title: Biological and environmental factors as predictors of language skills in very preterm children at 5 years of age.
abstract: OBJECTIVE
  Language problems are thought to occur more frequently in very preterm children compared with healthy term born children. The primary aim of this study was to examine the contributions of biological and environmental risk factors to language outcomes in very preterm children at 5 years of age.
  
  
  METHODS
  A cohort of 227 very preterm infants (birth weight <1250 g or gestational age <30 weeks) were recruited at birth and followed up at 2 and 5 years of age (corrected for prematurity) in a prospective, longitudinal study in Melbourne, Australia. Outcomes at 5 years of age were the Expressive and Receptive Language Scales from the Kaufman Survey of Early Academic and Language Skills. A range of hypothesized biological and environmental factors identified from past research were examined as predictors of language outcomes at 5 years of age using linear regression models.
  
  
  RESULTS
  Lower maternal education and poorer communication skills in the child at 2 years of age were predictive of poorer expressive and poorer receptive language outcomes at 5 years of age. Lower expressive language scores were also associated with the presence of moderate-severe white matter abnormalities on neonatal magnetic resonance imaging.
  
  
  CONCLUSIONS
  Results support the role of both biological and environmental factors in the evolution of language difficulties and highlight the need to consider these factors in the follow-up of preterm infants.
authors.affiliation: Critical Care and Neurosciences, Murdoch Childrens Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia.
authors.forename: Kelly
authors.initials: K
authors.lastname: Howard
authors.forename: Gehan
authors.initials: G
authors.lastname: Roberts
authors.forename: Jeremy
authors.initials: J
authors.lastname: Lim
authors.forename: Katherine J
authors.initials: KJ
authors.lastname: Lee
authors.forename: Natalie
authors.initials: N
authors.lastname: Barre
authors.forename: Karli
authors.initials: K
authors.lastname: Treyvaud
authors.forename: Jeanie
authors.initials: J
authors.lastname: Cheong
authors.forename: Rod W
authors.initials: RW
authors.lastname: Hunt
authors.forename: Terri E
authors.initials: TE
authors.lastname: Inder
authors.forename: Lex W
authors.initials: LW
authors.lastname: Doyle
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Anderson
mesh_terms: D002657:Child Development / Q000502:physiology*; D002663:Child Language; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000254:growth & development*; D007804:Language Development; D007807:Language Tests; D008297:Male; D012307:Risk Factors; D012931:Social Environment