NMH

NMH | 2024 60 Neonatology preterm. The support of an SLT is vital for children struggling with feeding or who present with speech and language delays. We know that preterm infants who have had early feeding problems are more likely to have language impairment, some with lasting effects into childhood and adolescence. Although preterm infants will not speak for a few years, elements of their care in the NICU may impact on their speaking ability over the long-term. Of our preterm group who were followed-up in 2022, 52% showed an expressive speech delay at least one standard deviation or more below the mean (score <85) while 31% had a receptive speech delay. The extent of language delay as a problem in preterm infants is often under-appreciated, as many centres, including ours, primarily report on composite cognitive and motor scores as opposed to language scores. Our data support the need for early speech and language therapy input commencing in the NICU. Our SLT now works with parents to initiate and develop their child's attention and listening skills, play skills, their comprehension and expression of language (combining words to make sentences), and their speech articulation, all which contribute to language development. For our cohort of children, born preterm (<+1500g/or at 29+6 weeks) and term with neonatal encephalopathy, the NICE Guideline NG72 provides a very comprehensive outline of the biomarkers for delay and the need for follow-up at 2 years and 4 years of age respectively. 5 We have introduced the ACORN Programme to ensure all our Very Low Birth Weight Infants receive early intervention while in NICU and during their first 2 years post discharge within the Dublin area. However, these babies are not yet being seen at 4 years of age, which should be our next goal, if we wish to better support their school life and learning potential, and their social and emotional development. We are still not formally assessing moderate (32-33 weeks >1500g) or late (34-36 weeks) preterms. This may be something we should consider going forward as recently published in the British Journal of Medicine 6 2024. The population cohort (diagnosed up to 16 years of age) was a national study of nearly 1.5 million (1,496 950 births exactly) births recorded in Sweden from 1998 – 2012. Birth weight was by centiles so more difficult to comprehend. The study concluded that children born moderately or late preterm have higher risks of adverse neurodevelopmental outcomes when compared to term infants. As these children compromise the largest proportion of children born preterm these risks should not be underestimated. The PARCA-R screening tool discussed above would be a good start for follow-up within this cohort of moderate to late preterms to measure potential cognitive or language delay. Dr Ebithal Abdelaziz, Neonatal Senior House Officer and Dr Marahaini Isa, Specialist Registrar in Neonatology, caring for Baby Basma Ekky on the Postnatal Ward.

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