience by teaching them about their child's development. Research shows a large volume of literature on improving outcomes for preterm infants, but less attention has been given to the impact and potential importance of education of parents regarding the care they provide from the home. OBJECTIVE: A scoping review was completed to determine the best practices for early intervention in premature children regarding the development of language skills during the preschool years. METHODS: The review followed the guidelines for the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA). RESULTS: Four general themes emerged from the review and included the importance of providing (1) parental training in the care of an infant born prematurely during neonatal intensive care unit stay; (2) education on the development of language and the importance of parental responsiveness; (3) provision of activities to support child language learning; and (4) overall and ongoing monitoring and support by qualified health professionals. CONCLUSIONS: The conclusions drawn will provide guidance to health care professionals regarding the education of parents on best practices for stimulating language development in their child.

Gross Motor Outcomes of Children Born Prematurely in Northern Ontario and Followed by a Neonatal Follow-Up Programme.

Purpose: The developing brain of a premature infant is vulnerable to injury. As a result, the long-term consequences of a premature birth include motor deficits, cognitive and behavioural problems. It is crucial to identify motor dysfunction during the preschool period because it interferes with a child's ability to explore the world. The goals of this study were to (1) provide preliminary data on the gross motor outcomes of children born prematurely and (2) determine the proportion and characteristics of the children who had maintained delays over the course of follow-up. Method: A retrospective chart review was conducted on all infants monitored by a neonatal follow-up programme. Each child was assessed by a single physiotherapist from birth until age 2 years. Of the 107 cases identified, 97 individuals were retained for analysis; they had a mean gestational age of 31.1 (SD 2.9) weeks and a mean birth weight of 1.66 (SD 0.53) kilograms. Results: The majority of children assessed were found to have gross motor outcomes in the average range. Children with scores below the average range were most often born very preterm (VPT) or moderately preterm (MPT), with very low or low birth weight, respectively. A total of 17 participants were referred to physiotherapy to address the gross motor delays identified in the follow-up programme; 14 of these 17 had previously been identified as delayed and were being monitored. Late preterm (LPT) children (n=6) were most often referred, followed by those born extremely preterm (EPT) and VPT (n=4). In total, 56 children were identified as delayed at one assessment point but were found to be within normal limits by the end of the follow-up period. Conclusion: It is important to periodically monitor premature children. A longitudinal, population-based study is also needed to provide more data on the predictors and long-term motor outcomes of MPT and LPT children.

Objectif : le cerveau du nourrisson prématuré est vulnérable aux lésions. Conséquemment, des difficultés motrices, ainsi que des troubles cognitifs et comportementaux peuvent être observés. Il est essentiel de diagnostiquer les dysfonctions motrices pendant la période préscolaire, comme elles compromettent la capacité de l'enfant à explorer le monde. La présente étude cherchait à 1) fournir des données préliminaires sur la motricité grossière des enfants nés prématurément et 2) déterminer la proportion et les caractéristiques des enfants qui ont maintenu des retards au fil du temps. Méthodologie : les chercheurs ont effectué une analyse rétrospective des dossiers de tous les nourrissons ayant fait l'objet d'un programme de suivi néonatal. Une seule physiothérapeute a évalué chaque enfant entre la naissance et l'âge de deux ans. Des 107 cas, 97 ont été conservés en vue de l'analyse. À la naissance, l'âge gestationnel moyen était de 31,1 semaines (ÉT 2,9) et le poids moyen était de 1,66 kg (ÉT 0,53). Résultats : les résultats ont montré que chez la majorité des enfants, la motricité grossière se situait dans une plage moyenne. Les enfants dont les scores se situaient sous la moyenne étaient souvent très prématurés ou modérément prématurés et avaient un poids très faible ou faible à la naissance, respectivement. Au total, 17 participants ont été orientés en physiothérapie afin de cibler les retards constatés durant le programme de suivi. De ceux-ci, 14 avaient déjà été identifiés comme ayant un retard. Les enfants peu prématurés (n=6) étaient les plus souvent orientés en physiothérapie, suivis des enfants extrêmement prématurés et très prématurés (n=4). Au total, 56 enfants identifiés comme ayant un retard se sont rattrapés et se situaient dans les limites de la norme à la fin de la période de suivi. Conclusion : l'évaluation périodique des enfants prématurés est nécessaire. Une étude longitudinale à plus grande échelle est nécessaire afin de mieux comprendre le portrait clinique à long terme des enfants modérément prématurés et peu prématurés.

Practical Methodology of Cognitive Tasks Within a Navigational Assessment.

This paper describes an approach for measuring navigation accuracy relative to cognitive skills. The methodology behind the assessment will thus be clearly outlined in a step-by-step manner. Navigational skills are important when trying to find symbols within a speech-generating device (SGD) that has a dynamic screen and taxonomical organization. The following skills have been found to impact children's ability to find symbols when navigating within the levels of an SGD: sustained attention, categorization, cognitive flexibility, and fluid reasoning. According to past studies, working memory was not correlated with navigation. The materials needed for this method include a computerized tablet, an augmentative and alternative communication application, a booklet of symbols, and the Leiter International Performance Scale-Revised (Leiter-R). This method has been used in two previous studies. Robillard, Mayer-Crittenden, Roy-Charland, Minor-Corriveau and Bélanger assessed typically developing children, while Rondeau, Robillard and Roy-Charland assessed children and adolescents with a diagnosis of Autism Spectrum Disorder. The direct observation of this method will facilitate the replication of this study for researchers. It will also help clinicians that work with children who have complex communication needs to determine the children's ability to navigate an SGD with taxonomical categorization.

Monolingual and bilingual children with and without primary language impairment: core vocabulary comparison.

Core vocabulary is an important component of augmentative and alternative communication (AAC) systems for school-aged children who have complex communication needs. One method of identifying core vocabulary for these individuals is to study the vocabulary of speaking children. To date, the use of core vocabulary by speaking bilingual children has not been well documented. The present study compared the core vocabulary used by children who are monolingual (French), and bilingual (French-English; English-French). We also gathered and compared language samples from French-speaking children identified as having primary language impairment (PLI), with the goal of better understanding the language differences demonstrated by children with this disability. Language samples were collected from a total of 57 children within a school setting, in a region where French is a minority language. Contrary to the hypothesis, the analysis of language transcripts revealed that there were no important differences between the core words from the groups studied.

Exploring the impact of cognition on young children's ability to navigate a speech-generating device.

This study examined the impact of cognition on young children's ability to navigate a speech-generating device (SGD) with dynamic paging. Knowledge of which cognitive factors impact navigational skills could help clinicians select the most appropriate SGD for children who have complex communication needs. A total of 65 typically developing children aged 48-77 months were assessed using the Leiter International Performance Scale-Revised (Leiter-R) and the Automated Working Memory Assessment (AWMA). Although significant correlations were found between the ability to navigate an SGD (using a taxonomic organization) and all cognitive factors except for cognitive flexibility, a stepwise linear regression revealed that sustained attention, categorization, and fluid reasoning were the most pragmatic set of factors to predict navigational skills. Future studies are needed to further understand the factors that impact children's navigational skills.