title: Characterizing early detection of language difficulties in children born preterm.
abstract: BACKGROUND
  The optimal age for assessing language difficulties in premature children remains unclear.
  
  
  OBJECTIVE
  To determine the most predictive and earliest screening tool for later language difficulties on children born preterm.
  
  
  METHODS
  A prospective population-based study in the Loire Infant Follow-up Team LIFT SUBJECTS: All children born <35weeks of gestation between 2003 and 2005 were assessed at corrected ages by four screening tools: the Ages & Stages Questionnaire (ASQ) communication scale at 18 and 24months, the language items of Brunet Lezine test at 24months, and the "Epreuves de Repérage des Troubles du Langage" (ERTL) at 4years.
  
  
  METHODS
  After 5years, the kindergarten teacher evaluated the vocabulary, grammar and pronunciation capacities of the child in comparison with the classroom performances.
  
  
  RESULTS
  Among 1957 infants enrolled at discharge, 947 were assessed by their teacher with 12.2% (n=116) of language difficulties. Full data at all time points were available for 426 infants. The area under curve of the receiver operator characteristic curve obtained for the ASQ communication scale at 18months was significantly lower (0.65±0.09) than that obtained at 24months (0.77±0.08) and the languages items of Brunet Lezine test at 24months (0.77±0.08), and the ERTL at 4years (0.76±0.09). The optimal cut-off value for ASQ communication at 24months is ≤45 [sensitivity of 0.79 (95%CI: 0.70-0.86); specificity of 0.63 (95%CI: 0.59-0.66)].
  
  
  CONCLUSIONS
  The Ages & Stages Questionnaire communication scale at 24 corrected months appears as an acceptable test at an early time point to identify preterm children at risk of later language difficulties.
authors.affiliation: Department of Otolaryngology (ENT), Nantes University Hospital, France; Centre d'Investigation Clinique INSERM CIC004, University Hospital of Nantes, France. Electronic address: julie.boyer@chu-nantes.fr.
authors.forename: Julie
authors.initials: J
authors.lastname: Boyer
authors.affiliation: Centre d'Investigation Clinique INSERM CIC004, University Hospital of Nantes, France; Nantes University, Department of Neonatal Medicine, University Hospital of Nantes, France; "Loire Infant Follow-up Team" (LIFT) Network, Pays de Loire, France.
authors.forename: Cyril
authors.initials: C
authors.lastname: Flamant
authors.affiliation: Nantes University, Department of Neonatal Medicine, University Hospital of Nantes, France.
authors.forename: Gerald
authors.initials: G
authors.lastname: Boussicault
authors.affiliation: "Loire Infant Follow-up Team" (LIFT) Network, Pays de Loire, France.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Berlie
authors.affiliation: "Loire Infant Follow-up Team" (LIFT) Network, Pays de Loire, France; Angers University, Department of Neonatal Medicine, University Hospital of Angers, France.
authors.forename: Géraldine
authors.initials: G
authors.lastname: Gascoin
authors.affiliation: "Loire Infant Follow-up Team" (LIFT) Network, Pays de Loire, France.
authors.forename: Bernard
authors.initials: B
authors.lastname: Branger
authors.affiliation: "Loire Infant Follow-up Team" (LIFT) Network, Pays de Loire, France; Angers University, Department of Neuropediatrics, University Hospital of Angers, France.
authors.forename: Sylvie
authors.initials: S
authors.lastname: N'Guyen The Tich
authors.affiliation: Centre d'Investigation Clinique INSERM CIC004, University Hospital of Nantes, France; Nantes University, Department of Neonatal Medicine, University Hospital of Nantes, France; "Loire Infant Follow-up Team" (LIFT) Network, Pays de Loire, France.
authors.forename: Jean-Christophe
authors.initials: JC
authors.lastname: Rozé
mesh_terms: D002675:Child, Preschool; D042241:Early Diagnosis; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D007234:Infant, Premature; D007805:Language Development Disorders / Q000175:diagnosis*; D008297:Male
keywords: Follow-up; Language difficulties; Parental questionnaires; Preterm infants