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Long-term effects of preterm birth on language and literacy at eight years*

Published online by Cambridge University Press:  24 August 2009

Department of Psychology, University of Bologna
Department of Psychology, University of Bologna
Department of Psychology, University of Bologna
Department of Psychology, University of Bologna
Institute of Neonatology, University of Bologna
Institute of Neonatology, University of Bologna
Birkbeck Centre for Brain and Cognitive Development, University of London
Address for correspondence: A. Guarini, Dipartimento di Psicologia, Università degli Studi di Bologna, Viale Berti Pichat, 5, 40127 Bologna, Italy. Tel: +39 051 2091875. Fax: +39 051 243086. Email:


The aims of this study were to investigate whether specific linguistic difficulties in preterm children persist at eight years and to examine the interrelationships between language and literacy in this population, compared with a control group of full-term children. Sixty-eight monolingual Italian preterms and 26 chronologically matched controls were recruited. Language (grammar comprehension, lexical production and phonological awareness), literacy (reading comprehension, reading and writing) and general cognitive development were investigated. Results showed no general delay in preterms, but slight difficulties in specific linguistic abilities (grammar, lexicon, phoneme synthesis and deletion of the first syllable), more difficulties in literacy (speed in reading and accuracy in writing) and certain correlations among competencies turning out to be different from the control group. In conclusion, our study established that a partially atypical trajectory emerged in preterms, showing specific long-term effects of preterm birth on language and literacy development.

Copyright © Cambridge University Press 2009

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This research was supported by research grants from the University of Bologna (Basic Oriented Research ex 60% 2004, 2005, 2006; University Research Project 2004–2007; Marco Polo fellowship; Strategic Project, 2007–2009, ‘Precoci abilità comunicativo-linguistiche e cognitive: rischi associati alla nascita pretermine’). We would like to thank the children and parents for their participation in the research, and Giulia Aquilano for her help with the medical examination. We are also grateful to the teachers and director of Ferrarin Primary School of Bellaria. We would like to thank Rossella Miglio and Serena Broccoli for their statistical advice. Finally we would like to thank Daniela Brizzolara and Anna Maria Chilosi for their suggestions concerning the tests of lexical production and grammar comprehension, and Paola Bonifacci, Cristina Santinelli and Silvana Contento for the Italian version of the K-BIT.



Anderson, P., Doyle, L. W. & Victorian Infant Collaborative Study Group (2003). Neurobehavioral outcomes of school-age children born extremely low birth weight or very preterm in the 1990s. The Journal of the American Medical Association 289, 3264–72.CrossRefGoogle ScholarPubMed
Aylward, G. P. (2002). Cognitive and neuropsychological outcomes: More than IQ scores. Mental Retardation and Developmental Disabilities Research Reviews 8, 234–40.CrossRefGoogle ScholarPubMed
Bhutta, A. T., Cleves, M. A., Casey, P. H., Cradock, M. M. & Anand, K. J. S. (2002). Cognitive and behavioural outcomes of school-age children who are born preterm. Journal of the American Medical Association 288, 728–37.CrossRefGoogle ScholarPubMed
Bonifacci, P., Santinelli, C. & Contento, S. (2007). Un test breve di intelligenza: il K-BIT. Bollettino di Psicologia Applicata 252, 3341.Google Scholar
Bradley, L. & Bryant, P. E. (1983). Categorizing sounds and learning to read – a causal connection. Nature 301, 419–21.CrossRefGoogle Scholar
Brizzolara, D., Cipriani, P., Chilosi, A. M. & de Pasquale, L. (1994). L'apprendimento del linguaggio scritto nei bambini con difficoltà di acquisizione del linguaggio orale: continuità o discontinuità? In Masi, G. and Martini, A. (eds), Apprendimento e Patologia Neuropsichica nei primi anni di scuola. Modelli interpretativi della clinica, 124–35. Roma: Borla.Google Scholar
Caravolas, M., Volin, J. & Hulme, C. (2005). Phoneme awareness is a key component of alphabetic literacy skills in consistent and inconsistent orthographies: evidence from Czech and English children. Journal of Experimental Psychology 92, 107139.Google ScholarPubMed
Chaudhari, S., Otiv, M., Chitale, A., Pandit, A. & Hoge, M. (2004). Pune low birth weight study – Cognitive abilities and educational performance at twelve years. Indian Pediatrics 41, 121–28.Google ScholarPubMed
Chilosi, A. M. & Cipriani, P. (1995). Test di Comprensione Grammaticale per bambini – TCGB. Pisa: Edizioni Del Cerro.Google Scholar
Consensus Conference (2007). Raccomandazioni per la pratica clinica sui DSA. Milano: Consensus Conference.Google Scholar
Cornoldi, C., Colpo, G. & Gruppo, M. T. (1998). Prova di lettura MT per la scuola elementare – 2. Firenze: Organizzazioni Speciali.Google Scholar
Crunelle, D., Le Normand, M. T. & Delfosse, M. J. (2003). Langage orale et écrit chez des enfants prématurés: résultats à 7½ ans. Folia Phoniatrica et Logopaedica 55, 115–27.CrossRefGoogle Scholar
Di Filippo, G., Brizzolara, D., Chilosi, A., De Luca, M., Judica, A., Pecini, C., Spinelli, D. & Zoccoletti, P. (2005). Rapid naming, not cancellation speed or articulation rate, predicts reading in an orthographically regular language (Italian). Child Neuropsychology 11, 349–61.CrossRefGoogle Scholar
Feder, K. P., Majnemer, A., Bourbonnais, D., Platt, R., Blayney, M. & Synnes, A. (2005). Handwriting performance in preterm children compared with term peers at age 6 to 7 years. Developmental Medicine and Child Neurology 47, 163–70.CrossRefGoogle ScholarPubMed
Foster-Cohen, S., Edgin, J. O., Champion, P. R. & Woodward, L. J. (2007). Early delayed language development in very preterm infants: evidence from the MacArthur-Bates CDI. Journal of Child Language 34, 655–75.CrossRefGoogle ScholarPubMed
Frost, J., Madsbjerg, S., Niedersøe, J., Olofsson, Å. & Sørensen, P. M. (2005). Semantic and phonological skills in predicting reading development: from 3–16 years of age. Dyslexia 11, 7992.CrossRefGoogle ScholarPubMed
Gombert, J. E. (2002). Children with Down syndrome use phonological knowledge in reading. Reading and Writing: An Interdisciplinary Journal 15, 455–69.CrossRefGoogle Scholar
Hesketh, A. (2004). Early literacy achievement of children with a history of speech problems. International Journal of Language & Communication Disorders 39, 453–68.CrossRefGoogle ScholarPubMed
Karmiloff-Smith, A. (2009). Nativism versus neuroconstructivism: rethinking the study of developmental disorders. Developmental Psychology 45, 5663.CrossRefGoogle Scholar
Laing, E., Hulme, C., Grant, J. & Karmiloff-Smith, A. (2001). Learning to read in Williams syndrome: looking beneath the surface of atypical reading development. Journal of Child Psychology and Psychiatry 42, 729–39.CrossRefGoogle ScholarPubMed
Luoma, L., Herrgård, E., Martikainen, A. & Ahonen, A. (1998). Speech and language development of children born at ⩽32 weeks' gestation: a 5 year prospective follow-up. Developmental Medicine & Child Neurology 40, 380–87.CrossRefGoogle ScholarPubMed
Marlow, N., Roberts, L. & Cooke, R. (1993). Outcome at 8 years for children with birth weights of 1250 g or less. Archives of Disease in Childhood 68, 286–90.CrossRefGoogle ScholarPubMed
Marotta, L., Trasciani, M. & Vicari, S. (2004). Valutazione delle competenze metafonologiche – CMF. Trento: Edizioni Erickson.Google Scholar
Menghini, D., Verucci, L. & Vicari, S. (2004). Reading and phonological awareness in Williams Syndrome. Neuropsychology 18, 2937.CrossRefGoogle ScholarPubMed
Muter, V., Hulme, C., Snowling, M. J. & Stevenson, J. (2004). Phonemes, rimes, vocabulary, and grammatical skills as foundations of early reading development: evidence from a longitudinal study. Developmental Psychology 40, 665–81.CrossRefGoogle ScholarPubMed
Orsolini, M., Fanari, R., Tosi, V., De Nigris, B. & Carrieri, R. (2006). From phonological recoding to lexical reading: a longitudinal study on reading development in Italian. Language and Cognitive Processes 21, 576607.CrossRefGoogle Scholar
Peterson, B. S., Vohr, B., Staib, L. H., Cannistraci, C. J., Dolberg, A., Schneider, K. C., Katz, K. H., Westerveld, M., Sparrow, S., Anderson, A. W., Duncan, C. C., Makuch, R. W., Gore, J. C. & Ment, L. R. (2000). Regional brain volume abnormalities and long-term cognitive outcome in preterm infants. The Journal of the American Medical Association 284, 1939–47.CrossRefGoogle ScholarPubMed
Pietz, J., Peter, J., Graf, R., Rauterberg-Ruland, I., Rupp, A., Sontheimer, D. & Linderkamp, O. (2004). Physical growth and neurodevelopmental outcome of nonhandicapped low-risk children born preterm. Early Human Development 79, 131–43.CrossRefGoogle ScholarPubMed
Pritchard, V. E., Clark, C. A. C., Liberty, K., Champion, P. R., Wilson, K. & Woodward, L. J. (2009). Early school based learning difficulties in children born very preterm. Early Human Development 85, 215–24.CrossRefGoogle ScholarPubMed
Saavalainen, P., Luoma, L., Bowler, D., Timonen, T., Määttä, S., Laukkanen, E. & Herrgård, E. (2006). Naming skills of children born preterm in comparison with their term peers at the ages of 9 and 16 years. Developmental Medicine & Child Neurology 48, 2832.CrossRefGoogle ScholarPubMed
Saigal, S., den Ouden, L., Wolke, D., Hoult, L., Paneth, N., Streiner, D. L., Whitaker, A. & Pinto-Martin, J. (2003). School-age outcomes in children who were extremely low birthweight from four international population-based cohorts. Pediatrics 112, 943–50.CrossRefGoogle ScholarPubMed
Sansavini, A., Guarini, A., Alessandroni, R., Faldella, G., Giovanelli, G. & Salvioli, G. (2006). Early relations between lexical and grammatical development in very immature Italian preterms. Journal of Child Language 33, 199216.CrossRefGoogle ScholarPubMed
Sansavini, A., Guarini, A., Alessandroni, R., Faldella, G., Giovanelli, G. & Salvioli, G. (2007). Are early grammatical and phonological working memory abilities affected by preterm birth? Journal of Communication Disorders 40, 239–56.CrossRefGoogle ScholarPubMed
Sansavini, A., Guarini, A., Savini, S., Alessandroni, R. & Faldella, G. (2008). Relations between phonological short-term memory and language at 3½ and 6 years in typically developing and preterm children. In Johansen, N. B. (ed.), New Research on Short-Term Memory, 241–65. Hauppauge, NY: Nova Science Publishers, Inc.Google Scholar
Sartori, G., Job, R. & Tressoldi, P. E. (1995). Batteria per la valutazione della Dislessia e della Disortografia Evolutiva. Firenze: Organizzazioni Speciali.Google Scholar
Storch, S. A. & Whitehurst, G. J. (2002). Oral language and code-related precursors to reading: evidence from a longitudinal structural model. Developmental Psychology 38, 934–47.CrossRefGoogle ScholarPubMed
Whitfield, M. F., Grunau, R. V. E. & Holsti, L. (1997). Extremely premature (<800 g) schoolchildren: multiple areas of hidden disability. Archives of Disease in Childhood 77, F85F90.CrossRefGoogle ScholarPubMed
Wocadlo, C. & Rieger, I. (2007). Phonology, rapid naming and academic achievement in very preterm children at eight years of age. Early Human Development 83, 367–77.CrossRefGoogle ScholarPubMed
Wolke, D. & Meyer, R. (1999). Cognitive status, language attainment, and prereading skills of 6-year-old very preterm children and their peers: The Bavarian Longitudinal Study. Developmental Medicine & Child Neurology 41, 94109.Google ScholarPubMed
Zoccolotti, P., De Luca, M., Di Pace, E., Judica, A., Orlandi, M., & Spinelli, D. (1999). Markers of developmental surface dyslexia in a language (Italian) with high grapheme–phoneme correspondence. Applied Psycholinguistics 20, 191216.CrossRefGoogle Scholar