Background: Children born very preterm are more likely to have difficulties with language acquisition and use that persist throughout childhood. Preterm birth occurs at a critical time in brain development and interrupts neurodevelopment, which has downstream implications for altered neural structure and function. Prematurity and socioeconomic status greatly impact language performance in children, but the neural substrates are poorly understood. Here the neural constituents of language performance are examined in select cortical and subcortical regions.
Methods: Fifty-one children born preterm (24-31 weeks) and 20 born full-term were seen at preschool (mean age = 47 months) and school age (mean age = 74 months). Diverse aspects of language performance were evaluated at preschool and school age and were also aggregated into a single score using principle components analysis. At preschool age, measures of cortical thickness, surface area, subcortical volumes, and fractional anisotropy of white matter tracts were calculated for select frontotemporal regions implicated in language. Caregivers reported on many sociodemographic variables which were reduced using principle components analysis. Repeated measures general linear models were used to examine group differences in language performance and to determine the contributions of group, socioeconomic status, and neuroanatomical substrates to language performance.
Results: Children born very preterm performed more poorly than children born full-term on tests of receptive language, verbal fluency and verbal working memory at preschool and school age. Five measures of language performance were reduced to one principle component at both preschool and school age. Socioeconomic status significantly accounted for language performance across groups and time points. Initial neuroanatomical analyses found that subcortical volumes significantly accounted for language performance. Analyses of language performance including neuroanatomy and socioeconomic status revealed that socioeconomic status had a significant main effect, as did some specific measures of cortical thickness, subcortical volumes and white matter tracts.
Conclusions: Our findings provide support for poorer language performance in children born very preterm at preschool and school age. The relationship between structural neuroanatomic variations associated with preterm birth and language deficits is supported by our findings that language performance was significantly associated with subcortical volumes. This result highlights the possible importance of corticostriatal learning circuits in poorer language performance in children born very preterm. Importantly, our findings that socioeconomic status substantially accounted for language performance also emphasizes the multifactorial determinants of language problems in preterm birth, which is still poorly understood despite decades of research. Finally, these results have important implications for early intervention on an individual level, as well as policy reform to improve the broader social conditions and medical resources needed by so many Americans.
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First Committee Member (Chair)
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Preterm Birth, Language Performance, Sociocultural Factors, Pediatric Neuropsychology, Neuroanatomy
Avila-Rieger, Rebecca E.. "SOCIOECONOMIC AND NEUROANATOMIC CONTRIBUTIONS TO LANGUAGE PERFORMANCE IN CHILDREN BORN VERY PRETERM AT PRESCHOOL AND SCHOOL AGE." (2020). https://digitalrepository.unm.edu/psy_etds/310