Gestation age and birth weight variations in young children with communication and language impairment at an early intervention clinic

Abstract

Background: South Africa presents with some of the highest preterm birth (PTB) and low birth weight (LBW) rates (14.17%), compared to some high-income countries. Numerous neurodevelopmental and congenital conditions are associated with LBW and PTB, with primary or secondary communication and language impairment as a common, but subtle characteristic. Speech-language therapists and other health professionals may encounter many older children in their caseloads whose disorders originate from LBW and PTB, but may fail to identify them as such. Objectives: The purpose of this study was to describe the frequency of LBW/PTB as well as associated conditions in comparison to being born full-term (FT) in children at an early communication intervention clinic. Methods: Retrospective data from 530 attendees of the clinic were captured and analysed according to two groups (LBW/PTB and FT with normal birth weight). Children were between three and 74 months old (mean = 28.47 months), and 91.9% presented with communication and language impairment after assessment at the clinic. The average gestation age for the LBW/PTB group was 35 weeks, which is considered late preterm (32–37 weeks). Results: Almost 40% of the study sample was born with LBW/PTB, and late preterm gestation was the most prevalent. Factors associated with the LBW/PTB group were maternal prenatal risks, caesarean section delivery, small-for-gestation age, perinatal risks, and primary developmental conditions such as genetic conditions and global developmental delay. Although there was no significant difference between LBW/PTB and FT children with primary communication and language impairment, the LBW/PTB group showed both primary (27.8%) and secondary communication and language impairment (68.9%). Almost half (49.1%) of the entire study sample had severe communication and language delay. Conclusion: The frequency of LBW/PTB in the clinic was high, drawing attention to the communication and language impairment and other developmental disorders of the group. Secondary communication and language impairment in this predominantly late LBW/PTB sample was prevalent, and associated with genetic conditions and global developmental delay. The finding is in agreement with some studies showing that primary communication and language impairment does not occur significantly more in children with LBW/PTB than in FT children.