Learning Objective #1: Describe the normal development of speech and language in the newborn infant/young child

Learning Objective #2: Examine the complex relationships within development and the environment that affect the development of speech and language in the preterm infant

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INTRODUCTION: There is evidence that early childhood experiences affect subsequent development in profound and long-lasting ways. There is also evidence that interventions during the post-natal and early childhood period may enhance cognitive development and modify social-emotional outcomes. Yet, the precise relationships between biological maturation and the influences of early environmental experiences continue to be explored.

BACKGROUND: The atypical early experiences of extremely early born(EEB)preterm infants alter their development, changing, reorganizing, and redirecting their behavior. One window into the evolving brain is through the study of the acquisition of speech and language. The development of this highly complex process reveals a great deal about the maturational process, the organization of the developing brain and, relationships between physiologic and behavioral indices.

PURPOSE: The purpose of this review is to explore how extreme prematurity, and early experiences in the Neonatal Intensive Care Unit (NICU) influence and alter the development of speech and language. Using the evidence to discern appropriate interventions which best support the preterm infant's development is the overall focus of this review.

METHODOLOGY: A critical review of the literature was conducted using several search techniques, and evidence-based standards for examination of the research findings.

RESULTS: The development of EEB preterm infants is multi-factorial and cause/effect relationships are difficult to discern. These infants experience so many risk factors concurrently in their NICU course that sorting out those that cause speech and language delays are challenging. It appears however, that interventions that promote normal neurologic development in EEB preterm infants concurrently facilitate the normal development of speech and language. These interventions include, but are not limited to, the prevention of intracranial hemorrhage, and other neurologic insults, decreasing stress in the NICU and, promotion of normal behavioral development through individualized developmentally supportive care, environmental modifications and implementation of family-centered care.