Prematurity and Language Development: Speech Therapy Guide
Prematurity refers to births before 37 weeks of amenorrhea. Children born prematurely are at increased risk of developmental difficulties, particularly in the area of language. Early monitoring and appropriate stimulation can support their development and prevent later difficulties.
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Early stimulation tools, visual supports, parental guidance
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Definition and Degrees of Prematurity
| Term | Gestational Age | Risks |
|---|---|---|
| Late Prematurity | 34-36 weeks | Moderate risks |
| Moderate Prematurity | 32-33 weeks | Intermediate risks |
| Very Premature | 28-31 weeks | Significant risks |
| Extremely Premature | <28 weeks | Very significant risks |
Corrected Age
To assess the development of a premature child, the corrected age (actual age minus the number of weeks of prematurity) is used at least until 2 years. A baby born at 32 weeks and aged 6 months has a corrected age of approximately 4 months.
Developmental Risks
Prematurity can affect different areas of development:
- Motor Skills: motor delay, coordination disorders
- Cognition: attention difficulties, executive functions
- Language: language delay, specific disorders
- Learning: frequent school difficulties
- Behavior: more frequent ADHD
- Sensory: visual, auditory disorders
💡 Additional Risk Factors
The risk increases with: the degree of prematurity, low birth weight, neonatal complications (brain hemorrhage, infection, respiratory distress), disadvantaged socio-economic status.
Impact on Language
Common Difficulties
- Language Delay: later first words and combinations
- Vocabulary: often reduced lexicon
- Morphosyntax: shorter, less complex sentences
- Phonology: more fragile phonological awareness
- Pragmatics: sometimes conversational difficulties
- Written Language: increased risk of learning difficulties
Development
Many premature children catch up on their initial delay with appropriate stimulation. However, more subtle difficulties may persist (elaborate language, reading, attention) and may become apparent upon entering school.
Oral Feeding and Nutrition
Premature babies often experience oral feeding difficulties:
- Sucking: immaturity, coordination of sucking-swallowing-breathing
- Enteral Nutrition: tube feeding during the neonatal period
- Oral Hypersensitivity: due to neonatal care
- Diversification Difficulties: refusal of textures
Support for oral feeding is essential from the neonatal period (developmental care) and continues as needed.
Monitoring and Intervention
Monitoring Network
Very premature children benefit from monitoring by perinatal networks and CAMSP (Early Medical-Social Action Center) until 7 years old. This multidisciplinary follow-up allows for early detection and management of difficulties.
Speech Therapy Intervention
- Parental Guidance: daily language stimulation
- Oral Feeding: support for feeding difficulties
- Early Stimulation: if delay is confirmed
- Rehabilitation: if disorders are established
- Prevention: before entering written language
Warning Signs
- No babbling at 12 months (corrected age)
- No first words at 18 months (corrected age)
- No word combinations at 24 months (corrected age)
- Persistent comprehension difficulties
- Significant feeding difficulties
Our Downloadable Tools
🖼️ Daily Picture Book
Images to stimulate early vocabulary.
Download🎵 Illustrated Nursery Rhymes
Nursery rhymes to stimulate language and joint attention.
Download📊 Texture Chart
To support food diversification.
Download📷 Sequential Images
Simple stories to develop narrative skills.
DownloadFrequently Asked Questions
Not necessarily. Many premature children develop normally. Regular monitoring allows for identifying those who need intervention. Parental guidance (advice to stimulate language daily) may be sufficient at first. Rehabilitation is only proposed if a delay or disorder is confirmed.
Corrected age is used for development assessment until at least 2 years, sometimes up to 3 years for very premature children. Beyond that, it is considered that the "catch-up" related to prematurity should have occurred, but the child's history is kept in mind when interpreting assessments.
Often yes, especially with early stimulation. However, some more subtle difficulties may persist or appear later (elaborate language, reading, attention, executive functions). Extended monitoring allows for identifying and supporting them. Prematurity does not determine outcomes: many former premature infants have a completely normal trajectory.
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