Effect of primary language on developmental testing in children born extremely preterm

Abstract

Aim: The aim of this study was to better understand the impact of non-English language spoken in the home on measures of cognition, language and behaviour in toddlers born extremely preterm. Methods: Eight hundred and fifty children born at < 28 weeks of gestational ages were studied. 427 male and 423 female participants from three racial/ethnic groups (White, Black and Hispanic) were evaluated at 18-22 months adjusted for age using the Bayley Scales of Infant Development third edition and the Brief Infant Toddler Social Emotional Assessment (BITSEA). Children whose primary language was Spanish (n = 98) were compared with children whose primary language was English (n = 752), using multivariable regression adjusted for medical and psychosocial factors. Results: Cognitive scores were similar between groups; however, receptive, expressive and composite language scores were lower for children whose primary language was Spanish. These differences remained significant after adjustment for medical and socio-economic factors. Spanish-speaking children scored worse on the BITSEA competence and problem scores using univariate analysis, but not after adjustment for medical and socio-economic factors. Conclusion: Our finding that preterm children whose primary language was Spanish had similar cognitive but lower language scores than those whose primary language was English suggests that using English language-based testing tools may introduce bias against non-English-speaking children born preterm